Flashcards in Gastroenterology Deck (23):
What is the best initial test for a pt presenting with dysphagia (difficulty swallowing) and you are not aware of the diagnosis?
A young nonsmoker presents with dysphagia to both solids and liquids at the same time, regurgitation of food particles, possible aspiration of previously eaten food and the symptoms can progressively get worse most likely suffer from ...
(failure of the gastroesophageal sphincter to relax)
What is the best initial test for achalasia?
barium swallow (bird's peak)
What is the most accurate test for achalasia?
esophageal manometry (absence of normal esophageal peristalsis; abnormally high pressure at lower esophageal sphincter)
What are likely causes of odynophagia (painful swallowing)?
What is the best initial therapy for achalasia?
surgical myotomy (or pneumatic dilation if surgery fails)
What is the best treatment for achalasia in a pt who refuses surgery or pneumatic dilation?
botulinum toxin injection (inhibits ACh to relax muscle)
A pt > 50 years old with a history of smoking/drinking alcohol presents with dysphagia that progressive from just solids to include solids and liquids, has associated weight loss and heme positive stool/ anemia most likely suffers from....
What is the best initial test for suspected esophageal cancer?
Endoscopy with biopsy
(Choose barium swallow if endoscopy not available)
What is the best initial therapy for esophageal cancer?
Surgical resection followed by 5- fluorouracil (5-FU)
A middle aged female pt presents with dysphagia, weight loss, history of iron deficiency anemia most likely suffers from...
Plummer Vinson syndrome
What disease is Plummer Vinson syndrome associated with?
Squamous cell esophageal cancer
(As well as iron deficiency anemia)
What is the treatment for Plummer Vinson syndrome?
What is the best diagnostic test for suspected webs/ rings/ strictures of the esophagus?
A pt presents with intermittent symptoms of dysphagia most likely suffers from ...
(Distal stricture of esophagus)
What is the best treatment for Schatzki's ring?
A pt presents with dysphagia and weight loss in association with acid reflux history most likely suffers from ...
(Tx with pneumatic dilation)
A pt presents with dysphagia and a history of allergies most likely suffers from ...
What is the best diagnostic test for eosinophilic esophagitis?
Endoscopy with biopsy
What is the best initial treatment for eosinophilic esophagitis?
Proton pump inhibitors and budesonide
A pt presents with dysphagia and history of bad breath most likely suffers from....
(Dilation of posterior pharyngeal constrictor muscle)
What is the best initial test for Zenker's Diverticulum?
Barium studies (dilation of posterior pharyngeal constrictor muscle)