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Flashcards in GIT: Esophagus Deck (31)
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1

describe esophgeal atresia

  • non-canalization of portion of esophagus (atresia/stenosis)

2

esophageal atresia is commonly associated with ____

esophageal atresia is commonly associated with tracheo-esophageal fistula (TEF)

3

list the clinical symptoms of esophageal atresia

  • clinical symptoms:
    • excessive drooling of saliva
    • aspiration pneumonia
    • choking and cyanosis

4

describe esophageal webs and rings

protrusions of mucosa into the lumen

  • upper esophagus = webs
    • covered by squamous mucosa with vascularized core
  • lower esophagus = Schatzi ring
    • undersurface have columnar epi. 

5

describe the triad seen in Plummer-Vinson syndrome (aka Kelly Patterson syndrome)

  • triad:
    • iron deficiency anemia
    • esophageal webs
    • atrophic glossitis

6

Plummer-Vinson syndrome has a high risk for ____

Plummer-Vinson syndrome has a high risk for squamous cell carcinoma of esophagus

7

patients with Plummer-Vinson sydrome present with ____ and ____

patients with Plummer-Vinson syndrome present with koilonychia (spoon nails) and splenomegaly (compensation for iron def.)

8

describe the treatment for Kelly Patterson syndrome

  • treatment:
    • iron
    • endoscopic dilatation

9

list the 3 main features of achalasia/cardiospasm

  • 3 main features:
    • partial or incomplete relaxation of LES with swallowing
    • aperistalsis
    • increased resting tone of LES

10

one of the 2 primary causes of achalasia is the loss of _____ of the LES

one of the primary causes of achalasia is the loss of intrinsic inhibitory innervation of the LES

11

one of the primary causes of achalasia is the loss/absence of _____ 

one of the primary causes of achalasia is the loss/absence of ganglion cells in myenteric plexus 

12

list the causes of secondary achalasia (pseduoachalasia)

  • Chagas disease (Trypanosoma cruzi)
  • diabetic autonomic neuropathy
  • infiltrative disorders: malignancy, amyloidosis, sarcoidosis
  • spinal motor neurons: polio, surgical ablation
  • Down syndrome
  • autoimmune disease

13

describe Mallory Weiss syndrome

  • longitudinal mucosal tears at esophagogastric junction
  • frequently in alcoholics after bout of severe retching
  • inadequate relaxation of LES during vomiting
  • hematemesis
  • usually heals but sometimes fatal

14

in Mallory Weiss syndrome, there are ____ at the esophagogastric junction

in Mallory Weiss syndrome, there are longitudinal mucosal tears at the esophagogastric junction

15

Mallory Weiss syndrome is commonly seen in ___ after bouts of ____

Mallory Weiss syndrome is commonly seen in alcoholics after bouts of severe retching

16

in Mallory Weiss syndrome, there is inadequate ____ of the ____ during vomiting

in Mallory Weiss syndrome, there is inadequate relaxation of the LES during vomiting

17

list irritants that can cause esophagitis 

  • irritants:
    • alcohol
    • acids
    • alkalis

18

list complications of reflux esophagitis

  • complications:
    • bleeding
    • stricture
    • aspiration pneumonitis
    • Barrett esophagus & adenocarcinoma

19

describe the image

reflux esophagitis with scattered intraepithelial eosinophils and mild basal zone expansion

20

list 1 fungal and 2 viral causes of esophagitis

  • fungal:
    • Candida
  • viral:
    • Herpes simplex
    • CMV

21

Barrett esophagus is replacement of esophageal ____ mucosa with metaplastic _____ with ____

Barrett esophagus is replacement of esophageal squamous mucosa with metaplastic columnar epithelium with goblet cells

22

Barrett's esophagus leads to an increased risk for ____; the risk is related to ____

Barrett's esophagus leads to an increased risk for adenocarcinoma; the risk is related to the length of Barrett's mucusa

23

in Barrett's esophagus screening with biopsy:

if there is no dysplasia, ____

if there is low grade dysplasia, ____

if there is high grade dysplasia, ____

if there is adenocarcinoma, _____

if there is no dysplasia, continue screening

if there is low-grade dysplasia, more frequent screening

if there is high-grade dysplasia, definitive therapy, resection or ablation

if there is adenocarcinoma, resection

24

esophageal varices are caused by dilated tortuous veins in the ___ and ___ of the lower esophagus (and prox. stomach) and is associated with ____

esophageal varices are caused by dilated tortuous veins in the mucosa and submucosa of the lower esophagus (and prox. stomach) and is associated with portal HTN

25

describe what is seen in the image

esophageal varices

26

describe what is seen in the image

esophageal varices

27

name diets that lead to higher risk of SCC

  • diet
    • vit. deficiency
      • A, C, riboflavin, thiamine, pyridoxine
    • fungal contamination
    • high nitrite content

28

list lifestyles that lead to a higher risk of SCC

  • lifestyle:
    • alcohol
    • tobacco use
    • HPV

29

list esophageal disorders that lead to a higher risk of SCC

  • esophageal disorders:
    • long-standing esophagitis
    • achalasia
    • Plummer-Vinson syndrome

30

list genetic changes that lead to higher risk for SCC

  • genetics:
    • Celiac disease
    • ectodermal dysplasia (Tylosis)