Diseases of the Esophagus Flashcards
Pt with Asthma symptoms and GERD not responsive to antacids. Allergic, eosinophilic infiltration of the esophagus
Eosinophilic esophagitis
Outpouching of posterior hypopharynx, men over 60, regurgitant symptoms several hours after eating, halitosis
Zenker diverticulum
Decreased peristalsis, increased sphincter tone, slowly progressive dysphagia, episodic regurgitation. Barium swallow: parrot-beak - dilated esophagus tapered to distal obstruction
Achalasia
Dysphagia to liquids and solids caused by injury at brainstem or cranial nerves
Neurogenic dysphagia
Corkscrew appearance on barium swallow
Diffuse Esophageal Spasm
Caused by forceful vomiting. Associated with alcohol use, upper endoscopy showing superficial longitudinal mucosal erosions
Mallory Weiss tear
Progressive dysphagia to solid foods along with weight loss, reflux and hematemesis
Esophageal Neoplasms
Complication of Barrett’s esophagus (screen barrett’s patients every 3-5 years with endoscopy), affects distal (lower) 1/3rd of esophagus
Adenocarcinoma of the esophagus
Associated with smoking and alcohol use, affects proximal (upper) 2/3rds of esophagus, progressive dysphagia, weight loss, hoarseness
Squamous cell carcinoma of the esophagus
Esophageal webs + dysphagia + iron deficiency anemia
Plummer-Vinson Syndrome
Solid food dysphagia in a patient with a history of GERD
Esophageal strictures
Often asymptomatic until hematemesis often a complication of portal hypertension (from cirrhosis)
Esophageal varices
What level of eosinophilia is diagnostic of eosinophilic esophagitis on biopsy?
> 15 eosinophils/HPF
In addition to peptic stricture what is another complication of chronic GERD?
Barrett’s esophagus
What is the Dx? Hematemesis from esophageal laceration after forceful retching.
Mallory-Weiss tear
Motility disorder caused by degeneration of Auerbach’s plexus?
Achalasia
What medication may be used to treat stable esophageal varices?
Beta blockers
Name 2 viruses seen in infectious esophagitis.
HSV (Herpes Simplex Virus) and CMV (Cytomegalovirus)
In which conditions do you often see infectious esophagitis?
Immunocompromised: HIV, Cancer patients, Bone marrow transplant patients
Medication used to treat candida esophagitis?
fluconazole
What conditions are associated with eosinophilic esophagitis?
Allergic conditions - Asthma
What type of esophagitis is often caused by bisphosphonates?
non-infectious
A patient complains he regurgitates small amounts of food back into his mouth. He also has noted very foul-smelling breath. What do you suspect?
Zenker’s diverticulum
What medication is indicated for the prevention of esophageal varices?
Beta Blockers - Nadolol or propranolol
