GIT: Esophagus Flashcards Preview

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Flashcards in GIT: Esophagus Deck (31)
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1
Q

describe esophgeal atresia

A
  • non-canalization of portion of esophagus (atresia/stenosis)
2
Q

esophageal atresia is commonly associated with ____

A

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

3
Q

list the clinical symptoms of esophageal atresia

A
  • clinical symptoms:
    • excessive drooling of saliva
    • aspiration pneumonia
    • choking and cyanosis
4
Q

describe esophageal webs and rings

A

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
Q

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

A
  • triad:
    • iron deficiency anemia
    • esophageal webs
    • atrophic glossitis
6
Q

Plummer-Vinson syndrome has a high risk for ____

A

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

7
Q

patients with Plummer-Vinson sydrome present with ____ and ____

A

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

8
Q

describe the treatment for Kelly Patterson syndrome

A
  • treatment:
    • iron
    • endoscopic dilatation
9
Q

list the 3 main features of achalasia/cardiospasm

A
  • 3 main features:
    • partial or incomplete relaxation of LES with swallowing
    • aperistalsis
    • increased resting tone of LES
10
Q

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

A

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

11
Q

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

A

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

12
Q

list the causes of secondary achalasia (pseduoachalasia)

A
  • Chagas disease (Trypanosoma cruzi)
  • diabetic autonomic neuropathy
  • infiltrative disorders: malignancy, amyloidosis, sarcoidosis
  • spinal motor neurons: polio, surgical ablation
  • Down syndrome
  • autoimmune disease
13
Q

describe Mallory Weiss syndrome

A
  • 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
Q

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

A

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

15
Q

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

A

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

16
Q

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

A

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

17
Q

list irritants that can cause esophagitis

A
  • irritants:
    • alcohol
    • acids
    • alkalis
18
Q

list complications of reflux esophagitis

A
  • complications:
    • bleeding
    • stricture
    • aspiration pneumonitis
    • Barrett esophagus & adenocarcinoma
19
Q

describe the image

A

reflux esophagitis with scattered intraepithelial eosinophils and mild basal zone expansion

20
Q

list 1 fungal and 2 viral causes of esophagitis

A
  • fungal:
    • Candida
  • viral:
    • Herpes simplex
    • CMV
21
Q

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

A

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

22
Q

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

A

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

23
Q

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, _____

A

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
Q

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

A

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
Q

describe what is seen in the image

A

esophageal varices

26
Q

describe what is seen in the image

A

esophageal varices

27
Q

name diets that lead to higher risk of SCC

A
  • diet
    • vit. deficiency
      • A, C, riboflavin, thiamine, pyridoxine
    • fungal contamination
    • high nitrite content
28
Q

list lifestyles that lead to a higher risk of SCC

A
  • lifestyle:
    • alcohol
    • tobacco use
    • HPV
29
Q

list esophageal disorders that lead to a higher risk of SCC

A
  • esophageal disorders:
    • long-standing esophagitis
    • achalasia
    • Plummer-Vinson syndrome
30
Q

list genetic changes that lead to higher risk for SCC

A
  • genetics:
    • Celiac disease
    • ectodermal dysplasia (Tylosis)
31
Q

____ is the precursor lesion for adenocarcinoma of the esophagus

A

Barrett’s esophagus is the precursor lesion for adenocarcinoma of the esophagus