A 48 year old female teacher has a three month history of progressive chewing difficulty and associated dysphagia


Question Number 0666
Question:
A 38 year old female teacher has a three month history of progressive chewing difficulty and associated dysphagia. She also complains of severe heartburn. On examination she is noted to have decreased facial flexibility, a decreased oral aperture and dry mucous membranes. She admits to a history of excessive cold sensitivity and recurrent pallor and cyanosis of the skin of her fingers. A likely diagnosis is
a) Rhabdomyoma
b) sliding hiatus hernia
c) upper esophageal web
d) scleroderma
e) Kaposi's sarcoma


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