Esophagus

Question 1

Most common agents of infectious esophagitis

Answer 1

Candida albicans Herpes simplex Cytomegalovirus

Question 2

Diagnosis of esophagitis

Answer 2

Barium swallow Endoscopy w biopsy to make definite dx

Question 3

Treatment for candida

Answer 3

Oral nystatin or clotrimazole or PO/IV fluconazole in AIDS patients

Question 4

Treatment for herpes esophagitis

Answer 4

PO/IV acyclovir

Question 5

Treatment for cytomegalovirus

Answer 5

IV ganciclovir or IV foscarnet

Question 6

Treatment for pill-induced esophagitis

Answer 6

Sucralfate suspension

Question 7

Disorder caused by degeneration of nerves in Auerbach’s plexus, vagus nerve, and swallowing center

Answer 7

Achalasia; most common esophageal motor disorder

Question 8

Diagnosis of achalasia - barium swallow shows what?

Answer 8

Dilated esophagus, air fluid level, delayed esophageal emptying, and smooth tapered “bird’s beak” deformity at the LES (lower esophageal sphincter)

Question 9

Smooth muscle relaxer medication

Answer 9

nifedipine (CCB)

Question 10

Sore throat with vesicles that ulcerate to form small, shallow, volvanic-shaped ulcers. How to treat?

Answer 10

Dx: Herpes esophagitis Tx: PO/IV acyclovir

Question 11

Sore throat w large, deep, often linear ulcers. How to treat?

Answer 11

Dx: Cytomegalovirus esophagitis Tx: IV ganciclovir

Question 12

Sore throat w white plaques. How to treat?

Answer 12

Dx: Candida esophagitis Tx: PO nystatin or clotrimazole or PO/IV fluconazole

Question 13

Upper Gi bleeding after vomiting/retching and drinking alcohol. What is procedure to diagnose?

Answer 13

Dx: Mallory-Weiss tear by endoscopy Tx: Most tears stop spontaneously

Question 14

Sxs include progressive dysphagia, first solids then liquids. What is procedure to diagnose?

Answer 14

Dx: Neoplasm cancer Procedure: Barium esophagram and upper endoscopy with biopsy

Question 15

What neoplasm is typically found in distal esophagus?

Answer 15

Adenocarcinoma

Question 16

What neoplasm is typically found in middle or distal esophagus?

Answer 16

Squamous cell

Question 17

Plummer-Vinson syndrome is often associated w what anemia?

Answer 17

Associated w iron deficiency anemia

Sx: intermittent solid food dysphagia

Question 18

Sx include spontaneous regurgitation several hours after eating indicate what possible disorder?

Treatment?

Answer 18

Zenker’s Diverticulum: outpouching of esophagus with dysphagia and regurgitation

Dx: barium esophagram

Tx: Surgery

Question 19

Patient is dx’d w esophageal varices via endoscopy. What treatment do you choose to treat?

Answer 19

• IV vasopressin
• IV nitroglycerin
• IV octreotide
• balloon tamponade
• Endoscopy hemostasis

Question 20

Presents w hx of chronic liver disease and cirrhosis. What do you expect for labs?

Answer 20

• Elevated liver enzymes
• Elevated bilirubin
• Elevated PT
• Decreased albumin
• Decreased cholesterol