on the way down

Question 1

Zencker’s diverticulum

Answer 1

Regurgitation of undigested food/liquids into pharynx hours after eating d/t outpouching in esophagus
patient with bad breath

Question 2

3 things you can do to work up zencker’s diverticulum & which one is diagnostic

Answer 2

• barium swallow– diagnostic
• direct visualization by EGD
• imaging

Question 3

2 treatment options for zencker’s

Answer 3

surgery or nothing

Question 4

achalasia

Answer 4

Episodic regurgitation, chest pain, global esophageal motor disorder where peristalsis is decreased and LES tone is increased

Question 5

two things you can do to work up (not diagnose) achalasia

Answer 5

barium swallow or EGD

Question 6

diagnostic test for achalasia

Answer 6

manometry

Question 7

3 tx options for achalasia

Answer 7

EGD Dilation,CCB, botox,

also myotomy, nitrates PRN, opioids

Question 8

which three disorders from this lecture is diagnosed by EGD w/ biopsy?

Answer 8

infectious esophagitis
esophageal neoplasm
gastric neoplasm

Question 9

Heartburn, worse after meals, relieved by antacids

Answer 9

GERD

Question 10

diagnosis of GERD

Answer 10

clinical unless alarm sx

Question 11

Odynophagia or dysphagia in an immunocompromised patient

Answer 11

infectious esophagitis

Question 12

work up & diagnostic for infectious esophagitis

Answer 12

endoscopy w/ biopsy/brushing

Question 13

how is infectious esophagitis treated?

Answer 13

if candida then fluconazole/ketoconazole
HSV: acyclovir
CMV: gangciclovr

Question 14

• genetic condition
• iron deficiency anemia
• esophageal web
• spoon nails

condition, work up & tx

Answer 14

plummer-vinson syndrome
* workup: CBC, EGD
* tx: iron supplement

Question 15

• Dysphagia to solids then liquids too, fast progression= malignancy, weight loss, heartburn

what is this, how is it worked up and diagnosed? how is it treated?

Answer 15

• esophageal neoplasm
• workup: barium swallow study first then EGD w/ biopsy to diagnose
• tx: surgical resection, oncology referral

Question 16

• Dyspepsia, weight loss, anemia, occult GI bleed in a pt older than 40
• Virchow’s node (L supraclavicular node)
• Sister Mary Joseph nodule (nodule by umbilicus)

condition, work up & diagnostic, tx

Answer 16

gastric neoplasm
* Work up: EGD
* diagnostic: EDG w/ biopsy
* tx: surgery

Question 17

Dysphagia to solids, slow progession

what is this, work up & diagnosis, tx

Answer 17

• esophageal web/stricture
• work up: EGD
• Tx: Dilation, resection if malignancy

Question 18

• sudden rise in intraluminal esophageal pressure, mot often during/after intense vomiting
• rupture at lower third of esophagus, above cardia
• sx: chest pain, dyspnea, dysphagia, subQ emphysema, tachy, fever, tachypnea, epigastric pain

condition, dignosis & tx

Answer 18

• boerhaave’s syndrome
• diagnosis: CT scan
• tx: surgery