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GI Exam 1 > Diseases of the Esophagus > Flashcards

Diseases of the Esophagus Flashcards

1
Q

common symptom with acid reflux?

A

dysphagia - oropharyngeal and esophageal

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2
Q

Esophageal dysphagia: Mechanical obstruction possibilities:

A
  • Schatzkis ring
  • peptic stricture
  • esophageal cancer

SOLID ONLY UNLESS SIGNIFICANT OBSTRUCTION THEN + LIQUID- worry about cancer if quickly cant swallow both

predictable recurrent symptoms

-progressive!

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3
Q

Esophageal dysphagia: Motility disorder possibilities:

A
  • achalasia
  • diffuse esophageal spasm
  • scleroderma

SOLIDS AND LIQUIDS

  • unpredictable and episodic
  • non-progressive
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4
Q

odynophagia is? What does it mean?

A
  • painful swallowing

- denotes severe erosive disease (acid reflx, infection, caustic ingestion, pill induced)

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5
Q

What percent of adults experience HB? How many weekly episodes?

A

40%

20% weekly

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6
Q

What we think causes acid reflux?

A

Not any particular food but just eating causes the LES to relax - some people more than others and in some people the esophagus doesnt clear out (VIA peristalsis) the acid as quick

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7
Q

What to do with hiatal hernias?

A

usually nothing unless they are experiencing a lot of symptoms

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8
Q

WHich condition decreases peristalsis and makes acid reflux diseases worse (less clearance)?

A

scleroderma

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9
Q

Which conditions decrease salivation and make acid reflux worse (less clearance)?

A

shogrens
anticholinergic meds
oral RT

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10
Q

Delayed gastric emptying caused by?

A
  • gastroparesis

- gastric outlet syndrome

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11
Q

GERD - clinical findings:

A
  • HB and non cardaic chest pain
  • relief with antacids
  • regurgitation
  • dysphagia
  • atypical symptoms (chronic cough and asthma, chronic laryngitis and sore throat, globus sensation)
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12
Q

Diagnsois of reflux disease?

A
  • usually based on history alone
  • upper endoscopy
  • response to antacids
  • barium upper GI
  • pH study
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13
Q

How to treat patients with lots of barrett or extremely symptomatic acid reflux?

A

PPIs for life - do not use anyting else - no H2 blockers or antacids

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14
Q

Peptic strictures - presenting and treatment

A
  • patients have erosive disease
  • progressive dysphagia
  • treat with dilators and long term PPI - the “-PRAZOLES”
  • NO SURGERY
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15
Q

Mild acid reflux Tx?

A
  • life style mods!
  • antacids
  • H2 blockers
  • do not lie down after eating
  • lose weight
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16
Q

Tx of Moderate acid reflux:

A
  • Daily H2 blockers

- PPI - the “-prazoles”

17
Q

PPI long term use issue?

A

osteopenia or osteoporosis

18
Q

Severe acid reflux tx:

A

PPI - 90% of patients respond

19
Q

Surgery for acid reflux:

A
  • good relief of symptoms but may need to redo surgery late -need to do a lot of these surgeries to do a good job bc if they wrap the esohagus around the stomach to tighten it up
  • dysphagia, bloating, flatulence side effects
  • only good for 10 years
20
Q

What to do in unresponsive cases of acid reflux?

A
  • Check EGD and pH probe (need to stop PPH use)
  • Rule out Zollinger-Ellison syndrome if still nothing
  • try higer dose PPI
  • consider surgery
21
Q

Best test for acid reflux?

A

pH probe

22
Q

Mallory Weiss Tear

  • what is it?
  • main predisposing factor?
  • patient presentation?
  • Tx?
A
  • non-penetrating tear of the GE junction due to sudden retching or vomiting
  • ALOCOHOLISM
  • present with hematemesis
  • usually self limited-no Tx
23
Q

Diagnostic for Mallory Weiss tear?

A

EGD

24
Q

Infectious esophagitis:

1) presentation?
2) who affected?
3) diagnostic?

A

1) odynophagia!
2) immuno-suppressed - oral thrush, Herpes, CMV
- herpes can affect healthy hosts too
3) EGD with brushings and biopsies

25
Q

Adenocarcinoma:

1) usually due to what?
2) What part most affected?

A

1) due to barrett

* 2) Lower 1/3**

26
Q

SCC:

1) causes?
2) Where

A

1) achalasia; caustic ingestions; tylosis; smoking and ETOH; other head and neck tumors
* 2) upper 2/3*

27
Q

Which is easier to treat?

A

SCC

28
Q

rapidly progressive dysphagia with wieght loss think****

A

esophageal cancer

29
Q

achalasia - what is it? due to?

A

-idiopathic motility disorder

  • loss or peristalsis lower esophagus
  • impaired relaxation of LES
  • denervation of myenteric plexus

-BiRDS BEAK*

30
Q

achalasia- symptoms

A

dysphagia to solids and liquids

  • slow and progressive
  • chest apin
  • regurg of food
  • WL
  • cough and aspiration
31
Q

TX of achalsia

A
  • pneumatic dilation
  • botulinum toxin injection
  • ***SURGICAL MYOTOMY

GI Exam 1 (11 decks)

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