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GI > 104b Esophagus clinical > Flashcards

104b Esophagus clinical Flashcards

1
Q

globus

A

perception of a lump in throat even without swallowing

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2
Q

water brash

A

excessive salivation; response to reflux

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3
Q

structural abnormality vs propulsive disorder - presentation for solids and liquids

A

structural - solid food only usually

propulsive - solid and liquid

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4
Q

structural abnormality examples

A

EoE
tumor
stricture

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5
Q

propulsive disorder examples

A

GERD

achalasia

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6
Q

esophageal rings/webs

A

schatzki ring - lower esophageal mucosal ring

cervial web - higher in esophagus (part of plummer vinson syndrome)

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7
Q

GERD pathophys

A

90% transient LES relaxations
impaired salvation
impaired partistalitic empting

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8
Q

Possible GERD outcomes

A

Non-erosive GERD (EGD negative) - poor QOL
Esophagitis - stricture, bleeding, BE and adenocar.
Extra-esophagus GERD

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9
Q

GERD treatment

A

Pharm: PPI and H2RA blockers
Lifestyle mods: weight loss, avoid certain foods
surgical: nissen

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10
Q

EoE - history, symptims, endoscopy, pathology

A 
history - atopy, food allergies 
symptoms - dysphagia and food impaction
endoscopy - rings, furrows, exudates
path - biopsy with eosinophil inflammation 
isolated to esophagus
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11
Q

EoE diagnosis, complications and outcomes

A

dx - biopsy (superficial eosinphils >15/hpf)

fibrosis in lamina propria, strictures, food impaction, NO CANCER

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12
Q

EoE treatment

A

medical - topical steroids (fluticasone, budesonide)
diet (6 food elimination diet)
endoscopic therapy

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13
Q

achalasia pathophys

A

loss of ganglion cells in esophagus myenteric plexus affects inhibitor neurons –> can’t relax LES

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13
Q

achalasia pathophys

A

loss of ganglion cells in esophagus myenteric plexus affects inhibitor neurons –> can’t relax LES

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14
Q

achalasia complications

A

progressive dilation and sigmoid deformity
bird’s peak tapering at LES
dysphagia, regurg, weight loss, aspiration, stasis–>increased cancer risk

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14
Q

achalasia complications

A

progressive dilation and sigmoid deformity
bird’s peak tapering at LES
dysphagia, regurg, weight loss, aspiration, stasis–>increased cancer risk

15
Q

achalasia diagnosis

A

manometry (impaired LES relaxation and absent peristalsis)

radiography (barium swallow - bird’s beak)

15
Q

achalasia diagnosis

A

manometry (impaired LES relaxation and absent peristalsis)

radiography (barium swallow - bird’s beak)

16
Q

achalasia treatment

A

botox (cleaves SNAP25 and prevents ACh release)
pneumatic dilation
heller myotomy

16
Q

achalasia treatment

A

botox (cleaves SNAP25 and prevents ACh release)
pneumatic dilation
heller myotomy

17
Q

diffuse esophageal spasm

A

simultaneous contractions leading to episodes of chest pain and dysphagia
Rx-nitrates, ccb, botox

17
Q

diffuse esophageal spasm

A

simultaneous contractions leading to episodes of chest pain and dysphagia
Rx-nitrates, ccb, botox

18
Q

infectious esophagitis - causes

A

candidal - most common
herpetic
CMV

18
Q

infectious esophagitis - causes

A

candidal - most common
herpetic
CMV

19
Q

candidal esophagitis - presentation, findings, treatment

A

odynophagia and dysphagia
white plaques
oral fluconazole

19
Q

candidal esophagitis - presentation, findings, treatment

A

odynophagia and dysphagia
white plaques
oral fluconazole

20
Q

herpetic esophagitis - causes, findings, treatment

A

HSV 1 or 2
punched out ulcers
self limited or acyclovir/valcyclovir

20
Q

herpetic esophagitis - causes, findings, treatment

A

HSV 1 or 2
punched out ulcers
self limited or acyclovir/valcyclovir

21
Q

CMV esophagitis - patient type, findings, treatment

A

immunicompromised
linear/serpiginous ulcers
ganciclovir

21
Q

CMV esophagitis - patient type, findings, treatment

A

immunicompromised
linear/serpiginous ulcers
ganciclovir

GI (29 decks)

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