Oesophageal disorders

Question 1

what level does the osephage start at

Answer 1

c6

Question 2

what level does the oesphagus end at

Answer 2

t11/t12

Question 3

what lines the eosphagus

Answer 3

stratified squamous epitheilum

Question 4

what nerve control osephagel swallowing

Answer 4

vagus

Question 5

what level of resting pressure is n the lower oesophagl shincter

Answer 5

high

Question 6

what are teh symptoes of osephgal disesae

Answer 6

heart burn, waterbrash- bad taste in mouth, cough

Question 7

what food/ drinks make reflux worse

Answer 7

, alchol nicotine due to reduded los pressure

Question 8

what are teh symptoms of oesophageal dysphagia

Answer 8

difficulty swallowing certain flood adn liquids

Question 9

what is the location of osephagl dysphai

Answer 9

oropharyngeal or oesophageal

Question 10

what to ask about osephagl dysphagia

Answer 10

type of food, pattern, ascoaced symptoms (weightlso, reguarataion, cough)

Question 11

what are teh causes of oesophagus disease

Answer 11

benign strucres, malignatn strucies, motility disorders (achalsaia, presbyosepgus, eosphilic oesphagits, extrins compression (lung cancer)

Question 12

investigon for oesophagel disase

Answer 12

endocops either upper gi endocopy
or
oesophago gastro duodenscopy

contrast radiobly - barium swallow

oesophagla ph metry ( sensor with ph messauerement) can be over 48 hr

osephagle manomenty (measere the movement of the oesphage

Question 13

examples of hypermotilty osepgal disoeres

Answer 13

diffuse oespagel spasm

Question 14

examples of hypomotiily disorders

Answer 14

ct disease, diabetes neurooyr

Question 15

effect of diffusre osep;gal spasm

Answer 15

sever episoic chest pain whihc could be confused with mi
hypertrophic structures
uncorodeanted smooth muscles control

Question 16

what does hypermovbily look like on a barium swallow

Answer 16

corkscrew apparance

Question 17

what fialures in hypo mobility

Answer 17

los

Question 18

what is achalasia

Answer 18

loso of fuciton of teh myenteric pleus gangion in the oespalga nd los, meaning los will not relax

Question 19

when does achalasi normally occur

Answer 19

3rd to 5th decade

Question 20

what are the sympoms of achalasia

Answer 20

progressive dysphagia for solids and liquids
weight loss
chest pain
regurgitation and chest infection

Question 21

what are the treat ment for achalmisa

Answer 21

phacologica - nitrates, ccb,
endoscopic
endoscopic, botox pnuatic ballow dilati;on
radiloc pnumait baloown dilation
surgical myotomy

Question 22

complicaitons of aschlasion

Answer 22

asopirational pneumonia and lung disease
incraed risk of squamous cell oesophageal carcinoma

Question 23

what percent of adults hae gord

Answer 23

7%

Question 24

what are teh symptoms of gord

Answer 24

heartburn, cough, water brash, sleep disturbance

Question 25

what are the risk factors for gord

Answer 25

pregnacy, obesity, drugs lowering los pressure, smoking, alcholism, hypomotility

Question 26

what gender and ethnicyt does gord mainly effect

Answer 26

men and cuacation and black ethnicty

Question 27

does gord need diganosic testing to be diagnosed

Answer 27

no

Question 28

will endoscopy show evidnece of gord

Answer 28

not in almostalll cases

Question 29

what are the alarm features of gord

Answer 29

weight loss, vomminting, dysphargia

Question 30

what physiological things can cause gord

Answer 30

transient relaxitoin of los hypotensive los delayed gastic tempting osepgal acid clearance is reduced tissue resiance to acid/ bile is reduced

Question 31

what anatomical absomailes can cause gord

Answer 31

hiatus herina

Question 32

what are type 1 and type 2 hiatus hernia

Answer 32

1 - sliding( expansino of bolottom of hiatus) , 2 para osepgal (septarte part of ufncgus is through)

Question 33

what age is nomrally experice hiatus hernia

Answer 33

over 50 years old

Question 34

what are the complication of gord

Answer 34

ulceration stricutre glandular metaplaseia carcinoma

Question 35

what is barretts spaghsus

Answer 35

damage to the disatla end as a reuslt to prolonged acid exposure

Question 36

what chagne is seen in barretts oesophagus

Answer 36

squamous to mucin sequcion columnar cells nthe lower oespghaus

Question 37

what is a risk of barretss oespaghsu

Answer 37

substancly higher likleyhood of developig osephagul cancer

Question 38

what is the treatment for barretss oesphagus

Answer 38

endoscopic mucosal reseciton ( using laser to remove part of osepahgsu surface) ratio frequcly ablaton oseophagluly (removing part or all of oesophagus)

Question 39

what is the treatment for gord

Answer 39

lifestyle measure e.g. lose weight, reduce caffeine, pharmacological, alginates e.g. gaviscaon h2 receptor antageon e.g. ranitidine proton pump inhibtors e.g omeprazole and lansoprazole anti reflux surgery

Question 40

how commmon is oesphagul cancer

Answer 40

5th ranced in cancer moroatly ranked

Question 41

what type of cancer is the most common in western world

Answer 41

adenocarcinam then squamous

Question 42

what type of cancer is most common in developing word

Answer 42

squamou then adenocarcima

Question 43

what are the sympoms of osepahg cancer

Answer 43

anorexia and weighloss progressive dysphagia odynophagia (painful swallowing) chest pain cough pnumia vocal cord paralysh haematomesis (vomiting blood)

Question 44

squamous cell carcinoma location on oepshaus

Answer 44

proximal and middl ethrid of oesphaus

Question 45

what are risk factors for squamous cell caricnoma

Answer 45

toacco, alchol, and possibly vitamen deficenty

Question 46

what other symphtoms are there with squamous cell carcinoma

Answer 46

achalasia, caustic strictures, plummer vinson syndrome

Question 47

what is the apperance of squamous cell carinoma

Answer 47

large exophytic occluding tumours

Question 48

where are adenocarcona often foudn

Answer 48

distal oesophaugs

Question 49

what are adenocarcinoma associed with

Answer 49

barreets oesophaugs

Question 50

what is the prognos of oesphagus cancer

Answer 50

5 year srvivcal less than 10%

Question 51

what is the investigatio for oesphagel cancer

Answer 51

endocpy and bi[ys stadging - ct endoscopic ultrasound pet scan bone scan tnm classification for staging

Question 52

what is the metasions of osepahgul cancer

Answer 52

fast progresioin due to no serosla linging in mesiaum it can inveate heart tracheal and aorat meatai in hepatic, brain, pulmonary and bone

Question 53

what are the treatement opitons for oesphagul cancer

Answer 53

surgical oesophagectomybefore and after chemothearphyy (high mobidy (10%)) nutrionla support chemo and radiotherapy inpove surpval after 1 year radio therapy brachylytherpy

Question 54

what is eospillic oshgaics

Answer 54

chronci immune allergen mediated contion defiend by clinclly by spomy of oepshagl dysction and pathology by eosinophulllinc filgtation in the abscenf of secionary causes

Question 55

what is teh teratment for eospillic oespgis

Answer 55

corticosteraiod dieteary elination endocpoic dilation