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FUN MED SPRING 2018 > 2. Disorders Of The Esophagus > Flashcards

2. Disorders Of The Esophagus Flashcards

1
Q

What are important questions to ask during a clinical history when evaluating esophageal disorders?

A 
Weight gain or loss
Gastro bleeding
Dietary habits including the timing of meals
Smoking
Alcohol consumption
History of vomiting
History of eating disorders
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2
Q

Sx of esophageal disease.

A

Heartburn. Regurgitation. Chest pain. Dysphagia. Odynophagia. Globus sensation. Water brash.

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3
Q

What is the most useful test for evaluation of the proximal GI tract?

A

Upper Endoscopy (EGD)

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4
Q

What can an EGD be used to detect?

A

Mucosal lesions. Detection of abnormalities id’d by color.

(Can also get biopsy and dilate strictures).

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5
Q

This test provides an assessment of esophageal function and morphology that may be undetected on endoscopy. (Also great or strictures, hernias, diverticula, and abnormal al motility.)

A

Barium radiography.

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6
Q

A pressure-sensing catheter w/in the esophagus that assesses the MOTILITY and FUNCTIONALITY of swallowing.

A

Esophageal Manometry

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7
Q

Combines an endoscope with an ultrasound transducer to create a trans mural image of the tissue (through the wall) surrounding the endoscope tip.

A

Endoscopic ultrasound

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8
Q

Demonstrates excessive esophageal exposure to refluxed gastric juice using a pH-sensitive transmitter or a transnasally positioned wire electrode.

A

Ambulatory Reflux Testing

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9
Q

The most common congenital esophageal abnormality.

A

Esophageal atresia

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10
Q

What parts of the esophagus are not communicating in esophageal atresia?

A

Proximal and Distal portions

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11
Q

Infants with this condition commonly have pneumonia and atelectasis

A

Tracheoesophageal fistula

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12
Q

What is “gastric type epithelium in the proximal cervical esophagus”?

A

Heterotopic gastric mucosa

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13
Q

The most common type of hiatal hernia.

A

Type I-sliding (95%)

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14
Q

Herniation of the gastric cardia and fundus.

A

Type II-paraesophageal hernia

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15
Q

Hernia including the colon.

A

Type IV

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16
Q

Distal esophageal B ring where the lumen is <13mm.

A

Schatki’s ring. “Steakhouse syndrome”. Tx-dilation.

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17
Q

Where are esophageal webs generally found?

A

Proximal esophagus.

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18
Q

Symptoms of Plummer-Vinson syndrome.

A

Iron-deficiency anemia in middle-aged women.

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19
Q

Esophageal diverticula just about the diaphragm.

A

Ephiphrenic

20
Q

Diverticula often caused by TB.

A

Midesophageal

21
Q

Herniation of the mucosa and submucosa through the esophageal muscle (upper esophageal sphincter).

A

Hypopharyngeal (Zenker’s)

22
Q

Dilation of the submucosal esophageal glands.

A

Intramural esophageal pseudodiverticulosis

23
Q

Complete rupture at the lower thoracic esophagus.

A

Boerhaave’s syndrome.

24
Q

Incomplete tear that only affects mucosa and submucosa, may extend to the distal esophagus.

A

Mallory-Weiss Syndrome

25
Q

A patient presents with pleuritic retrosternal pain, HX shows recent endoscopy.

A

Perforation from instrumentation.

26
Q

Diagnostic test for Boerhaave’s syndrome.

A

CT of chest. Esophageal perforation.

27
Q

Tx for Boerhaave’s Syndrome.

A

Nasogastric suction and IV broad-spectrum antibiotics with prompt surgical drainage and repair in non-contained leaks.

Conservative therapy-NPS and antibiotics.

Clipping or stent.

28
Q

A child drank cleaning fluid, what should you be concerned about?

A

Corrosive esophagitis

29
Q

Drugs that can cause radiation esophagitis.

A

Doxorubicin, bleomycin, cyclophosphamide , and cisplatin.

30
Q

What can happen years after radiation therapy (in terms of esophagus)?

A

Submucosal fibrosis and strictures.

31
Q

Pills that can cause pill esophagitis.

A

Bisphosphonates. NSAIDS. Ferrous.

32
Q

You see localized inflammation and shallow ulceration, in the mid-esophagus. Pt. has sudden chest pain.

A

Pill esophagitis.

33
Q

A common cause of hematemesis.

A

Mallory-Weiss Tears

34
Q

What can you use to treat uncontrolled bleeding in Mallory-Weiss tears?

A

Local epinephrine. Cauterization therapy, endoscopic clipping, or angiographic embolization.

35
Q

Most common esophageal cancer worldwide.

A

SCC

36
Q

Major risk factor for adenocarcinoma.

A

GERD and Barrett’s Esophagus.

37
Q

Major risk factor for SCC.

A

Tobacco and alcohol.

38
Q

SCC is usually found….

A

Cervical and thoracic portions of esophagus.

39
Q

Esophageal adenocarcinoma is usually found as…..

A

Dysplastic columnar epithelial cells in the distal esophagus.

40
Q

When healthy esophageal epithelium is replaced with meta plastic columnar and goblet cells.

A

Barrett’s Esophagus

41
Q

Result of damage from prolonged exposure of the esophagus to the gastric acid.

A

Barrett’s Esophagus.

42
Q

This test allows for visualization and ID of tumor.

A

Esophagoscopy.

43
Q

This test is used to assess spread of tumor and any associated lymph nodes.

A

Endoscopic Ultrasonography

44
Q

This test can assess the extent of tumor spread to the mediastinum and para-aortic lymph nodes.

A

CT scan of the chest and abdomen.

45
Q

This test is useful in assessing the presence of distant metastatic diseas.

A

PET

46
Q

Complications of esophageal carcinoma.

A

Metastasis to adjacent and supraclavicular lymph nodes, liver, lungs, pleura, and bone.

Tracheoesophageal fistula may develop.

Hypercalcemia may develop as a paraneoplastic response.

47
Q

Tx for high grade dysphasia, carcinoma in situ, and T1a.

A

Endoscopic mucosal resection and/or ablation.

FUN MED SPRING 2018 (14 decks)

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