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Year 2- GIT > Oesophageal Disorders > Flashcards

Oesophageal Disorders Flashcards

(56 cards)

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1
Q

What is the most common symptom of oesophageal disease?

A

Heartburn

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2
Q

Where is heartburn felt?

A

Retrosternal chest pain

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3
Q

What is dysphagia?

A

Difficulty swallowing food or fluids

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4
Q

What is odynophagia?

A

Painful swallowing

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5
Q

What is important to ask about if a patient presents with dysphagia?

A

-The type of food or fluid which causes difficulty as this could provide an indication to the severity of the obstruction.
-The pattern, if it’s infrequent or progressive
-Associated features like weight loss, cough, regurgitation

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6
Q

What is the commonest cause of oesophageal dysphagia?

A

Benign stricture

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7
Q

What are some other causes of oesophageal dysphagia?

A

Malignant stricture
Motility disorders
Oeosinophilic oesophagitis
Extrinsic compression, like lung cancer

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8
Q

Which investigations are common in those with oesophageal disease?

A

OGD- Oesophago-Gastro-Duodenoscopy
Upper GI Endoscopy

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9
Q

Which type of imagining might be used in those with oesophageal disease?

A

Contrast imaging using a barium swallow

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10
Q

How can the pH of the stomach be measured?

A

Using pH-mentry

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11
Q

What does manometry measure?

A

The pressure waves of the oesophagus

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12
Q

What are the two subdivions of motility disorders?

A

Hypermotility
Hypomotility

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13
Q

In those with hypermotility, if they did a barium swallow, what would the oesophagus look like?

A

Corkscrew appearance

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14
Q

What is the presentation of hypermotility oesophageal disorder?

A

Severe chest pain +/- dysphagia

Can often be mistaken for angina

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15
Q

What would manometry show in those with hypermotility oesophageal disorder?

A

Exaggerated, uncoordinated, hypertonic contractions

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16
Q

What is the treatment for hypermotility oesophageal disorders?

A

Smooth muscle relaxants like calcium channel blockers or nitrates

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17
Q

Name a common important hypomotility disorder.

A

Achalasia

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18
Q

What are the symptoms of achalasia?

A

Progressive dysphagia for solids and liquids
Chest pain
Weight loss
Regurgitation
Chest infections

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19
Q

What are some of the pharmalogical treatments for achalasia?

A

Nitrates
Calcium channel blockers

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20
Q

What are some of the endoscopic treatments for achalasia?

A

Botox
Pneumatic balloon dilation

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21
Q

What is one surgical treatment for achalasia?

A

Myotomy- affected muscle is cut to allow better passage of solids and liquids from the oesophagus to the stomach

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22
Q

What are some of the long term complications of untreated achalasia?

A

Aspiration pneumonia and lung disease
Increased risk of squamous cell oesophageal carcinoma

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23
Q

What is the most common oesophageal disease?

Study These Flashcards
A

Gastro-Oesophageal Reflux Disease

24
Q

What causes GORD?

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A

Acid and bile exposure to the lower oesophagus from the stomach

25
What are some of the symptoms for GORD?
Heartburn Waterbrash (too much saliva so combines w stomach acid and backs up into throat) Cough Sleep disturbance
26
What are some of the risk factors for GORD?
Pregnancy Obesity Drugs lowering LOS pressure Smoking Alcoholism Hypomotility
27
Who are most likely to be affected by GORD>?
Men> women Caucasian > Black > Asian
28
Why is endoscopy a poor diagnostic test for GORD?
Patient often has no oesophageal abnormality
29
When would an endoscopy be performed in someone with GORD?
When alarm symptoms are present e.g. weight loss, dysphagia, vomiting).
30
Which other problem can cause GORD?
Hiatus hernia
31
What are the two types of hiatus hernia?
Sliding Para-oesophageal
32
What happens in a hiatus hernia?
Fundus of stomach moves proximally through the diaphragmatic hiatus.
33
What are some of the complications of GORD?
Ulceration Stricture Carcinoma Barrett's oesophagus- glandular metaplasia
34
Describe what happens in Barrett's oesophagus.
Squamous epithelium changes to mucus-secreting columnar epithelium in the lower oesophagus in response to acid exposure.
35
What is Barrett's oesophagus a precursor for?
Dysplasia/adenocarcinoma
36
What are some possible treatments for Barrett's oesophagus?
Endoscopic mucosal resection Radio-Frequency Ablatic Rarely but sometimes oesophagectomy
37
Which drug is the main drug used to help treat GORD after dealing with any lifestyle changes?
Proton pump inhibitors.
38
What are the two types of oesophageal cancer?
Squamous cell Adenocarcinoma
39
What is the presentation for oesophageal cancer?
Progressive dysphagia Anorexia and weight loss Odynophagia Chest pain Cough Pneumonia Vocal cord paralysis Haematemesis
40
Describe a squamous cell carcinoma.
Often large exophytic, occluding tumours
41
Where in the oesophagus would a squamous cell carcinoma occur?
First 2/3 of oesophagus
42
What are two significant risk factors for an oesophageal squamous cell carcinoma?
Smoking and alcohol
43
Where in the oesophagus would an adenocarcinoma occur?
Distal end, last 1/3
44
What are some predisposing factors for an oesophageal adenocarcinoma?
Male Obesity Middle aged Caucasian
45
Which condition is an oesophageal carcinoma associated with?
Barrett's oesophagus
46
Which investigation helps to diagnose oesophageal cancer?
Endoscopy
47
Which investigations can be useful in the staging of oesophageal cancer?
CT scan PET scan Bone scan Endoscopic ultrasound
48
What is the only potential cure for oesophageal cancer?
Oesophagectomy +/- chemotherapy
49
Which patients can get an oesophagectomy?
Those <70 with localised disease
50
As most patients with oesophageal cancer present late, what treatment can be offered?
Palliative treatment
51
In those with incurable oesophageal cancer, what is the main priority?
To get rid of the dysphagia
52
How can patients w incurable oesophageal cancer be treated of their dysphagia?
Endoscopic insertion of stent
53
Name the condition- Chronic immune/allergy related condition Affects children and young adults more Incidence and prevelance are increasing Symptoms of oesophageal dysfunction
Eosinophillic Oesophagitis
54
What's the presentation of Eosinophillic Oesophagitis?
Dysphagia and food bolus obstruction
55
What is the treatment for Eosinophillic Oesophagitis?
Topical/swallowed costisteroids Dietary elimination Endoscopic dilatation
56

Year 2- GIT (37 decks)

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