Ch. 14 slide 35-66 Flashcards

1
Q

what is esophagitis? MC cause? % of U.S. adults?

A

esophageal inflammation; reflux esophagitis (GERD); 25-40% of adults

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2
Q

what is Chemical esophagitis?

A

acute, self-limited; tobacco, alcohol, pill-induced etc.

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3
Q

what is infectious esophagitis?

A

MC secondary to Ulcer; HSV, CMV, fungal; severe mucosal necrosis

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4
Q

Mallory-Weiss tear?

A

MC cause of esophageal laceration; inadequate LES relaxation

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5
Q

Hematemesis occurs in 80% of upper G.I bleeds from a Mallory-Weiss tear

A

false; 50%

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6
Q

what is a hiatal hernia?

A

widening of esophageal hiatus

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7
Q

types of hiatal hernia?

A

Axial (sliding)- bell shaped, MC 95%

Non-axial (rolling)- separate portion of stomach protrudes, prone to strangulation or obstruction

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8
Q

hiatal hernias occur in 90% of all adults and only 20% of those are asymptomatic

A

false; 20% of all adults get one; 90% are asymptomatic

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9
Q

hiatal hernia symptoms?

A

esophagitis; possible perforation; MC among non-axial type

DDx: angina pectoris; GERD

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10
Q

what is barrett esophagus?

A

esophageal metaplasia- stratified squamous and columnar epi with goblet cells; distal esophagus; preneoplastic lesion

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11
Q

who is at risk for Barrett esophagus?

A

males 4x; Caucasians 30-100x, obese; 40-60 yrs. old; family hx.

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12
Q

complications of Barrett esophagus?

A

esophageal carcinoma (30-100x); ulcerations, strictures; METAPLASIA- red, velvety mucosa, the bands extend superiorly

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13
Q

types of esophageal tumors

A

leiomyoma; adenocarcinoma (50% of US esophageal cancer); squamous cell carcinoma (MC worldwide, 90% of esophageal cancer)

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14
Q

Esophageal adenocarcinoma

A

developed nations; MC in late stages- obstruction, vomiting, cachexia, fatigue
Early invasion of lymphatic’s has POOR prognosis <25%

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15
Q

esophageal adenocarcinoma doesn’t have a diffuse infiltration, its in the upper 1/3 of esophagus, & is not associated with TP53.

A

false; distal 1/3, Does have diffuse infiltration with flat or raised patches; commonly has TP53 mutation early on.

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16
Q

who is at risk for esophageal squamous cell carcinoma

A

> 45 male (4x), Af. Am. (6x), alcohol, tobacco, HPV (3x); rural, underdeveloped, poverty

17
Q

esoph. squam. cell carc. has a poor prognosis if mets to lymphatics

A

true; <10% 5 year survival

18
Q

features of esoph. squam. cell carc.

A

may cause strictures/rigidity, hemorrhage, or fistula; dysphagia, odynophagia, cahexia

19
Q

where does esoph. sqam. cell carc. occur?

A

middle 1/3 of esophagus

20
Q

what is gastritis? risks? types?

A

inflammation of gastric mucosa;

risks: alcohol, nsaid’s, age, chemo; commonly asymptomatic
types: acute & chronic

21
Q

acute gastritis

A

acute inset: transient inflam. neutrophils

-acute erosive hemorrhagic gastritis is possible

22
Q

acute peptic ulceration

A

severe stress; NSAID’s; coffee ground hematemesis; heal within days/weeks

23
Q

chronic gastritis

A

less severe, more prolonged; assoc. with peptic ulcers

24
Q

complications of chronic gastritis

A
peptic ulcer disease
gastric adenocarcinoma (5x)
25
10-20% of chronic gastritis have h. pylori infxn.
false; 70-90%
26
effects of chronic gastritis
inc. acid prod.; epi metaplasia MC ~60 yrs. old pernicious anemia- Ab's to parietal cells
27
Peptic ulcer disease (PUD)
develops in highly acidic areas: Prox. duodenum (4x); gastric antrum Has solitary "punched out " lesion
28
PUD causes
NSAID; heli. pylori; older age, alcohol, smoking, corticosteroids
29
Does PUD have epigastric pain?
yes; MC at night 1-3 hours after eating, relieved by alkaline substances
30
treat PUD?
antibiotics, PPI's, H2 receptor antagonist | if perforation/hemorrhage= medical emergency
31
duodenal PUD
relieved by food; pain returns 1-3 hours after eating
32
gastric PUD
less predictable- empty stomach or after eating
33
shared charac. of duodenal & gastric PUD
relieved by alkaline; worse at night; inconsistent pain patterns
34
what are gastric polyps? MC type?
mass projecting from mucosa; inflammatory & hyperplastic polyp MC (75%)
35
what makes up more than 90% of gastric cancers?
gastric adenocarcinomas
36
where is gastric adenocarc. MC? risks?
japan (20x); h. pylori, EBC
37
symptoms of gastric adenocarc.
MC develop late; gastritis, nausea, anorexia, weight loss, altered bowels, anemia, hemorrhage