Achalasia

Question 1

define Achalasia etymologically?

Answer 1

without relaxation

Question 2

what is the proposed aetiology?

Answer 2

problem with myenteric plexus

Question 3

what age are people most commonly affected?

Answer 3

middle-aged

Question 4

which genetic condition is associated with achalasia?

is this condition dominant or recessive?

Answer 4

Allgrove syndrome

recessive

Question 5

which infection can cause achalasia & why?

what is another name for this infection?

Answer 5

trypanosoma cruzi infection

damages myesnteric plexus

chagas disease

Question 6

what is a typical Hx of someone with achalsaia?

Answer 6

Chronic dysphagia, regurgitating food, lost weight and I cough when lying down

Question 7

what happens to weight?

Answer 7

weight loss

Question 8

why is oesophagus dilated?

Answer 8

LES sphincter can not relax

Question 9

what essentially is the LES sphincter?

Answer 9

bundle of muscles

Question 10

why is there coughing?

Answer 10

regurgitation

Question 11

which complication of achalasia has an increased risk when asleep?

why does risk increase when asleep?

Answer 11

aspiration pneumonia

more likely to regurgitate

Question 12

which malignancy has a 140x increase risk?

Answer 12

oesophageal cell carcinoma

Question 13

symptoms of achalasia?

-3

Answer 13

Dysphagia (solids and liquids)
Heartburn
Regurgitate food

Question 14

gold.S Ix?

Answer 14

manometry

Question 15

What are the primary Ix for achalasia?

-3

Answer 15

manometry
endoscope
barium swallow

Question 16

why might endoscopy be done in the investigative process?

Answer 16

exclude cancer

Question 17

barium swallow will have what appearance?

what is this appearance nicknamed as?

Answer 17

oesophagus dilated, tapers off at LES

bird beak appearance

Question 18

result on CXR

Answer 18

wide mediastinum

Question 19

which treatment option has best outcome?

Answer 19

heller cardiomyotomy

Question 20

what is the risk of heller cardiomyotomy ?

Answer 20

GORD

Question 21

surgery is not possible, what treatment option can be used instead?

what is this option essentially doing?

Answer 21

botulinum toxin injection

paralyse LES

Question 22

explain what happens in a cardiomyotomy?

Answer 22

LES sphincter located in cardia, muscles of LES sphincter are cut

Question 23

which treatment option has risk of perforation?

Answer 23

endoscopic pneumatic dilation

Question 24

person has dysphagia which is explained by a cancer.

is this called achalasia?

why?

Answer 24

no

for it to be called achalaisa there can be no other explanation