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GI - 2 > 17-2 -- Esophagus > Flashcards

17-2 -- Esophagus Flashcards

1
Q

3 Functional causes of Esophageal obstruction?

A

Nutcracker Esophagus
Diffuse Esophageal Spasms
LES dysfunction - increased pressure

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2
Q

What can cause Zenker Diverticulum?

A

Increased intraesophageal pressure

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3
Q

Functional causes of Esophageal obstruction disrupt?

A

Coordinated peristalsis

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4
Q

What can cause Benign Esophageal Stenosis?

A

Inflammation and scarring from GERD

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5
Q

How does Benign Esophageal Stenosis differ from carcinomas?

A

Patient maintains appetite and weight

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6
Q

Esophageal webs are associated with?

A

GERD, skin diseases, graft vs. host

Plummer Vinson Syndrome

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7
Q

Plummer Vinson Syndrome

A

Iron deficient anemia, Cheilosis, Koilonychia, Glossitis

=> Esophageal webs

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8
Q

Semi-circumferential lesions in the esophagus

A

Webs

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9
Q

Circumferential and thicker lesions in the esophagus

A

Schatzki’s rings

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10
Q

2 Types of Schatzki’s rings?

A

Type A - Above GE junction

Type B - @ Squamocolumnar juction

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11
Q

Type A Schatzki rings are covered by what type of mucosa?

A

Squamous

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12
Q

Type B Schatzki rings are covered by what type of mucosa?

A

Gastric mucosa

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13
Q

Triad of Achalasia?

A
  1. Incomplete LES relaxation
  2. Increased LES tone
  3. Aperistalsis of esophagus
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14
Q

Triad of Achalasia?

A
  1. Incomplete LES relaxation
  2. Increased LES tone
  3. Aperistalsis of esophagus
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15
Q

Primary Achalasia is due to?

A

Degeneration of Nitric Oxide producing neurons that normally relax LES

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16
Q

Secondary Achalasia is due to?

A 
Chagas disease (Trypanosoma Cruzi)
- Destroys myenteric plexus
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17
Q

In what direction are Mallory Weiss Tears?

A

Longitudinal mucosal tears

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18
Q

What usually causes Mallory Weiss Tears?

A

Alcohol use that results in severe retching and vomiting

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19
Q

In what esophageal tear will it likely present with hematemesis?

A

Mallory Weiss Tear

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20
Q

In what esophageal tear will it likely present with chest pain, tachypnea, shock?

A

Boerhaave Syndrome

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21
Q

Describe how Esophageal Varices (dilated veins) arise?

A
  • Portal Hypertension causes impaired blood flow
  • Collateral veins develop
    = Some drainage occurs but then also causes congestion and dilation of the venous plexuses in esophagus and stomach
22
Q

Describe how Esophageal Varices (dilated veins) arise?

A
  • Portal Hypertension causes impaired blood flow
  • Collateral veins develop
    = Some drainage occurs but then also causes congestion and dilation of the venous plexuses in esophagus and stomach
23
Q

4 treatment options if Esophageal Varices rupture?

A
  • Splanchnic Vasoconstriction
  • Sclerotherapy (thrombotic agents)
  • Balloon Tamponade
  • Variceal Ligation
24
Q

4 treatment options if Esophageal Varices rupture?

A
  • Splanchnic Vasoconstriction
  • Sclerotherapy (thrombotic agents)
  • Balloon Tamponade
  • Variceal Ligation
25
Q

Those who had Esophageal Varices rupture are at an increased risk for recurrent hemorrhage within?

26
Q

3 common causes of Infectious Esophagitis?

A
  • Herpes Simplex Virus
  • CMV
  • Candidiasis
27
Q

If Herpes Simplex Virus is causing the Infectious Esophagitis, how will the ulcers look?

A

Deep, punched out appearance

28
Q

If Herpes Simplex Virus is causing the infectious Esophagitis, how will the histo present?

A

Viral nuclear inclusions @ margin of ulcer

- in degenerating, multinucleate, epithelial cells

29
Q

If Herpes Simplex Virus is causing the infectious Esophagitis, how will the histo present?

A

Viral nuclear inclusions @ margin of ulcer

- in degenerating, multinucleate, epithelial cells

30
Q

If CMV is causing the Infectious Esophagitis, how will the ulcers look?

A

Shallow, superficial

31
Q

If CMV is causing the Infectious Esophagitis, how will the histo present?

A

Nuclear and Cytoplasmic inclusions in capillary endothelium

32
Q

If CMV is causing the Infectious Esophagitis, how will the histo present?

A

Nuclear and Cytoplasmic inclusions in capillary endothelium

33
Q

What is the most frequent cause of Esophagitis?

34
Q

GERD can be caused by?

A

LES relaxation

35
Q

Barrett’s Esophagus creates an increased risk for?

A

Esophageal Adenocarcinoma

36
Q

How can Barrett’s Esophagus be diagnosed?

A

EGD with biopsy

- Columnar cells + Goblet cells instead of stratified squamous at the distal esophagus

37
Q

Esophageal tumors that are submucosal, mesenchymal, and usually smooth muscle tumors are?

38
Q

SCC/Adenocarcinoma - location

A

SCC - Iran, China, Hong Kong

Adenocarcinoma - US, UK, Canada

39
Q

SCC/Adenocarcinoma - risk populations

A

SCC - African American Males

Adenocarcinoma - White Males

40
Q

SCC/Adenocarcinoma - risk factors

A

SCC - tobacco, alcohol, poverty, HOT beverages, LOW fruits and veggies, esophageal injury
Adenocarcinoma - GERD, Barrett’s Esophagus, tobacco

41
Q

What can decrease the risk for developing Adenocarcionma?

42
Q

What in Kenya can increase risk for developing SCC?

A

Mursik (fermented milk)

- Contains Acetaldehyde

43
Q

Increased SOX2 and Cyclin D1

44
Q

Increased SOX2 and Cyclin D1

45
Q

SCC/Adenocarcionma - location

A

SCC - Middle 1/3 of esophagus

Adenocarcinoma - Lower 1/3 of esophagus

46
Q

1st symptoms of SCC?

A

Aspiration of food due to TE fistula

47
Q

Aspiration of food due to TE fistula may indicate?

48
Q

Small, grey plaques that grow into tumor masses that may cause obstruction are seen with?

49
Q

Flat or raised patches that can infiltrate or ulcerate are seen with?

A

Adenocarcinoma

50
Q

What do Adenocarcinomas produce/form?

A

Produce Mucin

Form Glands

51
Q

What cells can be seen with Adenocarcinomas?

A

Signet Cells

52
Q

What do Adenocarcinomas produce/form?

A

Produce Mucin

Form Glands

GI - 2 (61 decks)

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