3.2.2 Esophageal Disorders

Question 1

What is the basic mechanism of antacids?

Answer 1

Act as a buffer on acid in the stomach

Question 2

What is achalasia?

Answer 2

Loss of peristalsis in the distal esophagus

Failure of Lower esophageal sphincter relaxation with swallowing

Question 3

All patients with GERD should elevate head of bed (T/F)

Answer 3

False - Only patients with nocturnal symptoms

Question 4

How will a barium swallow appear in a patient with achalasia?

Answer 4

Bird-beak appearance - caused by persistently contracted LES

Question 5

What is pill induced esophageal injury?

Answer 5

Question 6

What are some of the mechanisms of GERD?

Answer 6

Defective esophageal clearance

LES dysfunction

Hiatal hernia

Delayed gastric emptying

Increased intra-abdominal pressure

Question 7

What is the treatment of eosinophilic esophagitis?

Answer 7

Topical steroids

PPI

6 point elimination diet

Esophageal dilation

Question 8

What is Schatski’s ring?

Answer 8

Question 9

Draw a flow chart that characterize the different types of heartburn

Answer 9

Question 10

What are the extraesophageal manifestations of GERD?

Answer 10

Question 11

GERD patients should lose weight (T/F)

Answer 11

True - increased intraabdominal pressure is found to be in close correlation with GERD

Question 12

Cimetidine, Rantidine, and Famotidine are what types of drugs?

Answer 12

Histamine Receptor Antagonists

Question 13

What is eosinophilic esophagitis?

Answer 13

Allergic inflammation of the esophagus - high eosinophil count

PPI does not help

Question 14

What is Barrett’s esophagitis?

Answer 14

This is a metaplastic reaction that results in the change of the esophageal squamous epithelium to columnar

Question 15

What are the symptoms of achalasia?

Answer 15

Progressive dysphasia for solids and liquids

Question 16

What is a peptic stricture?

Answer 16

Scar tissue that has formed from chronic inflammation

Question 17

In normal patients what is the cause of stomach acid in the esophagus for short periods of time?

Answer 17

Transient lower esophageal relaxation

Question 18

What is GERD defined as?

Answer 18

Defined as symptoms or complicaton resulting from the reflux of gastric contents in the esophagus

Question 19

Atypical reflux symptoms respond well to treatment (T/F)

Answer 19

False - heartburn and regurgitation respond well

Question 20

What is esophageal hypersensitivity?

Answer 20

Patients that are sensitive to physiologic amounts of acid

Patients tend to respond to high levels of PPIs

Question 21

Omeprazole is what type of drug?

Answer 21

Proton pump inhibitor

Question 22

What is NERD?

Answer 22

Non erosive reflux disease

The response to proton pump inhibitors is less in NERD than GERD

Question 23

Draw a flow chart of treatment of acid reflux

Answer 23

Question 24

All patients with GERD should change diet (T/F)

Answer 24

False - no supporting evidence

Question 25

PPIs can have what side effects?

Answer 25

C. Diff

Pneumonia

Increased risk of CKD

Question 26

GERD puts a patient at increased risk of?

Answer 26

Esophageal carcinoma

Question 27

What is the endoscopic appearance of eosinophilic esophagitis

Answer 27

Question 28

What are the different classifications and management of Barrett’s?

Answer 28