question: Q:A 68-year-old man comes to the physician because of a 6-month history of difficulty swallowing pieces of meat and choking frequently during meal times. He also sometimes regurgitates foul-smelling, undigested food particles. Examination shows a 3 x 3 cm soft cystic, immobile mass in the upper third of the left side of his neck anterior to the left sternocleidomastoid muscle that becomes prominent when he coughs. A barium swallow shows an accumulation of contrast on the lateral aspect of the neck at the C5 level. Which of the following is the most likely underlying cause for this patient's condition?? 
  {'A': 'Inadequate relaxation of lower esophageal sphincter', 'B': 'Remnant of the embryological omphalomesenteric duct', 'C': 'Increased intrapharyngeal pressure', 'D': 'Remnant of the thyroglossal duct', 'E': 'Remnant of the second branchial cleft'},