Path III Quiz 3 Esophagus Flashcards Preview

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Flashcards in Path III Quiz 3 Esophagus Deck (41):
1

What is most common type of esophageal atresia?

distal fistula

2

- Where are congenital esophageal webs located?
- Where are acquired esophageal webs?

congenital: distal (middle and inferior 1/3)
aquired: proximal 2/3 (top/cervical area)

3

What does achalasia look like on an x-ray?

bird beak

4

What is achalasia?

- Increased pressure and tone at lower esophageal sphincter
- Diminished or absent peristalsis
- Lack of coordinated LES in response to swallowing (can't relax)

5

Histology of achalasia?

- lymph infiltrate of auerbachs plexus
- fibrosis
- loss of auerbachs plexus = no peristalsis in lower esophagus

6

What is etiology of iopathic achalasia according to study findings?

autoimmune and highly related to emotional problems

7

Where is auerbachs plexus located?

between longitudinal and circular layers of muscularis externs in GI tract
- parasympathetic and sympathetic fibers

8

Diffues Esophageal Spasm (DES)

- corkscrew esophagus
- contractions are uncoordinated
- several segments contract at same time
- dysphagia

9

Nutcracker esophagus

- contractions are coordinated
- amplitude is excessive

10

Mallory Weiss Syndrome

Bleeding from tears in mucosa at gastro esophageal junction
- involves mucosa and submucosa, but not muscular layer
- caused by coughing, vomitting
- associated with alcoholism and NSAID abuse

11

Boerhaave's Syndrome

- full thickness tear or rupture in esophageal wall
- from severe vomitting or coughing, perforation of ulcer, lye poisoning

12

Most common cause of esophagitis

GERD

13

Most common infection to cause esophagitis

candida in immunocompromised

14

Histology of candida infection

budding hyphae

15

Sliding hiatal hernia

gastroesophageal junction moves above diaphragm with some of the stomach

16

What is esophagtits called if it is caused by GERD?

reflux esophagitis

17

GERD

mucosal damage to esophageal lining due to stomach acid reaching the esophagus
- caused by changes in barrier between stomach and esophagus:
- abnormal relaxation of LES
- hiatal hernia

18

Paraesophageal hernia

part of stomach herniates through diaphragm and lies next to esophagus without movement of GE junction

19

Shatski Ring

form of web near gastro-esophageal junction that marks proximal margin of hiatal hernia
- A ring above esophagus/stomach junction
- B ring lower esophagus at squamocolumnar junction.
- B is more common

20

Barrett's Esophagus

transformation of cells at lower esophagus from squamous to columnar epithelium

21

What type of cancer is Barrett's esophagus more likely to acquire?

Adenocarcinoma due to metaplastic changes

22

In Barretts' esophagus, what type of metaplasia is associated with increased risk of malignancy in genetically susceptible individuals?

Colonic type

23

What type of cancer are pt with Barrett's esophagus at higher risk for?

Adenocarcinoma

24

What are the cellular changes associated with malignancy?

1) increased nucleus to cytoplasm ratio due to cells undergoing division
2) abnormal nucleus: dark stain, increased mitotic figures
3) Abnormal cell shape

25

Esophageal Varices

dilated veins in lower 1/3 of esophagus

26

What is #1 etiology of esophageal varices?

Cirrhosis due to portal HTN backing up

27

What is #1 cause of cirrhosis in US?

alcoholism

28

What is risk of esophageal varicose?

hemorrhage

29

What is most common cause of cirrhosis worldwide?

hep B or C

30

What pressure is considered portal HTN?

>5mmHg

31

Granular Tumor

benign
from schwann cells
can be anywhere in body
smooth, pink, normal

32

Henangioma

benign
from blood vessels

33

Leiomyoma

from smooth muscle
benign
smooth

34

What is most common benign esophageal tumor?

leiomyoma = 2/3 of all benign esophageal tumors

35

leiomyosarcoma

malignant

36

Where is adenocarinoma found?

lower 1/3 esophagus
associated with Barrett's and GERD

37

Where is SCC found?

upper 2/3

38

What is most common esophageal cancer worldwide?

SCC

39

What is most common esophageal cancer in US?

adenocarcinoma

40

Hist of adenocarcinoma?

- normal squamous epithelium becomes glandular
- crypt cells
- columnar
- goblet cells
- darker staining nuclei

41

Hist of SCC

- in situ: basement membrane is intact
- full thickness replacement with dysplastic cells