Esophageal Disorders

Question 1

What is pyrosis?

Answer 1

Heartburn

Question 2

What is dysphagia?

Answer 2

Food sticking

Question 3

What is globus sensation?

Answer 3

Globus hystericus

Question 4

What is waterbrush?

Answer 4

Excessive salivation secondary to vagal reflex triggered by acidification

Question 5

What is the best test for diagnosing esophageal problems?

Answer 5

Endoscopy

Question 6

What is esophageal manometry?

Answer 6

Testing for contractility

Question 7

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

Answer 7

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

Question 8

What is involved in reflux testing?

Answer 8

Wear a monitor that detects contractility (manometry) and pH

Question 9

What are the two types of hiatal hernias?

Answer 9

Sliding (common) and paraesophageal

Question 10

What are the ssx of hiatal hernias?

Answer 10

Reflux and feeling of fullness

Question 11

What is plummer-vinson syndrome?

Answer 11

Esophageal webs + anemia

Question 12

What are the classic ssx of esophageal diverticula?

Answer 12

Halitosis

Question 13

What is a traction diverticulum? Zenker?

Answer 13

traction = mid-esophageal
Zenger = between cricohyoid/cricothyroid

Question 14

What is the treatment for esophageal varices?

Answer 14

IVF and some other drugs

Question 15

What are the ssx of achalasia?

Answer 15

Solid food dysphagia with weight loss and chest pain

Question 16

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

Answer 16

Achalasia

Question 17

What is the pathophysiology of achalasia?

Answer 17

Increased LES pressure

Proximal dilatation and lack of peristalsis

Question 18

What is the treatment for achalasia?

Answer 18

Incurable, but surgical resection

Question 19

The risk for what disease is increased with achalasia?

Answer 19

esophageal SCC

Question 20

Who usually gets eosinophilic esophagitis?

Answer 20

young white males

Question 21

What is the etiology of eosinophilic esophagitis?

Answer 21

Immunologic vs Ag sensitization

Question 22

What are the ssx of eosinophilic esophagitis?

Answer 22

Recurrent attacks of dysphagia with food impaction

Question 23

What is the endoscopic findings with eosinophilic esophagitis?

Answer 23

Rings

Question 24

What is the treatment for eosinophilic esophagitis?

Answer 24

PPIs, avoid allergens, inhaled steroids

Question 25

What are the ssx of infectious esophagitis?

Answer 25

Odynophagia | wwo oral lesions

Question 26

Infectious esophagitis is usually secondary to what?

Answer 26

1. immunosuppression 2. immunosuppression from chronic inflammation 3. HIV/AIDs

Question 27

What is the treatment for candidal esophagitis patients?

Answer 27

Fluconazole or nystatin

Question 28

What are the histological findings of candida esophagitis?

Answer 28

Pseudohyphae in silver staining

Question 29

What is the treatment for oral candidiasis for HIV pts?

Answer 29

Swish and **swallow** fluconazole/nystatin

Question 30

What are the ssx of CMV esophagitis?

Answer 30

LAD Cough Mono-like presentation

Question 31

What is the virus that causes CMV?

Answer 31

HHV5

Question 32

What are the EGD findings with CMV esophagitis?

Answer 32

Large, serpiginous ulcers in the mid-distal areas

Question 33

What are the histological findings of CMV?

Answer 33

Owl=eye findings

Question 34

What is the treatment for CMV esophagitis?

Answer 34

Ganciclovir or foscarnet

Question 35

What is the painful infectious cause of esophagitis?

Answer 35

herpetic esophagitis

Question 36

What is the treatment for herpetic esophagitis?

Answer 36

acyclovir

Question 37

What are the histological findings of HSV?

Answer 37

Giant cells

Question 38

HHV3 = ?

Answer 38

Varicella

Question 39

What is the smear that tests for HSV?

Answer 39

Tzanck smear

Question 40

Mallory weiss tears are usually caused by what? Presentation?

Answer 40

Alcoholics or bulimics Coughing and painful hematemesis

Question 41

What are the ssx of esophageal varicies?

Answer 41

Painless hematemesis

Question 42

What is the risk of having mallory-weiss tears?

Answer 42

Perforation

Question 43

What causes radiation esophagitis?

Answer 43

Fibrosis of esophagus to other structures

Question 44

What is the usual cause of corrosive esophagitis?

Answer 44

Alkali or acidic material ingestion

Question 45

What are the complications associated with alkali/acidic esophagitis?

Answer 45

FB and food impaction

Question 46

What is the treatment for alkali/acidic esophagitis?

Answer 46

EGD + glucagon

Question 47

In whom is pill esophagitis common? Why?

Answer 47

Elderly--lower secretions, more pills

Question 48

What is the treatment for pill esophagitis?

Answer 48

fluids

Question 49

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

Answer 49

Scleroderma Hypotensive LES, absent esophageal peristalsis

Question 50

What is CREST syndrome?

Answer 50

Idiopathic Autoimmune disease associated with anticentromere antibodies. Features include: ``` Calcinosis Raynaud's phenomenon *Esophageal Dysmotility* Sclerodactyly Telangiectasia ```

Question 51

What disease can Barrett's esophagus progress to?

Answer 51

Adenocarcinoma

Question 52

What are the gross findings with Barrett's esophagus?

Answer 52

Bright red/pink esophagus

Question 53

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

Answer 53

``` US = adenoCA World = SCC ```

Question 54

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

Answer 54

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

Question 55

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

Answer 55

40%

Question 56

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

Answer 56

EtOH | Smoking

Question 57

Hot tea = ?

Answer 57

SCC