Esophagus

Question 1

Esophagus starts at the level of __ and ends at __

Answer 1

Cricoid catilage (c6)
Cardia of stomach (T11)

Question 2

Layer that is absent in the esophagus is

Answer 2

Serosa

Question 3

Blood supply of the cervical region of esophagus is

Answer 3

Inferior thyroid artery

Question 4

What is the blood supply of the thoracic region of the esophagus

Answer 4

Bronchial arteries

Question 5

Blood supply of the abdominal region of esophagus

Answer 5

Ascending branch of the left gastric artery
Inferior phrenic artery

Question 6

This is the gold standard for the diagnosis of GERD

Answer 6

24 hour ambulatory pH monitoring

Question 7

Most consistent characteristic of a mechanical defective LES

Answer 7

Intraabdominal sphincter length of <1cm

Question 8

Hallmark of intestinal metaplasia

Answer 8

(+) intestinal goblet cells

Question 9

Gold standard treatment for GERD

Answer 9

Proton Pump Inhibitor

Question 10

Most common antireflux procedure that involves 360 deg fundoplication around the lower esophagus for a distance of 4-5cm, without division of the short gastric vessel

Answer 10

Nissen fundoplication

Question 11

270 deg fundoplication around the distal 4cm of esophagus

Answer 11

Toupet fundoplication

Question 12

180 deg anterior fundoplication of the distal esophagus

Answer 12

Dor fundoplication

Question 13

This procedure uses stapler to divide the cardia and upper stomach which results to gastric tube continuous with the esophagus thereby extending length of esophagus by several centimeters

Answer 13

Collis gastroplasty

Question 14

A 240-270 deg fundoplication is done thru thoracic approach

Answer 14

Belsey mark IV

Question 15

Arcuate ligament repair plus gastropexy to diaphragm

Answer 15

Hill Posterior Gastropexy

Question 16

Deterioration of the phrenopharyngeal membrane

Answer 16

Diaphragmatic hernia

Question 17

Signs and symptoms of sliding hernia

Answer 17

GERD (heart burn, regurgitation)

Question 18

Common symptoms of paraesophageal hernia

Answer 18

Dysphagia
Postprandial fullness
Massive bleeding
Gastric volvolus
Infarction

Question 19

Borchardt triad

Answer 19

Chest pain
Retching with inability to vomit
Inability to pass a nasogastric tube

Question 20

This is indicative of incarcerated intra thoracic stomach

Answer 20

Borchardt triad

Question 21

Findings of the upper GI barium swallow in hiatal hernia

Answer 21

Outpouching of barium at the lower end of esophagus
Wide hiatus
Free reflux of barium

Question 22

Most common esophageal diverticula that results from high pressure from the hypopharynx

Answer 22

Zenker diverticulum or pahryngoesophageal diverticulum

Question 23

This is the area of potential weakness situated behind the esophagus at the level of cricopharyngeus muscle

Answer 23

Killian triangle

Question 24

Symptoms of zenker diverticulum

Answer 24

Dysphagia
Regurgitation of undigested food
Halitosis
Choking
Aspiration

Question 25

Tx of zenker diverticulum of less than or equal 2cm

Answer 25

Pharyngotomy

Question 26

Tx for zenker diverticulum that is more than 2cm

Answer 26

Diverticulectomy or diverticulopexy

Question 27

It is a primary motility disorder characterized by loss of peristaltic waveform in the esophageal body and failure of the LES to relax

Answer 27

Achalasia

Question 28

Triad of achalasia

Answer 28

Hypertensive LES Aperistalsis of the esophagus Failure of the LES to relax

Question 29

Gold standard for dx of Achalasia

Answer 29

Manometry

Question 30

Sign of Achalasia in esophagram

Answer 30

(+) Bird's beak

Question 31

Most effective non surgical management for achalasia

Answer 31

Pneumatic dilatation

Question 32

Medications that can be given for Achalasia

Answer 32

CCB, Nitrate or Botilinum toxin

Question 33

Most common primary esophageal motility disorder

Answer 33

Nutcracker esophagus

Question 34

Necrosis caused by alkali

Answer 34

Liquefactive necrosis

Question 35

Acids cause this necrosis

Answer 35

Coagulation necrosis

Question 36

Most common type of esophageal carcinoma

Answer 36

Squamous cell carcinoma

Question 37

Squamous cell carcinoma of the esophagus is most commonly seen at what site?

Answer 37

Middle 3rd of the thoracic esophagus

Question 38

Most common site of adenocarcinom of esophagius

Answer 38

Distal esophagus

Question 39

Premalignnt lesion of adenocarcinoma

Answer 39

Barret's esophagus

Question 40

Triad of plummer vinson syndrome

Answer 40

Iron deficiency anemia Dysphagia Esophageal web