Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

GI Pathology > Esophagus > Flashcards

Esophagus Flashcards

(74 cards)

Start Studying
1
Q

Atresia

A

Incomplete development

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Tracheoesophageal fistula

A

Abnormal connection b/w 2 tubes (this case = esophagus and trachea)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is TE fistula?

A

Congential defect w/connection b/w esophagus and trachea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Most common variant of TE fistula?

A

Proximal esophageal atresia w/distal esophagus arising from stomach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Presentation of TE fistula?

A

Vomiting, polyhydramnios (excess amniotic fluid b/c baby can’t remove any via swallowing), abdominal distension (air entering stomach), and aspiration (gastric contents coming up into trachea)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Esophageal web?

A

Thin protrusion of esophageal mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is esophageal web found?

A

Most often upper esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Presentation of esophageal web?

A

Dysphagia w/poorly chewed food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Esophageal web increases risk of?

A

Esophageal squamous cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Plummer-Vinson Syndrome/Patterson-Brown-Kelly Syndrome? (4)

A

Severe iron deficiency anemia
Esophageal web
Beefy red tongue due to atrophic glossitis and exposed BV
Cheilosis (inflammation at corners of mouth)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Esophageal rings - Schatzki A and B

A

Similar to webs but circumferential and thicker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Rings include…

A

Mucosa and submucosa (and sometimes hypertrophic muscularis propria)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

A rings

A

Above gastroesophageal junction (GEJ) - A (squamous mucosa)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

B rings

A

Below gastroesophageal junction - B (gastric cardia-type mucosa)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Diverticulae

A

Outpouching of pharyngeal mucosa thru an acquired defect in muscular wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Esophageal diverticula

A

FALSE diverticulae b/c lack true muscularis involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How to get diverticulae

A

Disordered swallowing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Presentation of diverticula

A

Dysphagia, obstruction, and halitosis (due to rotting food stuck in throat)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Types of esophageal diverticula

A

Zenker (above UES)
Epiphrenic (above LES)
Traction (midpoint of esophagus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Esophageal lacerations/Mallory Weiss tears

Mallory-Weiss Syndrome

A

Longitudinal laceration of mucosa at GEJ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Lacerations caused by

A

Severe vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Presentation of lacerations

A

Painful hematemesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Expect w/lacerations (2 diseases)

A

Alcoholism or bulimia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Pathophys of Mallory Weiss Syndrome?

