GI-Esophagitis

Question 1

Esophagitis

Answer 1

Path: Pill-induced
Infectious
Eosinophilic
Caustic
GERD

Pt: Odynophagia, Dysphagia

Dx: EGD w Biopsy

Tx: Dz- specific
Anti-Acid (PPI, H2)

Question 2

Pill-Induced Esophagitis

Answer 2

Path: pill gets stuck
- NSAIDs, Abx, Bisophosphonates, HIV

Pt: Esophagitis

Dx: EGD w Bx

Tx: EGD (right arrow) Remove Pill
Remove offending agent
Time and PPI

F/u: No recumbency, water w pills

Question 3

Infectious esophagitis

Answer 3

Candida - Oral Thrush - Fluconazole

HSV - Oral Lesions - Valacyclovir

CMV - blank - Valagancylovir

HIV - opportunistic infections - HAART

Question 4

Eosinophilic esophagitis

Answer 4

Path + Pt: Asthma
allergies
atopy
Allergic Rxn

Dx: EGD w Bx > 16 eos/hpf
Trial PPI x 6 wks

Tx: Oral Aerosolized Steroids

Question 5

Caustic esophagitis

Answer 5

Path: Kid (accidental ingestion)
Adult (suicide attempt)
Alkaline&raquo_space; Acid

Pt: Larynx (right arrow) Hoarse, STRIDOR
Esophagus (right arrow) drooling

Dx: EGD w biopsy

Tx: Low severity……liquid diet
High severity…..NPO x 72 hrs EGD

F/u: NEVER neutralize