doc_clotaire
Forum Guru
Topics: 159
Posts: 1,242
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A 23-year-old college student comes to the clinic because of odynophagia with solids and liquids and dysphagia that is most severe when eating solid foods. The patient had a past medical history of Shigella colitis last year while she was a Peace Corps volunteer in Peru. She takes oral contraceptives and smokes 1 pack of cigarettes daily. She does not drink alcohol. Vital signs are: temperature 37.8 C (100 F), blood pressure 100/70 mm Hg, pulse 79/min, and respirations 8/min. Physical examination is normal. Electrocardiogram reveals normal sinus rhythms with a rate of 85/min and a markedly enlarged QRS complex in leads V3-V5. Chest x-ray reveals an enlarged cardiac silhouette. A barium esophagram demonstrates a tapering of the distal esophagus that eventually releases as the esophagus is distended. There is no evidence for extrinsic or intrinsic compression of the distal esophagus or an esophageal mass. There is no reflux. The test most likely to lead to a unifying diagnosis in this case is
A. an agglutination test for trypanosomes
B. a chest CT
C. an esophageal manometry
D. a liver biopsy
E. a myocardial biopsy
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| farnsworth
Forum Newbie
Topics: 0
Posts: 165
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A
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| docnikki
Forum Guru
Topics: 93
Posts: 680
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seems like Chagas disease by trypanosoma cruzii---but for a definite diagnosis Im not sure if its A or E.
I will go with E...Im not sure but.
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| simi
Forum Elite
Topics: 53
Posts: 358
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i too think its chagas disease disease....i will go with A.
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| Korotkoff
Forum Senior
Topics: 14
Posts: 164
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I would pick A too.
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| sherry39
Forum Junior
Topics: 3
Posts: 105
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ccccccc...diffuse esophageal spasm
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