Chapter 69 : Diseases of the Esophagus Flashcards
(39 cards)
Dysphagia refers to the sensation of food being delayed in its normal passage from mouth to stomach. Differentiate Oropharyngeal from Esophageal Dysphagia
Oropharyngeal Dysphagia is difficulty in initiating a swallow while esophageal dysphagia is difficulty transporting food down the esophagus secondary to structural or neuromuscular defects in the smooth muscle of the esophagus
______ is defined as a sensation of a lump in the throat in which food transport is not limited
Globus
oropharyngeal swallow is best assessed by _______
Videofluoroscopy
______ is the fined as appearance of acid or bitter taste in the mouth
Regurgitation
In GERD, ______ is defined as a sudden filling of the mouth with clear, slightly salty fluid which is later found out to be salivary secretions not regurgitated acid contents.
Water Brash - the mechanism is vagally mediated
The squamocolumnar junction can be recognized by the _____ which demarcates the interface between the light pink squamous mucosa and the red columnar gastric mucosa
Z line
The gastroesophageal junction is defined by this specific part of the gastric mucosa
proximal margin of the gastric folds
True or False, the squamocolumnar junction and GEJ are synonymous
The two are not synonymous, In patients with Barrett esophagus (BE), the squamocolumnar junction is more proximal in the esophagus than the GEJ is
In normal esophageal manometry, the distal wave amplitudes measured range from ___ to ___ mm Hg while the basal LES pressure is about?
30 to 180 mm Hg ; 10 to 45 mm Hg
In 24 hour pH probe monitoring, a reflux episode is defined as a drop in pH below _____
pH drops below 4.0. This value is chosen on the basis of the proteolytic activity of pepsin
_____ refers to regurgitation of duodenal contents through the pylorus into the stomach with subsequent reflux into the esophagus
Duodenogastroesophageal reflux
Only diagnostic tool that allows for measurement of both acidic and nonacidic refluxate of liquid ang gas consistency
Multichannel intraluminal impedance (MII)
_____ is a provocative test for GERD wherin 0.1N hydrochloric acid is infused in the esophagus where in a patient’s chest pain is considered a positive test
Bernstein test - rarely used and mostly of historic value only
_____ is a primary esophageal motility disorder of unknown etiology characterized by insufficient LES relaxation and loss of esophageal peristalsis.
Achalasia
In this disease entity, manometric changes include the presence of simultaneous and repetitive contractions in the esophageal body, but unlike in achalasia, some normal peristalsis is maintained
Diffuse esophageal spasm
The classic radiologic finding in Diffuse Esophageal Spasm
“Corkscrew” Esophagus
_____is another common manometric diagnosis in patients with noncardiac chest pain. It is defined by high-amplitude peristalsis
Nut Cracker Esophagus
Ineffective esophageal motility is a hypocontractile disorder, defined by a distal esophageal contraction amplitude of less than ______ in 30% or more of wet swallows
30 mm Hg
Secondary motility disorders are commonly a result of systemic conditions. The most common condition that affects esophageal motility is___,or___
scleroderma, or progressive systemic sclerosis (PSS)
The normal esophagus measures _____ in diameter
20 mm
The predominant clinical symptom of strictures is dysphagia, which is usually most prevalent when the luminal diameter is less than _____.
15 mm
The goal of esophageal dilation is to obtain an objective diameter greater than _____
15 mm
In dilation of esophageal strictures, to minimize this risk, the so-called rule of threes applies defined as ____
no more than three sequential dilators are to be used per session
Plummer-Vinson or Paterson-Kelly syndrome to the triad that consists of _____
proximal esophageal webs, iron deficiency anemia, and dysphagia