A

Reflex relaxation of GE musculature precedes antiperistaltic contractile wave associated w/ vomiting –> this fails during prolonged vomiting and gastric contents overwhelm gastric inlet –> esophageal wall stretches and then tears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Achalasia
A = w/out Chalasis = relaxation Disordered esophageal motility w/inability to relax LES
26
Cause of achalasia
Damaged ganglion cells in myenteric plexus (b/w IC and OL of ME, important for regulating bowel motility and LES relaxation)
27
Damage to myenteric plexus ganglion cells is...
``` Primary = idiopathic Secondary = Chagas disease (caused by Trypanosoma cruzi) ```
28
Clinical features of Achalasia (5)
1. Dysphagia for solids and liquids (b/c need peristalsis to move both down esophagus) 2. Putrid breath (accumulation of rotten food in esophagus) 3. High LES pressure on esophageal manometry 4. Bird break sign on barium swallow study (inability to relax LES --> dilation of esophageal wall as food/liquid build up in esophagus) 5. Increased risk for esophageal squamous cell carcinoma
29
Tx for Achalasia
Botox, laparoscopic myotomy, pneumatic balloon dilation
30
Pathophys for achalasia
Increased tone of LES because of impaired smooth muscle relaxation. Normally NO and VIP are released from inhibitory cells and cholinergic signaling is interrupted to allow for LES relaxation.
31
Hiatal hernia - definition
Protrusion of stomach through diaphragmatic hiatus into thorax
32
2 types of hiatal hernia
Sliding and paraesophageal
33
Sliding hiatal hernia
Most common type | Stomach herniates into esophagus so there is reflux into esophagus and increases risk for GERD
34
Paraesophageal hiatal hernia
Part of stomach herniates into thorax beside the esophagus Less common Classic Sx: bowel sounds in lower lung fields If congenital --> less space for lung to develop so there is lung hypoplasia
35
Cause of GERD
Reflux of acid from stomach due to decreased LES tone
36
Risk factors for GERD (6)
Alcohol, tobacco, obesity, fat-rich diet, caffeine, and hiatal hernia (sliding type)
37
Clinical fx for GERD (5)
1. Heartburn (mimics cardiac chest pain) 2. Asthma (due to airway irritation from gastric reflux) and cough 3. Damage to enamel of teeth 4. Ulceration w/stricture and Barrett esophagus (late complications) as well as melena and hematemesis 5. Noticeable regurgitation of sour-tasting gastric contents
38
Why do you see stricture as complication of GERD?
Acid erosion --> ulceration (taking out a chunk of mucosa and a bit of submucosa) --> kills stem cells --> healing then involves fibrosis --> thickening of wall --> narrows lumen
39
Pathophys of GERD?
Nonkeratinized SSE of esophagus has a very linear epi w/LP and is resistant to food abrasion but sensitive to acid Increased submucosal glands production will secrete mucin and bicarb LES tone keeps gastric contents out of esophagus so anything that decreases LES tone (risk factors!) or increase abdominal pressure (b/c gastric contents are under + pressure)
40
Tx for GERD
Proton pump inhibitors (PPI) or H2 R antagonists
41
Z line
Line b/w gastric mucosa (cardia) and esophageal mucosa
42
Normal esophageal mucosa
White b/c it doesn't have metabolically active mucosa (unlike say the stomach)
43
Early mucosal changes in GERD (5)
Thickening of SSE, prominence of lamina propria papillae, and intraepithelial inflammation
44
Intestinal (Barrett) metaplasia (2)
Increased glandular production in submucosa that secrete mucin and bicarb Change from SSE to nonciliated columnar epi (NCCE) w/goblet cells
45
What causes the intestinal metaplasia?
Esophageal stem cells to acidic stress
46
Why called specialized intestinal metaplasia?
Goblet cells + mucous cells --> acid mucus (normal gastric mucous cells produce neutral mucus Full features of intestinal mucosa (e.g. Paneth cells) not seen
47
Barrett's Esophagus can progress to....
Dysplasia and adenocarcinoma
48
Dysplasia (3)
``` Increased nuclear size, disordered nuclear polarity (linear basal region of epi becomes more chaotic), and prominent mitotic figures ```
49
Classic presentation of Barrett's
White males b/w 40-60
50
Morphology of Barrett's Esophagus
Red velvety mucosa alternating w/normal smooth, pale SSE mucosa and light brown columnar (gastric) mucosa
51
Other complications of Barrett's Esophagus
``` Peptic ulcer (normally only seen in stomach and duodenum) Stricture ```
52
Esophageal varices
Dilated submucosal veins in lower esophagus
53
Esophageal varices arise secondary to...
portal HTN
54
Portal HTN
Distal esophageal vein normally drains into portal vein via L gastric vein. L gastric vein gets backed up into esophageal vein w/portal HTN so as a result the esophageal veins dilate
55
Associate esophageal varices w/
Alcoholics and cirrhosis (thus portal HTN)
56
Sx of esophageal varices
Painless hematemesis w/rupture, otherwise is ASx
57
Most common cause of death in pts w/cirrhosis
Ruptured esophageal varices
58
Pathophys behind death from ruptured esophageal varices and cirrhosis
Liver isn't functioning so not producing adequate coagulation factors --> have a functional coagulopathy and so if hemorrhage occurs (b/c varices rupture) then it is a bleed w/out ability to seal it
59
Sx of hemorrhage from ruptured varice
Pain, anemia, tarry vomit/stool (melena) (thus bleeding Sx)
60
Tx of hemorrhage from ruptured varice
Band ligation of sclerotherapy (endoscopic injection of thrombotic agents), octreotide (inhibits vasodilation), and ceftriaxone
61
Adenocarcinoma of esophagus
Malignant proliferation of glands (produce acidic mucin)
62
Are glands normal in esophagus?
NO!
63
Most common esophageal carcinoma in West
Adenocarcinoma | Think white, men, developed countries
64
Cause of esophageal carcinoma?
Preexisting Barrett's esophagus
65
In what part of esophagus is esophageal carcinoma found?
Lower 1/3 of esophagus (and may invade gastric cardia)
66
Squamous Cell Carcinoma (in esophagus)
Malignant proliferation of squamous cells
67
Most common esophageal carcinoma WW
Squamous cell carcinoma | Think AA, men, >45 (for West)
68
In what part of esophagus is esophageal squamous cell carcinoma found?
Upper or middle 1/3 of esophagus
69
Risk factors for squamous cell carcinoma (5) --> all irritate mucosa
1. Alcohol and tobacco (most common causes) 2. Very hot tea/beverages 3. Achalasia 4. Esophageal web (e.g. Plummer-Vinson Syndrome) 5. Esophageal injury (e.g. lye ingestion)
70
Microscopic features of squamous cell carcinoma (well-differentiated)
Keratin pearls and intercellular bridges
71
Prognosis for esophageal carcinoma
Presents late --> poor
72
Sx for esophageal carcinoma (squamous cell or adenocarcinoma) (4)
1. Progressive dysphagia (solids to liquids) 2. Wt loss 3. Odynophagia (pain w/swallowing) 4. Hematemesis
73
2 more Sx for sqamous cell carcinoma
1. Hoarse voice (b/c of recurrent laryngeal n involvement, seen in upper part of esophagus) 2. Cough (b/c of tracheal involvement)
74
Location of lymph node spread depends on level of esophagus involved --> 3 levels
Upper 1/3 = cervical nodes Middle 1/3 = mediastinal or tracheobronchial nodes Lower 1/3 = celiac and gastric nodes

GI Pathology (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions