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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?
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