Esophageal Disorders Flashcards

1
Q

What is pyrosis?

A

Heartburn

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2
Q

What is dysphagia?

A

Food sticking

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3
Q

What is globus sensation?

A

Globus hystericus

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4
Q

What is waterbrush?

A

Excessive salivation secondary to vagal reflex triggered by acidification

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5
Q

What is the best test for diagnosing esophageal problems?

A

Endoscopy

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6
Q

What is esophageal manometry?

A

Testing for contractility

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7
Q

What are the three things that endoscopic ultrasound particularly good for?

A
  1. Stage esoph CA
  2. Evaluate dysplasia
  3. Assess submucosal lesions
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8
Q

What is involved in reflux testing?

A

Wear a monitor that detects contractility (manometry) and pH

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9
Q

What are the two types of hiatal hernias?

A

Sliding (common) and paraesophageal

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10
Q

What are the ssx of hiatal hernias?

A

Reflux and feeling of fullness

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11
Q

What is plummer-vinson syndrome?

A

Esophageal webs + anemia

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12
Q

What are the classic ssx of esophageal diverticula?

A

Halitosis

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13
Q

What is a traction diverticulum? Zenker?

A
traction = mid-esophageal
Zenger = between cricohyoid/cricothyroid
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14
Q

What is the treatment for esophageal varices?

A

IVF and some other drugs

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15
Q

What are the ssx of achalasia?

A

Solid food dysphagia with weight loss and chest pain

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16
Q

“Bird’s beak” appearance on barium swallow = ?

A

Achalasia

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17
Q

What is the pathophysiology of achalasia?

A

Increased LES pressure

Proximal dilatation and lack of peristalsis

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18
Q

What is the treatment for achalasia?

A

Incurable, but surgical resection

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19
Q

The risk for what disease is increased with achalasia?

A

esophageal SCC

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20
Q

Who usually gets eosinophilic esophagitis?

A

young white males

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21
Q

What is the etiology of eosinophilic esophagitis?

A

Immunologic vs Ag sensitization

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22
Q

What are the ssx of eosinophilic esophagitis?

A

Recurrent attacks of dysphagia with food impaction

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23
Q

What is the endoscopic findings with eosinophilic esophagitis?

A

Rings

24
Q

What is the treatment for eosinophilic esophagitis?

A

PPIs, avoid allergens, inhaled steroids

25
Q

What are the ssx of infectious esophagitis?

A

Odynophagia

wwo oral lesions

26
Q

Infectious esophagitis is usually secondary to what?

A
  1. immunosuppression
  2. immunosuppression from chronic inflammation
  3. HIV/AIDs
27
Q

What is the treatment for candidal esophagitis patients?

A

Fluconazole or nystatin

28
Q

What are the histological findings of candida esophagitis?

A

Pseudohyphae in silver staining

29
Q

What is the treatment for oral candidiasis for HIV pts?

A

Swish and swallow fluconazole/nystatin

30
Q

What are the ssx of CMV esophagitis?

A

LAD
Cough
Mono-like presentation

31
Q

What is the virus that causes CMV?

A

HHV5

32
Q

What are the EGD findings with CMV esophagitis?

A

Large, serpiginous ulcers in the mid-distal areas

33
Q

What are the histological findings of CMV?

A

Owl=eye findings

34
Q

What is the treatment for CMV esophagitis?

A

Ganciclovir or foscarnet

35
Q

What is the painful infectious cause of esophagitis?

A

herpetic esophagitis

36
Q

What is the treatment for herpetic esophagitis?

A

acyclovir

37
Q

What are the histological findings of HSV?

A

Giant cells

38
Q

HHV3 = ?

A

Varicella

39
Q

What is the smear that tests for HSV?

A

Tzanck smear

40
Q

Mallory weiss tears are usually caused by what? Presentation?

A

Alcoholics or bulimics

Coughing and painful hematemesis

41
Q

What are the ssx of esophageal varicies?

A

Painless hematemesis

42
Q

What is the risk of having mallory-weiss tears?

A

Perforation

43
Q

What causes radiation esophagitis?

A

Fibrosis of esophagus to other structures

44
Q

What is the usual cause of corrosive esophagitis?

A

Alkali or acidic material ingestion

45
Q

What are the complications associated with alkali/acidic esophagitis?

A

FB and food impaction

46
Q

What is the treatment for alkali/acidic esophagitis?

A

EGD + glucagon

47
Q

In whom is pill esophagitis common? Why?

A

Elderly–lower secretions, more pills

48
Q

What is the treatment for pill esophagitis?

A

fluids

49
Q

What is the autoimmune disease that can cause esophageal disease? Ssx?

A

Scleroderma

Hypotensive LES, absent esophageal peristalsis

50
Q

What is CREST syndrome?

A

Idiopathic Autoimmune disease associated with anticentromere antibodies. Features include:

Calcinosis
Raynaud's phenomenon
*Esophageal Dysmotility*
Sclerodactyly
Telangiectasia
51
Q

What disease can Barrett’s esophagus progress to?

A

Adenocarcinoma

52
Q

What are the gross findings with Barrett’s esophagus?

A

Bright red/pink esophagus

53
Q

What is the most common esophageal CA in the US? World?

A
US = adenoCA
World = SCC
54
Q

What are the appropriate next steps for treating low grade Barrett’s esophagus? Intermediate? High grade?

A
Low = follow with 2-3 years
Intermediate = 1 6 months
High = 2nd pathology/surgery
55
Q

What is the risk of progression (per year) with high grade dysplasia in Barrett’s esophagus?

A

40%

56
Q

What are the two risk factors for getting Barrett’s esophagus?

A

EtOH

Smoking

57
Q

Hot tea = ?

A

SCC