Exam 2

Question 1

Dysphagia

Answer 1

Difficulty in swallowing (subjective)

Question 2

Causes of dysphagia

Answer 2

Motility dysfunction
Obstructive lesions
Hang up

Question 3

Heart burn

Answer 3

Esophageal reflux (retrosternal pain, bitter tast)

Question 4

What motion can instegate heart burn?

Answer 4

Intraabdominap pressure increase: bending over, laying down, heavy lifting and obesity

Question 5

Odynophagia

Answer 5

Painful swallowing

Question 6

What is associat d with odynophagia?

Answer 6

Acute esophageal inflammation and ulceration

Question 7

Sliding hernia

Answer 7

90% of hernia cases

Gastroesophageal junction shifted above hiatus

Question 8

Manifastation of sliding hernia symptoms occur when?

Answer 8

50% asymtamatic
Heart burn (regurgitation) and with increased intraabdominal pressure

Question 9

Paraesophageal hernia

Answer 9

Rolling hernia

Section of fundus reflected up through hiatus next to esophagus

Question 10

What are the complications of paraesophageal herniations?

Answer 10

Postprandial bloating
Paraesophageal bleeding
Ulceration

Question 11

Esophagitis

Answer 11

Contributes to esophageal mucosal injury

Question 12

The potential risks of esophagitis are?

Answer 12

Erosion
Ulcers/bleeding
Metaplasia
Inflammatory scarring

Question 13

Barretts espohagus (columnar cell metaplasia), mucosal inflamation, erosion and/or ulcers are associated with chronic or acute esophagitis?

Answer 13

Chronic esophagitis

Question 14

Whar are the complications of acute and chronic esophagitis?

Answer 14

Ulceration
Dysphagia
Increaed risk of cancer

Question 15

Morphology of esophageal carcinoma

Answer 15

Mostly squamous cell ca (except Barretts esophagus presenting with adenocarcinoma)

Question 16

How will carcinoma of the esophagus present?

Answer 16

Mechanical obstruction(solids more so)
Hematemsis
Poor prognosis (10% make it 5y)

Question 17

What are the effects of food and drink on Achalasia and carcinoma of the esophagus?

Answer 17

Achalasia- food and drink

Carcinoma- solids more

Question 18

What do Helicobacter pylori do?

Answer 18

Secretes enzymes that degrade mucin and produces ammonia.

The associated alkalinity stimulates HCL secretion

Question 19

Is acute gastritis reversable?

Answer 19

Yes

Question 20

25% of people taking aspirin daily might experiance what over time?

Answer 20

Acute gastritis

Question 21

The range of superficial g., atropic g. And gastric atrophy reffer to what kind of gastritis?

Answer 21

Chronic gastitis

Question 22

Autoantibodies against parietal cells and IF (intrensic factor) are what type of gastritis?

Answer 22

Chronic gastritis

Fundic- type A

Question 23

Fundic-type A is associated with what?

Answer 23

Loss of parietal cells and penicious anemia
Decrease iron absorp.
No ulcers
Increased risk g.ca (10%)

Question 24

What is a decrease in red blood cells when the body can’t absorb enough vitamin B-12 called?

Answer 24

Pernicious anemia

Question 25

What is Antral gastritis-type B?

Answer 25

80% most common Mucosal atrophy Dyspepsia Increased risk chronic ulcers and g. ca (2-4%)

Question 26

Whar will contribute to type B (antral gastritis)?

Answer 26

Age, chronic duodenum reflux, alcohol abuse, aspirin and helicobacter pylori

Question 27

Percentages of those who are exposed to helicobacter pylory are asymptamatic or symptomatic.

Answer 27

Asymptomatic10-50% in US | Symptomatic 60-90% with type B

Question 28

Multiple shallow small ulcerative lesions with rapid onset are what?

Answer 28

Acute, stress ulcers

Question 29

Acute ulcerative burn lesions are called what and associated with what?

Answer 29

Curling’s | Circulatiry alterations leading to mucosal ischemia

Question 30

Acute ulcerative cranial/trauma lesions are called what and associated with what?

Answer 30

Cushing’s | Incresed HCL

Question 31

T/F | Are acute, stress ulcers irreversable?

Answer 31

F

Question 32

What does punched out referr to?

Answer 32

Seen in chronic peptic ulcers where there are distinct mucosal defects having smooth margins.

Question 33

Chronic peptic ulcer

Answer 33

Single lesions in regions exposed to peptic juices

Question 34

List common regions of the chronic peptic ulcer.

Answer 34

``` Duodenum Stomach Esophagus Mechels diverticulum-(g. Mucosa) Jejunum-(rare) ```

Question 35

Where are 98% of chronic peptic ulcers located?

Answer 35

Duodenum and stomach

Question 36

jejunal ulcers are associated with what?

Answer 36

Zillinger-Ellison syndrome