MKSAP: 54-year-old man with dysphagia

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 54-year-old man is evaluated for a 4-month history of intermittent, nonprogressive solid-food dysphagia. He has a long-standing history of heartburn that has been well controlled with once-daily proton-pump inhibitor (PPI) therapy for the past 5 years. Results of a screening colonoscopy 4 years ago were normal. There is no family history of colorectal cancer. Physical examination findings are unremarkable. Upper endoscopy reveals a 3-cm hiatal hernia, an esophageal (Schatzki) ring, and approximately six polyps smaller than 4 mm in the fundus and upper body of the stomach. The...

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