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Flashcards in GI- 1 Deck (37):
1

What are the layers of the esophagus?

Mucosa, submucosa, and muscularis propria

2

Where does most important pathology occur?

GE junction, where the squamous epithelium gives way to the glandular epithelium

3

The GE junction is AKA

The z-line

4

What is the most common congenital anomaly?

A tracheo-esophgeal fistula

5

Tracheo-esophageal fistula is associated with what in 90% of cases?

Esophageal atresia in the middle third

6

When does tracheo-esophageal fistula present itself and how can it lead to death?

During the neonatal period

Death by aspiration pneumonia

7

What are the 2 major types of hernias?

Hiatal and paraesophageal

8

What is a hiatal hernia?

When the entire proximal stomach protrudes into the mediastinum

9

What is a paraesophageal hernia?

Rolling when part of the fundus protrudes into the mediastinum

10

What is the most important cause of esophagitis?

Reflux

11

What happens in reflux esophagitis?

There is passage of gastric and duodenal contents through the lower esophageal sphincter

12

What are common elements of reflux esophagitis?

Elongation of rete, basal cell hyperplasia, and intraepithelial eosinophils

13

Intraepithelial eosinophils are seen in what other type of esophagitis? The pattern seen endoscopically is called?

Hypersensitivity esophagitis

Feline or trachealization

14

Intestinalization of glandular epithelium occurs in?

Barret's esophagus

15

How does the color of the mucosa in barret's compare to normal?

Red, velvety vs. pale pink

16

Intestinalization refers to presence of what cells?

Goblet cells

17

What is the most common cause of infectious esophagitis?

Candida like albicans or tropicalis

18

How does candida related esophagitis present itself and how is it treated?

Dysphagia, treated with antifungals like fluconazole

19

What is the 2nd most common cause of infectious esophagitis?

Herpes simplex virus

20

Who gets infected with HSV related IE?

Immunocompromised adults and children

21

HSV can cause what other then IE?

Ulcers

22

How do you treat HSV?

Antivirals like acyclovir

23

Cytomegalovirus is seen in who? What can it lead to?

Always in immunocompromised patients and leads to ulcers that resemble HSV ulcers

24

CMV cells possess what type of nucleus?

Owl eye

25

What is Mallory-Weiss syndrome?

When there are longitudinal tears in the lower esophagus that may also extend into the upper stomach

26

What does MW syndrome lead to and who gets it?

Leads to hematemesis or vomiting blood, seen in alcoholics

27

Are the tears perforating or superficial?

Superficial

28

A syndrome that has transmural tears is?

Boerhaave syndrome

29

Esophageal varices are a complication of?

Portal hypertension

30

What is the cause of varices and what can it result in?

Caused by alcohol and leads to hematemesis and death

31

Which vein is a major player in the formation of esophageal varices?

The left gastric vein or the cardiac vein

32

What are the two types of esophageal carcinoma?

Squamous cell and adenocarcinoma

33

Which type of esophageal carcinoma is most common the US? Worldwide?

In the US the numbers are about the same due to genetic and environment. Worldwide SCC is 90%

34

What are the main causes of esophageal carcinoma in the US? Who gets it more often, men or women?

Smoking and alcohol, men get it 4x as often

35

Almost all esophageal adenocarcinomas occur in the presence of?

Barret's esophagus

36

Describes types A-E of atresia and fistulas

A is atresia without fistula
B is atresia with proximal fistula
C is atresia with distal fistula
D is atresia with proximal and distal
E is fistula without atresia

37

Esophageal varices result from?

Increase in pressure in the portal vein which shunts blood into associated veins not meant to withstand the increased pressure