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GI Week 1 > Esophageal Disorders > Flashcards

Esophageal Disorders Flashcards

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1
Q

what is the characteristic appearance of squamous cell carcinoma on histo slide?

A

solid clusters of cells

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2
Q

what is the difference between erosion and ulcer?

A

erosion is superficial necrosis that heals with regeneration while ulcer is deep necrosis that heals with fibrosis

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3
Q

what are three ways GI malignancies can grow?

A

fungating
infiltration
ulceration

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4
Q

what is fungating malignancy growth?

A

when it grows up

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5
Q

what is infiltrating malignancy growth?

A

when it grows to sides

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6
Q

what is ulcerating malignancy growth?

A

when it grows down and chews out some tissue

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7
Q

what is another GI issue that fibrosis or scarring can actually lead to?

A

a stricture

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8
Q

what are the two causes of achalasia?

A

lack of peristalsis in smooth muscle of esophagus and non relaxation of LES

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9
Q

what bug can cause achalasia? where does the bug infiltrate?

A

T cruzi

myenteric plexus ganglion

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10
Q

what will you see with barium swallowing with achalasia?

A

dilated esophagus and a BIRD BEAK narrowing at distal end

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11
Q

how to treat achalasia?

A

botox or dilatation with balloon

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12
Q

what is jackhammer esophagus?

A

hypercontractility of esophagus

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13
Q

what are two symptoms with jackhammer esophagus?

A

chest pain and dysphagia

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14
Q

what is ineffective esophageal motility? what disease does it occur with?

A

peristalsis happening just not effective..like CHF…happens with reflux disease

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15
Q

what is a scleroderma esophagus? when does this occur?

A

lack of peristalsis in the esophagus due to scleroderma autoimmune disease

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16
Q

what happens to the LES with scleroderma esophagus?

A

sphincter hypotension so you get regurg

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17
Q

name three infectious agents that cause esophagitis

A

candida
herpes simplex 1
CMV

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18
Q

what three things are seen in candida plaques in esophagitis?

A

candida pseudohyphae
necrotic debris
PMNs

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19
Q

with HSV1 what are the three Ms you see on histo slides in the esophagus?

A

margination
multinucleation
molding

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20
Q

what cells does HSV1 infect in esophagus?

A

epithelial cells

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21
Q

CMV leads to what gross pathology in the esophagus?

A

ulcers or erosions

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22
Q

what cell does CMV infect in the esophagus?

A

endothelial and fibroblasts

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23
Q

what are two findings on histo slides of CMV in the esophagus?

A

nuclear intrusions and cytomegaly

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24
Q

what can stuck pills causes grossly in esophagus?

Study These Flashcards
A

inflammation and ulcer/erosion

25
what is eosinophilic esophagitis? how does it look grossly?
infiltration of eosinophils in the esophagus...leads to ring like structures that cause dysphagia
26
what is a hiatal hernia?
protrusion of stomach into the thorax through an enlarged diaphragmatic hiatus
27
what are the two types of hiatal hernias? which is most common?
sliding or rolling...sliding is most common
28
what is a common issue associated with hiatal hernias?
GERD bc LES not working well
29
is a hiatal hernia acquired or congenital?
acquired usually
30
what two cells are commonly seen in distal esophageal epithelium with GERD?
PMNs and eosinophils
31
what are extraesophageal symptoms of GERD?
chronic cough, laryngitis asthma and tooth decay
32
what are esophageal symptoms of GERD?
heartburn acid regurg chest pain
33
what can GERD lead to if it is persistent?
a stricture
34
what do you give to treat GERD as empiric therapy?
PPI
35
what are fivered flags of GERD?
``` weight loss vomiting bleeding anemia jaundice ```
36
what is the surgery for GERD called?
fundoplication...where they wrap part of the stomach around the esophagus
37
GERD can lead to Barrett metaplasia...what is this?
when distal esophagus starts to change into simple intestinal columnar epithelium
38
in Barretts...why does it change to intestinal columnar epithelium?
because it is used to stomach contents and has mucus to protect from the acid
39
what are the two types of neoplastic injuries of the esophagus?
squamous epithelium and metaplasia intestinal adenocarcinoma
40
what is the main cause of adenocarcinoma in the esophagus?
GERD/Barretts
41
what are two risk factors for squamous cell carcinoma of esophagus?
tobacco and alcohol
42
Barrett metaplasia has to go through one other step before it becomes adenocarcinoma...what is that step?
dysplasia...big pleomorphic nuclei
43
what is the pattern of adenocarcinoma of esophagus?
fungating ulcerating or infiltrating...any of them
44
where can squamous cell carcinoma occur in the esophagus?
any portion!
45
how does esophageal cancer present? 2 things
dysphagia with solids progressing to liquids...and weight loss
46
what appearance will esophageal cancer have on barium swallow?
raggedy appearance
47
if you have esophageal dysphagia with intermittent issues with solid food only...what do you likely have?
lower esophageal ring...schatzki ring
48
what is the cause of a lower esophageal ring?
unknown
49
if you have esophageal dysphagia with progressive issues with solid food only and chronic heartburn...what do you likely have?
peptic stricture
50
does a peptic stricture appear smooth or raggedy on barium swallow test?
smooth
51
if you have esophageal dysphagia with progressive issues with solid food only and weight loss...what do you likely have?
carcinoma of esophagus
52
if you have esophageal dysphagia with intermittent issues with solid and liquid food and chest pain...what do you likely have?
diffuse esophageal spasms
53
what is the cause of esophageal spasms?
unknown
54
if you have esophageal dysphagia with progressive issues with solid and liquid food and heartburn...what do you likely have?
scleroderma
55
if you have esophageal dysphagia with progressive issues with solid and liquid food and bland regurg/weight loss...what do you likely have?
achalasia
56
does scleroderms or achalasia have GERD? or both?
just scleroderma
57
if you have progressively worsening dysphagia with solid or liquid food and there are rings in the esophagus on upper endoscopy...what do ya have?
eosinophilic esophagitis
58
if you have iron deficiency and esophageal webs...what do you have?
plummer vinson syndrome

GI Week 1 (5 decks)

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