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Robbins Pathology GI (Chptr 16,17,18,19) > Clinical-Esophageal Disorders 2 > Flashcards

Clinical-Esophageal Disorders 2 Flashcards

1
Q

What is Zenker Diverticulum

A

Faisal diverticulum involving herniation between the cricopharyngeaus muscle and the inferior pharyngeal constrictor muscles

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2
Q

What area does Zenker diverticulum occur and what is the method used for diagnosis

A

Killian’s triangle and found using a Barium swallow

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3
Q

What are the symptoms of a peptic stricture

A

Gradual development of solid food dysphagia with reduction of heartburn (stricture acts as a barrier)

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4
Q

What is the diagnosis used for peptic strictures

A

Endoscopy with biopsy in all cases

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5
Q

What is the common patient demographics in the case of squamous cell carcinoma

A

Older than 50, African American males, who drinks, smokes, and lots hot beverages

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6
Q

What are the drugs that commonly cause pill esophagitis

A

NSAIDs, potassium chloride pills, alendronate, risedronate, antibiotics

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7
Q

What are the most common pathogens leading to infectious esophagitis

A

Candida albicans, herpes simplex, CMV

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8
Q

What is the pathogenesis of large, shallow, superficial ulcerations in the esophagus

A

CMV

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9
Q

What is the pathogenesis of small, multiple deep ulcerations in the esophagus

A

Herpes Simplex

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10
Q

What is the pathogenesis of diffuse, linear, yellow-white plaques and the esophagus mucosa

A

Candida

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11
Q

In the case of patients with caustic esophageal injury (usually doe to direct ingestion) what is the first initial examination

A

-Circulatory status and airway patency, laryngoscopy for mucosal assessment

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12
Q

What should not be administered in patients with caustic esophageal injury

A

-Nasogastric lovage or oral antibiotics

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13
Q

What is the state of surveillence in a patient after caustic esophageal injury

A

15-20 years after due to increased risk adenocarcinoma

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14
Q

In the case of eosinophilic esophagitis, what is the cause and what is the setoff usually

A

Food or environmental allergens cause and stimulate and inflammatory response

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15
Q

In patients of eiosinophilic esophagitis, what previous conditions tend to be present in 50% of patients

A
  • Asthma
  • Eczema
  • Hay fever
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16
Q

What are complications seen with eosinophilic esophagitis

A

-*Food impaction can cause long history of dysphagia

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17
Q

What are the diagnostic findings in the physical and lab tests

A

-Increased IgE along with multiple concentric rings

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18
Q

What are the findings of the endoscopy in eosinophilic esophagitis

A

White exudate or papules, red furrows, concentric rings, and strictures

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19
Q

What is the treatment of eosinophilic esophagitis

A

Corticosteroids

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20
Q

How are esophageal webs best visualized

A

Barium esophagigram

21
Q

How are the majority of esophageal webs treated

A

Passage of bougie dilators

22
Q

What condition is almost always associated with esophageal rings, aka Schatzki rings

A

Hiatal hernias

23
Q

What is the characteristics of esophageal rings

A

Dysphagia is intermittent and not progressive

24
Q

What is likely to cause symptoms in esophageal rings

A

Large poorly chewed food, usually like beefsteak

25
Q

What is the treatment for esophageal rings

A

Bougie dilators

26
Q

As the size of Zenker diverticulum enlarge, what are some characteristic sings that may appear

A
  • Bad breath (halitosis)
  • spontaneous regurgitation of undirected food
  • Nocturnal choking
27
Q

What are the complications of Zenker diverticulum

A

Pneumonia
Bronchiectsis
Lung abcess

28
Q

What is the best diagnostic tool for Zenker diverticulum

A

Video esophageography

29
Q

What is the diagnostic finding during upper endoscopy

A

“Feline esophagus”

-multiple esophageal rings treating a curragated appearance looking like a trachea

30
Q

What are the complication associated with eosinophilic esophagitis

A

Esophageal perforation

31
Q

What is the most common cause of GIB due to portal hypertension

A

Esophageal varices

32
Q

What is a crucial initial management of esophageal varices

A

Fluids, blood products, and taken to the ICU

33
Q

What blood products can be given to patients with esophageal varices

A

FFP or fresh frozen plasma, vitamin K

34
Q

Which antibiotics are given to patients with bleeds/ esophageal varices

A

3 gen cephalosporins, or flouroquinolones

35
Q

What is the short term agents given to esophageal varices to reduce rebleeding

A

Nonselective beta blockers

36
Q

What is the long term treatment of esophageal varices to prevent rebleeding

A

Band ligation

37
Q

During active esophageal varices bleeding, what is done for the airway

A

Endotracheal tube to prevent aspiration

38
Q

What is the emergent treatment for esophageal varices bleeding

A

Banding (the endoscopy of choice)

39
Q

What are Minnesota or Sengstaken-blakemore tubes used to treat

A

Esophageal varices, and is a form of ballon tube, and only in cases where the bleeding can not be controlled (temporary fix)

40
Q

What is transvenous intrahepatic portosystemic shunts used to treat

A

Aka TIPS, and for lowering risk of rebleeding, but does not lower mortality. Reserved for those patients with 2 or more epidsodes of bleeding that have not responded to treatment

41
Q

What is the cause of achalasia

A

Loss of relaxation of the lower esophageal sphincter due to loss of NO production as there is the loss of the myenteric plexus

42
Q

What is used to confirm the diagnosis of achalasia and what is the finding

A

Esophageal manometry and will have the complete absence of normal peristalsis and incomplete lower esophageal sphincter relaxation with swallowing

43
Q

What is occurring during Boerhhave’s syndrome

A

Spontaneous transmural rupture at the GE junction due to belching or vomiting

44
Q

What is the diagnostic tool used for Boerhaave’s syndrome

A

CT of chest and detecting air in the mediastinum

45
Q

What is the treatment for Boerhaave’s syndrome

A

NGT suction

46
Q

What are the three signs of pneumomediastinum

A
  • SubQ emphysema
  • Hamman’s sign
  • Dyspnea
47
Q

What is SubQ emphysema and where is it heard in pneumomediastium

A

Air trapped under the skin, usually heard in the neck or precordial area

48
Q

What is Hamman’s sign and what condition is it associated with

A

-heard during pneumomediastinum
Crunching, rasping sound, synchronous with the heartbeat and heard over the precordium during systole and in the decubitus position (on their side)

49
Q

How can Mallory Weiss tear be treated locally and quickly

A

Epinephrine

Robbins Pathology GI (Chptr 16,17,18,19) (32 decks)

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