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Flashcards in Quiz 3 Deck (83)
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1

Esophageal atresia:

incomplete formation of the esophagus, with abnormal connection to the stomach; N/V common; typically easy to fix surgically.

2

Plummer-Vinson:

difficulty swallowing and esophageal webs d/t iron deficiency anemia

tx with iron supplementation

3

Achalasia - features:

Increased pressure at LES
diminished peristalsis in lower 1/3 of esophagus
lack of coordinated LES relaxation w/swallowing

4

Achalasia - Dx:

Manometry & Barium swallow (bird-beak)

5

Achalasia - etiology:

lymphocytic infiltration of Auerbach's plexus
destruction of ganglion cells
mb autoimmune, toxin, or infectious cause

6

Nutcracker esophagus:

dysphagia d/t over-vigorous peristaltic contraction (>180mmHg)

7

Mallory-Weiss syndrome - features:

bleeding tears in the stomach/esophageal jct, involving the mucosa & submucosa layers (NOT muscular layer)
typically caused by vomiting, retching, and severe coughing

mimics angina, relief with nitroglycerine (like MI), but occurs anytime (doesn't follow worse-exertion-better-rest MI pattern)

8

Boerhaave's syndrome - features:

full-thickness tear or rupture of esophageal wall
allows leak into mediastinum
caused by vomiting, lye, or rupture d/t instrumentation (scope)

9

Diffuse esophageal spasm (DES) - features:

corkscrew esophagus
uncoordinated contractions (several segments contract simultaneously, inability to progress bolus)
intermittent dysphagia
occasional angina

10

Most common cause of esophagitis:

GERD

also caused by chemical injury (acid or alkaline solution)

Candida/CMV/HSV cause in immunocompromised

11

GERD - cause:

change in barrier btw stomach and eso
* abnormal LES relaxation
* hiatal hernia
* increased intra-abdominal pressure (pregnancy, straining)

12

Two types of hiatal hernia:

Sliding
Paraesophageal

13

Sliding hiatal hernia is:

where GE jct & upper stomach move above the diaphragm

14

Paraesophageal hiatal hernia is:

upper stomach moves up and alongside distal esophagus (no mvmt of GE jct; more likely to incarcerate)

15

Schatzki ring:

narrowing of the lower part of the eso d/t ring of mucosal & submucosal tissue
causes intermittent dysphagia &/or obstruction

A ring: above GE jct
B ring: AT the squamocolumnar jct (SQJ)

Most common - B ring

16

Barrett's esophagus - features, cause:

metaplasia of cells at the distal eso - from squamous to columnar

thought to be caused by chronic acid exposure (GERD) to better withstand erosive action

increased risk of adenocarcinoma

17

Barrett's esophagus - Dx:

Biopsy and histological confirmation

18

The metaplastic cells of Barrett's can be two types:

gastric - similar to stomach cells, elongated columnar/goblet cells

colonic - similar to intestinal mucin-producing cells, worse prognosis, increased malignancy

19

Most common cause of esophageal varies:

cirrhosis secondary to portal HTN
serious risk for hemorrhage (bleed + clotting problems)

20

Esophageal varices are:

dilated sub-mucosal veins in the lower 1/3 of the esophagus

21

How are esophageal varices treated:

banding - very effective treatment, tissue eventually necroses and sloughs off.

doesn't affect primary cause (portal HTN) so recurrence is quite common!

22

Caput medusa:

distended & engorged appearance of peri-umbilical veins, not typically seen w/o portal HTN

23

Nearly 2/3 of benign esophageal tumors are:

leiomyomas

24

The gold standard for dx tissue growths:

biopsy

25

Granular cell tumors arise from:

Schwann cells

typically benign
can develop anywhere in the body
esophagus most common GI site

26

Two main forms of esophageal cancer:

Squamous cell carcinoma
Adenocarcinoma (glandular mucin-producing cells)

27

Esophageal cancer that arises from cells in the upper esophagus:

Squamous cell carcinoma

assoc w/alcohol & tobacco use
unexpected weight loss
low albumin

28

Esophageal cancer that arises at the GE jct:

Adenocarcinoma

Hx of GERD & Barrett's

29

Cytological features of esophageal adenocarcinoma:

increased number of mitotic figures
variable nuclear size, staining, shape

30

In situ means:

basement membrane is intact
only in this site
does not have the capacity to enter circulation/lymph