Correct answer:

Often this is negative, but search is made for clinical evidence of Plummer–Vinson syndrome (a smooth tongue, anaemia and koilonychia); secondary nodes from a carcinoma of the oesophagus may be felt in the neck and supraclavicular fossae; and the upper abdomen is carefully palpated, as a carcinoma of the cardia is a common cause of dysphagia in elderly patients and indeed is more common in this country than carcinoma of the oesophagus.