ROSH Gastrointestinal Practice Exam

In patients with weight loss and dysphagia, what might indicate a serious underlying condition?

1. Normal appetite

2. Ability to tolerate liquids

3. Solid food dysphagia

4. Absence of weight loss

The correct answer is: Solid food dysphagia

In patients experiencing weight loss and dysphagia, the indication of solid food dysphagia can point towards a serious underlying condition. This symptom often suggests an obstruction or a pathological process affecting the esophagus, such as a tumor or strictures, which may be more significant than dysphagia associated with liquids. When a patient can swallow liquids but struggles with solid food, it typically signals that there may be a physical blockage or a compromise in esophageal integrity that is not present with liquids. Solid food requires a more complex process during swallowing and can exacerbate any obstruction or motility disorder, making it a crucial symptom to assess. Other choices, such as maintaining a normal appetite or being able to tolerate liquids, do not necessarily indicate a serious condition since they could suggest that the swallowing difficulty is intermittent or less severe. The absence of weight loss also doesn't imply that there is no serious underlying condition, as some conditions can result in dysphagia without immediate weight loss depending on the phase of the disease or compensatory behaviors. Thus, solid food dysphagia is a more telling sign that warrants further investigation for potential serious esophageal conditions.