From Above or Below

Question: A 22 year old woman is referred to you for globus sensation. She is a lifelong nonsmoker and recently graduated from college. She appears fatigued and pale. Her head and neck examination is unremarkable, with the exception of cobblestoning of the posterior pharyngeal wall on nasopharyngoscopy and halitosis. Review of vital signs shows a BP of 83/50, pulse of 96, and BMI of 16.2. What would you do next?

a) Initiate anti-reflux therapy

b) Perform tracheoscopy to rule out a subglottic mass

c) Further questioning regarding eating habits

d) Referral for EGD

[Answer will be posted with next week's new question]

Answer to last week's question, “What Could Go Wrong, Will Go Wrong” (July 27, 2020)

A - Evaluation of cognition to rule out dementia.