a usmle wxam question??????????????????

[Anonymous]

hi freinds...................
one of my freinds got this question in his step-2.........
but he got confused........
i don't remember the exact question..but it was required to distinguish between nutcracker esophagus and diffuse esophageal spasm........


what the difference betn DES and NUTCRACKER ESOPHAGUS.........?????

[protonix]

Nutcraker is not diffuse...its isolated to the LES

[Anonymous]

THAT DOES NOT EXPLAIN THE QUERY..............

[Anonymous]

plz help orbit................

[Anonymous]

Diffuse esophageal Spasm / Nutcracker Esophagus: both have irregular, forceful, painful esophageal contractions that cause intermittent chest pain. Diagnose with esophageal manometry. Treat with calcium channel blocker and, if needed, surgery (myotomy).

Based upon the findings of esophageal manometry, pts may be diagnosed with:
1. Diffuse esophageal spasm: normal primary peristalsis with more than 10% simultaneous contractions.
2. Nutcracker esophagus: normal peristalsis but increased duration and high amplitude of distal contractions (>180 mm Hg).
3. Hypertensive LES: elevated LES pressure (>45mm Hg) with normal peristalsis.
4. Nonspecific esophageal motility disorder: internittent normal peristalsis with any of the above # of abnormalities that don't allow classification into one of the above.

now go answer some of my questions

sources: Crush and CMDT

[baci]

think about it after your exam...

[Anonymous]

that's ok,as many guys asked me the whole collection of orbitqs,one guy asked my permission to put the qs on cd and send to anyone who wants,so he got my permission,as i couldn't do this job,he's going to send cd,now 850qs for step2(ready)and 700qs for step1.i'm going to post qs on the forum...and do my best...ok,that's it,i tried to gather a collection of most interesting and difficult qs. good luck.

[Anonymous]

HEY ORBIT....
YOU ARE DOING A WONDERFUL JOB.........
I DON'T KNOW WHETHER YOU R A GIRL OR A BOY....BUT IF YOU R A GIRL THEN I M DEFINITELY IN LOVE WITH U...

I M IMPRESSED BY YOUR WORK ON FEW OF THESE FORUMS......