Conditions of ESOPHAGUS

Question 1

What are the 2 most common causes of esophagitis?

Answer 1

GERD and infectious

Question 2

Name the 3 most common types of infectious esophagitis. / What demographic do these most frequently affect?

Answer 2

Candida, HSV, CMV / Immunocompromised (you won’t typically see infectious esophagitis in immunocompetent patients)

Question 3

Name 3 symptoms a patient with esophagitis might have:

Answer 3

*Odynophagia, dysphagia, GERD (retrosternal chest pain)

Question 4

Imaging test of choice for esophagitis?

Answer 4

Endoscopy + biopsy

Question 5

How will Candida, HSV, and CMV look different on endoscopy?

Answer 5

Candida: Raised white plaques which can be removed
HSV: Multiple shallow ulcers throughout the esophagus
CMV: Large, solitary, deep ulcers

Question 6

What are the treatments for the different types of esophagitis? (GERD, Candida, Herpes, CMV)

Answer 6

GERD: Antacids + PPI
Candida: Fluconazole x3 weeks
Herpes: Acyclovir
CMV: Ganciclovir

Question 7

Allergic, inflammatory esophagitis is called:

Answer 7

Eosinophilic esophagiits

Question 8

What often causes pill-induced esophagitis? / Name 2 common types of pills that cause pill-induced esophagitis.

Answer 8

Laying supine after pill ingestion (prolonged pill contact with esophagus) / NSAIDs and Bisphosphonates

Question 9

What will endoscopy likely show in the case of pill-induced esophagitis? / besides avoiding laying down for 30-60 min after taking a pill, what else is recommended to avoid this?

Answer 9

Small, well-defined ulcers varying depths / drink pill with adequate water

Question 10

What is a Zenker’s Diverticulum?

Answer 10

Pharyngeoesophageal pouch - “pouch” located at junction of the pharynx and esophagus

Question 11

Name the #1 most common presenting symptom of a patient with Zenker’s Diverticulum. Name 3 others.

Answer 11

1) REGURGITATION of undigested food a few hours after a meal, 2) Halitosis (d/t food retention in pouch), 3) Dysphagia, 4) Odynophagia,

Question 12

Test of choice to assess Zenker’s Diverticulum

Answer 12

Barium Swallow –> collection of dye behind esophagus at pharyngeoesophageal pouch

Question 13

Treatment for Zenker’s Diverticulum:

Answer 13

Hydration after meals, thorough chewing of food, surgical repair (diverticulectomy or cricopharyngeal myotomy)