American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the classic presentation for eosinophilic esophagitis?

1. Chronic heartburn

2. A young man with solid-food dysphagia requiring endoscopy for removal

3. Recurrent vomiting

4. Severe weight loss without other symptoms

The correct answer is: A young man with solid-food dysphagia requiring endoscopy for removal

The classic presentation of eosinophilic esophagitis typically involves a young individual experiencing solid-food dysphagia, which is the sensation of food getting stuck in the esophagus. This symptom often leads to patients seeking medical attention and may result in endoscopic interventions to remove food impactions. Eosinophilic esophagitis is characterized by an allergic response in the esophagus, which can cause structural changes and swelling, consequently making swallowing solid foods difficult. In this context, young adults or children are frequently affected, and they may present with a history of food aversion or a need to modify their diet due to these swallowing difficulties. The use of endoscopy is not uncommon, as it allows for direct visualization of the esophagus and assessment of any impacted food, as well as providing biopsies to confirm the eosinophilic infiltration characteristic of the condition. Other symptoms or presentations, such as chronic heartburn, recurrent vomiting, or severe weight loss without other symptoms, may be seen in various gastrointestinal conditions but are not characteristic or classic for eosinophilic esophagitis. These symptoms may suggest other diagnoses or complications unrelated to the eosinophilic process, making the presentation mentioned in the selected answer a more accurate reflection of eos