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Gastroenterology > Midterm > Flashcards

Midterm Flashcards

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1
Q

This condition is an esophageal motility disorder involving the smooth muscle layer of the esophagus and the lower esophageal sphincter.

A

Achalasia aka Cardiospasm

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2
Q

T or F

Achalasia has decreased tone in the lower portion of the esophagus and increased tone in the upper portion

A

False

increase lower
Decrease upper

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3
Q

What is primary achalasia?

A

The most common

Failure of distal esophageal inhibitory neurons - the Auerbach’s plexus (myenteric plexus)

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4
Q

T or F

Auerbach’s plexus only has sympathetic input

A

False

Parasympathetic and sympathetic

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5
Q

T or F

Meissner’s plexus has only parasympathetic fibres

A

True

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6
Q

Achalasia from Trypanosoma Cruzi is called?

A

Chagas Disease

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7
Q

What plexus does Achalasia from Trypanosoma Cruzi harm?

A

Myenteric Plexus

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8
Q

T or F

The chest pain associated with Achalasia with radiate to the neck and down one arm

A

False

radiates down BOTH arms not just one.

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9
Q

On X-Ray what sign is associated with Achalasia?

A

Birds Beak Sign or Rat’s Tail sign

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10
Q

List the complications of Achalasia

A 
Aspiration pneumonia or airway obstruction
Lower esophageal Diverticulum 
Esophageal cancer (5% of patients)
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11
Q

This condition is a protrusion of the upper part of the stomach into thorax in the space between the muscular crura of the diaphragm.

A

Hiatal Hernia

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12
Q

What is the MC form of hiatal hernia?

A

Sliding Hernia

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13
Q

What is a sliding hernia?

A

where the gastroesophageal junction together with the stomach move above the diaphragm

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14
Q

What is the difference between a rolling or paraesophageal hernia and a sliding hernia?

A

With the rolling hernia a separate portion of the stomach, usually along the greater curvature enters the thorax through the widening foramen.

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15
Q

List some of the aetiologies for a hiatal hernia

A

Kyphoscoliosis
Increased pressure within the abdominal cavity
Congenital diaphragmatic weakness
Obesity & T

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16
Q

What is known as the “great mimic disease” and why?

A

Hiatal Hernia

- most cases of hiatal hernia does not cause any symptoms or specific symptoms

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17
Q

What other conditions are in your differential dx with a hiatal hernia?

A

Ischemic heart disease
GERD
Lung disease (shortness of breath)

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18
Q

What is a major complication of a rolling hernia?

A

Can develop venous infarction due to its possible strangulation by the diaphragm. Emergency situation

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19
Q

T or F

GERD usually happens because the UES opens at the wrong time or does not close properly

A

False

LES

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20
Q

What can cause the LES to fail with GERD?

A

CNS depressants
Hypothyroidism
Pregnancy
Alcohol or tobacco exposure

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21
Q

Etiologies of GERD

A

Sliding hernia
Obesity
H.Pylori Infection
some visceral diseases: SLE, asthma, gall stones, laryngitis

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22
Q

What is a major sign of GERD

A

Increased salivation

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23
Q

What conditions must be in your differential for GERD

Study These Flashcards
A

heart disease

Hiatal hernia

24
Q

What are the complications of GERD?

Study These Flashcards
A 
Reflux esophagitis necrosis 
esophageal stricture 
Barett esophagus
Aspiration pneumonia 
esophageal cancer
25
Signs and symptoms of GERD
Heartburn Hematemesis Painful eating Dysphagia (in case of complication by stricture)
26
T or F Frank Esophageal adenocarcinoma is a complication of a Hiatal Hernia
False GERD
27
Lacerations of the esophagus is associated with what condition?
Mallory-Weiss Syndrome
28
T or F Mallory Weiss syndrome has vertical tears in the mucosa at the esophagogastric junction
False Horizontal
29
Esophageal rupture associated with Mallory Weiss Syndrome is called?
Boerhaave Syndrome
30
T or F Esophageal varicies are extremely dilated submucosal veins in the upper third of the esophagus.
False Lower third
31
What is the main etiological factor for Esophageal Varicies?
Portal Hypertension
32
T or F Posthepatic portal hypertension is associated with liver cirrhosis and liver tumors
False Posthepatic aka Suprahepatic = chronic right sided heart failure Hepatic aka intrahepatic = liver cirrhosis or cancer
33
What are the factors leading to pre hepatic portal hypertension?
Portal vein thrombosis Portal vein sclerosis Portal vein congenital stenosis
34
What percentage of ppl with liver cirrhosis will develop varicies?
65%
35
Zenker's Diverticulum aka?
Pharyngoesophageal
36
Where in the esophagus are Zenker's Diverticulum commonly found?
Immediately above the upper esophageal sphincter
37
Midesophageal Diverticulum aka?
Traction
38
Traction diverticulum usually result from what other condition?
Mediastinal lymphadenitis
39
T or F Traction Diverticulum are near the lower portion of the esophagus
False Midpoint
40
This type of diverticulum is found immediately above the lower esophageal sphincter.
Epiphrenic
41
What are the signs and symptoms for Zenker's Diverticulum?
Food regurgitation in the absence of dysphagia, can be complicated by aspiration pneumonia
42
Which type of Diverticulum will give rise to nocturnal regurgitation?
Epiphrenic
43
Benign tumors of the esophagus are usually from what tissue type?
Mesenchymal
44
What is the most common benign tumor of the esophagus?
Leiomyomas - smooth muscle
45
Where is the MC location for leiomyomas in the esophagus
Distal 2/3
46
Polyps are usually composed of a combination of what types of tissues?
Fibrous, vascular, or adipose and covered by an intact mucosa.
47
Name all the benign tumors of the esophagus
``` Leiomyomas Polyps Fibromas Lipomas Hemangiomas Neurofibromas Squamous papillomas ```
48
what are the MC malignant esophageal tumors?
Squamous cell carcinoma | Adenocarcinoma
49
Adenocarcinoma arises from what cell type?
Metaplastic columnar or goblet cells.
50
Which type of malignant esophageal cancers represents 50-80% of esophageal cancer in the USA?
Adenocarcinoma
51
T or F Squamous cell carcinoma usually occurs in the distal third of the esophagus or gastroesophageal junction
False proximal 2/3 **adenocarcinoma = distal third
52
Celiac disease Hot tea with increased concentration of tannins Tylosis (palmar/plantar hyperkeratosis) are associated with what type of malignant esophageal tumors?
Squamous Cell Carcinoma
53
Adenocarcinoma has a direct correlation with what other esophageal pathologies?
GERD Barrett Esophagus Scleroderma Zollinger-Ellison Syndrome
54
T or F Esophageal malignancies are more common in woman than men
False Male : female = 4-5:1
55
What is the best test for estimating the stage and metastases of the cancer?
PET
56
Where are common locations of metastases for esophageal cancers?
Regional lymph nodes Aorta Liver and lungs

Gastroenterology (1 decks)

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