UPSC-CMS 2014 - Radiology PYQs Practice Questions

Q: An air fluid level with dilated oesophagus and “bird beak” appearance in a barium swallow is diagnostic of:

Achalasia cardia. ***Achalasia cardia*** - The classic radiographic features of achalasia on a barium swallow include a **dilated esophagus** with proximal food retention (leading to an **air-fluid level**) and a characteristic narrowing at the gastroesophageal junction, creating a **"bird-beak" appearance**. - This appearance is due to the failure of the lower esophageal sphincter to relax during swallowing, combined with absent esophageal peristalsis. *Carcinoma oesophagus* - Oesophageal carcinoma typically presents as an **irregular, constricting lesion** or a **filling defect** on barium swallow, often with mucosal irregularity or shelf-like margins, rather than a smooth "bird beak." - While it can cause dysphagia and possibly proximal dilation, the specific "bird beak" morphology is not characteristic of cancer. *Barrett's oesophagus* - Barrett's esophagus is a histological diagnosis involving **metaplastic changes** in the esophageal lining, usually due to chronic GERD. - It does not have a distinct radiographic appearance on barium swallow, though it might be associated with reflux changes or **ulcerations**, but not a "bird beak" sign. *Hiatus hernia* - Hiatus hernias are characterized by the **protrusion of a portion of the stomach into the chest cavity** through the esophageal hiatus of the diaphragm. - On a barium swallow, this appears as an **accumulation of barium above the diaphragm**, often with a wide opening at the esophagogastric junction, which is distinct from the narrowed "bird beak" of achalasia. [Practice more Radiology PYQs on OnCourse]

Question 1

In an unconscious patient with multiple injuries, what is the best and reliable modality for assessment of cervical spine injury?

Accepted Answer

While doing CT scan of brain take extra cuts at the cervical spine region

Answer

MRI scan

Answer

Full AP and lateral radiographs of spine

Answer

Rely only on clinical examination

Question 2

An air fluid level with dilated oesophagus and “bird beak” appearance in a barium swallow is diagnostic of:

Accepted Answer

Achalasia cardia

Answer

Carcinoma oesophagus

Answer

Barrett's oesophagus

Answer

Hiatus hernia

UPSC-CMS 2014 — Radiology