UKMLA PLAB AMC USMLE Prometric MCQ

Question Number 0621

Question:
A 15 year old girl complains of a one year history of vomiting and a nocturnal cough. She is currently doing her school exams and is very tense. She has no problems with swallowing. Investigations include a barium meal. This reveals a grossly dilated esophagus with symmetric tapering and stenosis of the distal esophagus. There are no mucosal irregularities and some passage of barium into the stomach can be seen. A likely diagnosis is

a) psychogenic
b) achalasia
c) cyclical vomiting
d) mesenteric adenitis
e) Pertussis syndrome