GI - 3 Esophagus pt 4 Flashcards Preview

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Flashcards in GI - 3 Esophagus pt 4 Deck (24)
1

Dilated submucosal veins (in esophagus) due to portal hypertension, can result in major UGI bleed,

Esophageal varices

2

What will confirm that bloody vomit is from an UGI bleed?

NG (nasogastric) tube

3

How are varices treated?

banding

4

Meds for Esophageal varices:

IV qinolong b/c of high risk of infection (peritonitis)
Octreotide, somatostatin, vasopressin - reduce portal pressure

5

If medication treatment fails for esophageal varices, what can help stop the bleeding?

Balloon Tampanode (applies pressure)

6

Signs and symptoms of Eosinophilic Esophagitis:

Dyaphagia for solid food, heartburn, vomiting, elevatead igE

7

Diagnosis of Eosinophil Esophagitis

Barium swallow (for new patients complaining of dysphagia)

8

Barium swallow shows multiple concentric rings and eosinophils in mucosa of proximal esophagus

That's how you diagnose Eosinophil Esophagitis

9

What are 2 types of Esophageal Cancer?

Squamous cell and Adenocarcinoma

10

Barrett's is associated with what?

Adenocarcinoma esophageal cancer

11

Alcohol and tobacco are more associated with

Squamous cell esophageal cancer

12

Symptoms of Esophageal cancer

Progrssive dysphagia (solids then even liquids)
Weight loss
Coughing with swallowing or pneumonia

13

Why does Esophageal Cancer spread fast?

B/c there is no mucosa protecting the esophagus

14

Diagnosis of Esophageal cancer

Barium Esophagram (new patient comes and complains ofdysphagia)
Upper endoscopy allows to biopsy area

15

Anything beyond Stage IIIa is:

Too advanced for surgery to cure

16

Idiopathic. Loss of peristalsis in distal 2/3 of esophagus. Impaired relaxation of LES, gradual onset of dysphagia for solids and liquids. Regurgitating undigested food hours later, coughing, aspiration, weight loss

Achalasia

17

How is Achalasia diagnosed? (2 tests, 4 signs)

Barium Esophagram: Absent peristalsis, dilated esophagus, smooth symmetric beak appearance
CXR: Air fluid level in enlarged esophagus.

18

How is Achalasia CONFIRMED?

Esophageal Manometry. The Barium is only suggestive. This actually confirms there isn't peristalsis, there is incomplete relaxation of LES, and intraesophageal pressure > gastric pressure

19

What is the treatment for Achalasia? (2)

1. Balloon Dilitation of LES
2. Laproscopic Myotomy (cut out and remove LES)
3. Botulinum toxin injection -- reduces LES pressure (for ppl that can't handle invasive procedures like 1&2

20

Nonpropulsive/hyperdynamic/irritable contractions in esophagus. Chest pain, dysphagia (solids and liquids)

Diffuse Esophageal Spasm

21

Barium Esophagram shows poor progression of bolus, disordered contraction

Diffuse Esophageal Spasm

22

How is Diffuse Esophageal Spasm diagnosed?

Barium Esophagram shows poor progression of bolus, disordered contraction

23

How is Diffuse Esophageal Spasm treated?

Anticholinergics (antispasmotics)

24

Esophageal Manometry must be done to confirm:

Achalasia