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GI > Esophageal Disorders > Flashcards

Esophageal Disorders Flashcards

1
Q

what causes esophageal atresia (fistula)

A

polyhydramnios in utero

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2
Q

Most common type of esophageal atresia

A

EA with distal TEF

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3
Q

Complications of esophageal atresia

A

aspiration

suffocation

pneumonia

fluid/ electrolyte imbalance

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4
Q

clinical presentation of esophageal atresia

A

excessive drooling

aspiration pneumonia

rales

coughing spells

cyanotic attacks

gastric distension

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5
Q

why would a neonate with esophageal atresia have gastric distention

A

the fistula is connected to the distal esophageal segment, allowing air to go directly into the stomach

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6
Q

differentiate between an esophageal web and schatzki web

  • Definition
  • Cause
  • Location
A

Definition:

  • web*: idiopathic ledge like protrusion of the mucosa
  • ring*: circumferential hypertrophy of mucosa, submucosa and muscularis propria

Cause:

  • web*: idiopathic
  • ring*: hypertrophy of the esophagus

Location:

  • web*: upper esophagus
  • ring*: lower esophagus
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7
Q

associations of esophageal web

A

Plummer vinson syndrome

glossitis

cheilosis

blistering skin diseases

iron-deficiency anemia

patterson-brown kelly syndrome

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8
Q

what is Zenker’s Diverticulum

A

false diverticulum at the upper esophageal junction caused by intraluminal pressure, which bulges the mucosa and submucosa through weak points in the muscularis propria

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9
Q

what defines a true diverticulum

A

bulging in which all of the esophageal layers protrude

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10
Q

Clinical presentation of zenker diverticulum

A

halitosis

dysphagia

regurgitation

weight loss

coughing after food intake

neck mass

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11
Q

what is achalasia

A

failure of the lower esophageal sphincter to relax, due to degeneration of inhibitory neurons within the myenteric (Auerbach plexus) within the esophageal wall

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12
Q

clinical presentation of achalasia

A

dysphagia

regurgitation

retrosternal pain

weight loss

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13
Q

barium swallow for achalasia

A

bird beak appearance

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14
Q

complications of achalasia

A

megaesophagus

increased risk of esophageal cancer

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15
Q

what drugs likely cause pill esophagitis

A

NSAIDS

ABx

bisphosphonates

potassium chloride

quinidine

iron compounds

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16
Q

what does pill esophagitis look like

A

punched out ulcers with mild inflammatory changes of the surrounding mucosa

17
Q

what does eosinophilic esophagitis look like

A

circumferential mucosal lesions with frail mucosa and increased eosinophils

18
Q

what causes Mallory-Weiss Syndrome

A

severe retching due to alcohol intoxication

19
Q

what does Mallory-Weiss Syndrome look like

A

longitudinal tears near the gastroesophageal junction

20
Q

clinical presentation of GERD

A

burning retrosternal pain

belching

regurgitation

dysphagia

cough

N/V

Halitosis

21
Q

what causes GERD

A

transient Lower esophageal sphincter relaxations allowing regurgitation of stomach contents into the esophagus

22
Q

associations of GERD

A

smoking

drinking

caffeine

stress

obesity

pregnancy

diaphragmatic dysfunction

GI malformations

scleroderma

sliding hiatal hernia

esophageal strictures

schatzki rings

barrett esophagus

23
Q

what happens during Barrett Esophagus

A

stomach acid damages squamous epithelium, causing it to change from squamous epithelium to columnar epithelium and goblet cells

z line shifts upwards

24
Q

what neoplasm dies barrett esophagus lead to

A

esophagal adenocarcinoma

25
Q

what causes esophageal adenocarcinoma

A

TP53 mutation in the distal 1/3 of the esophagus causes downregulation of CDK2NA/INK4, amplification of EGFR, ERBBw, MET, Cyclin D1 and Cyclin E

26
Q

Predisposing factors of Esophageal Adenocarcinoma

A

Barrett Esophagus

Smoking

Radiation

H. pylori

27
Q

Predisposing Factors of Esophageal Squamous Cell Carcinoma

A

Drinking

Smoking

Malnutrition

Poverty

Esophageal Injury

Drinking Hot Beverages

Previous radiation to mediastinum

HPV

28
Q

Clinical Presentation of Esophageal Squamous Cell Carcinoma

A

Dysphagia

Odynophagia

Obstruction

Weight loss

Hemorrhage

Sepsis

Tulor ulceration

Iron deficiency

food aspiration

29
Q

Clinical Presentation of Esophageal Adenocarcinoma

A

Reduced acid secretion

reflux

dysphagia

chest pain

N/V

30
Q

What causes Esophageal Squamous Cell Carcinoma

A

Amplification of SOX2 in the upper 2/3 of the esophagus, causing overexpression of Cyclin D1, loss of function mutations to TP53 , E-cadherin and NOTCH1

GI (7 decks)

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