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GI (inpt) > Esophagus > Flashcards

Esophagus Flashcards

1
Q

Barrett’s Esophagus

A

intestinal metaplasia of the esophagus

can be a complication of GERD (10-20% pts)

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2
Q

Barrett’s PP

A

squmaous to columnar epithelium

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3
Q

Barrett’s may lead ot?

A

adenocarcinoma of the esophagus (distal third)

squamous cell lesion tend to occur in the proximal two-thirds

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4
Q

Esophagitis

A

rare, except in immunocompromised persons

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5
Q

causes os esophagitis

A

Fungal (Candida), viral (CMV and HSV), HIV, mycobacterium tuberculosis, EBV,

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6
Q

esophagitis main CF

A

odynophagia (painful swallowing) or dysphagia (difficulty swallowing)

PE may show fever, lymphadenopathy, or rashes

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7
Q

what would endoscopy in esophagitis reveal?

A

large, deep ulcers (CMV or HIV). infx w/ HSV -multiple shallow ulcers)

candidal infxn shows white plaques

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8
Q

esophagitis definitive dx?

A

cytology of culture from endoscopic brushings

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9
Q

tx of esophagitis

A

fluconazole or ketoconazole

acyclovir for HSV

Ganiciclovir for CMV

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10
Q

Mallory-Weiss tear?

A

linear mucosal tear in the esophagus, generally at the gastroesophageal junction

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11
Q

what can cause a MW tear>

A

forceful vomiting or retching–> hematemesis

also often associated with alcohol use

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12
Q

how are MW tears dx?

A

with endoscopy

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13
Q

tx of MW tear

A

most resolve w/o tx, a ppi may be used if active bleed is resovled

*may need ingx of epi or thermal coag if bleeding doesn’t resolve on its own

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14
Q

what are esophageal varicies?

A

dilation of the veins of the esophagus, generally at distal end

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15
Q

what is the underlying cause of esophageal varicies?

A

portal htn due to cirrhosis from aocohol abuse or chronic viral hepatitis

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16
Q

what can make esoph. varicies bleed?

A

NSAIDs (hepatic vein obsturction)

17
Q

what is Budd-Chiari syndrome?

A

thrombosis of portal vein, leading to varices: y occlusion of the hepatic veins that drain the liver. It presents with the classical triad of abdominal pain, ascites, and liver enlargement. The formation of a blood clot within the hepatic veins can lead to Budd–Chiari syndrome. The syndrome can be fulminant, acute, chronic, or asymptomatic.

18
Q

how do most pats present with e/ varicies?

A

painless upper GI bleed that can be bright red frank bleeding or coffee ground in appearance

19
Q

what are complications of eso. varicies?

A

hypovolemic shock

20
Q

how are eso. varicies dx?

A

dx established when a pt with signs of cirrhosis presents wtih hematemesis- endoscopy localizes the bleed

asx until they bleed

21
Q

tx of esopha. var?

A

prevention can be done wtih BB +/- isosorbied mononitrate (relaxies smooth muscle)

22
Q

what is the method of tx for those who failed meds w/ esophageal varicies?

A

endoscopic band ligation

23
Q

how is bleeding controlled with esop/ varicies?

A

endoscopic band ligation is the preferred therapy for acute bleed

octreotide can also be used

hemodynamic support

24
Q

what are the most common esophageal neoplasms?

A

squamous cell carcinomas and adenocarcinomas

25
Q

where and what is barrett esophagitis associated with?

A

adenocarcinomas and distal third of the esophagus

26
Q

where do squamous cell carcinomas occur?

A

proximal 2/3

27
Q

where can esophageal neoplasms spread?

A

to the mediatinum bc eosph. has no serosa

28
Q

what are caustic agents of esophageal can?

A

cigarette smoking, chronic alcohol use, nitrosamines, fungal toxins, hot foods, mucosal abnormalities, poor oral hygiene, HPV

29
Q

what is the s/sx of esophageal cancer?

A

progressive dysphagia for solid food, and marked weight loss

heartburn, V, and hoarseness may occur

30
Q

what is the best initial test for esoopha. can dx?

A

biphasic barium esophagram-visualized the lesion

31
Q

what is used for diagnosis of E. C?

A

endoscopy w/ brushings

32
Q

what can be used for eso. Cancer stagin?

A

endoscopic sonogrpahy and CT

33
Q

how is eso. cancer tx?

A

generally surgical. +/- adjunctive chemo

GI (inpt) (16 decks)

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