1. **Case Study**: A 45-year-old male presents with dysphagia and

odynophagia. Upon examination, a barium swallow study reveals a

narrowed esophagus with tertiary contractions. What is the most likely

diagnosis?

 - A) Achalasia

 - B) Esophageal cancer

 - C) Gastroesophageal reflux disease (GERD)

 - D) Esophageal spasm

 **Answer**: A) Achalasia. The presence of dysphagia and

odynophagia, along with the radiographic findings, suggest a motility

disorder of the esophagus, most likely achalasia.

2. **Case Study**: A 60-year-old female with a history of smoking and

chronic cough presents with hemoptysis. A chest X-ray shows a mass in

the upper lobe of the right lung. Which diagnostic procedure would be

most appropriate to determine the nature of the mass?

 - A) Bronchoscopy

 - B) Thoracentesis

 - C) Pulmonary function test

 - D) Sputum culture

 **Answer**: A) Bronchoscopy. Given the patient's history and

radiographic findings, bronchoscopy is the most appropriate procedure to

obtain a biopsy for histopathological examination.

3. **Case Study**: During a dental examination, a 50-year-old patient is

found to have gingival recession, pocket formation, and tooth mobility.

Which condition is most consistent with these findings?

 - A) Dental caries

 - B) Periodontitis

 - C) Gingivitis

 - D) Dental abscess

 **Answer**: B) Periodontitis. The symptoms described are indicative

of periodontitis, which involves inflammation and destruction of the

supporting structures of the teeth.

4. **Case Study**: A patient presents with flank pain and hematuria.

Imaging studies reveal a staghorn calculus occupying a large portion of

the renal pelvis. What is the first-line treatment for this condition?