Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

GI > Disorders of the Esophagus High Yield > Flashcards

Disorders of the Esophagus High Yield Flashcards

1
Q

Two types of dysphagia

A
  • Oropharyngeal
  • Esophageal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

2 MC Symptoms of GERD

A
  • Heartburn
  • Regurgitation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

3 Dysfunctions of the GEJ that cause GERD

A
  1. Transient LES relaxation
  2. Anatomic disruption of GEJ
  3. Hypotensive LES
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Typical symptom of GERD

A

Heartburn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Besides heartburn, what else can occur in GERD?

A

Extraesophageal or atypical manifestations

Asthma
Chronic cough
Chronic laryngitis
Sore throat
Non-cardiac chest pain
Sleep disturbances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When do we do further studies on someone with GERD?

A
  • Only if they have alarm symptoms
  • Only if they fail empiric PPIs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What imaging modality is best to observe GERD?

A

EGD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What kind of patient almost always has an associated hiatal hernia?

A

90% of Barrett’s patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which hiatal hernia type is worse?

A

Sliding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

MC Risk factors for hiatal hernia

A
  • Age > 50
  • Obesity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What endoscopic finding is diagnostic of Barrett’s?

A

Biopsy of salmon colored gastric type epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Tx of low-grade Barrett’s

A
  1. Resect
  2. EGD 6mo
  3. Annual EGD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Tx of high-grade Barrett’s

A
  1. Resect
  2. Immediate EGD
  3. 3,6,12 mo EGD
  4. Annually for 5 years, then q3-5years
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Tx of mild, intermittent GERD

A
  1. Lifestyle modifications
  2. Antacids or H2RA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Tx of failed H2RA therapy or severe GERD?

A

PPIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Who gets long-term PPI therapy?

A
  1. Severe erosive esophagitis
  2. Barrett’s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Best surgery for GERD

A

Surgical fundoplication laparoscopically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

3 groups that can get surgical fundoplication

A
  1. Extraesophageal manifestations of GERD
  2. Severe reflux and refuse lifelong PPI
  3. Large hiatal hernias despite PPI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When is gastric bypass better than surgical fundoplication

A

Obese GERD patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Who can use a LINX procedure

A

Hiatal hernias < 3cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What epithelial type is esophageal cancer due to Barrett’s?

A

Adenocarcinoma

MC type of esophageal cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Where are most esophageal cancers located?

A

Distal 3rd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Top two modifiable risk factors that contribute to Squamous cell carcinoma?

A
  • Alcohol
  • Tobacco
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What esophageal cancer type is more common in blacks vs whites and where does it occur in the esophagus?

A

Squamous cell carcinoma in the MIDDLE esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is the common symptom of esophageal cancer?
Significant weight loss
26
How to diagnose esophageal cancer?
EGD with biopsy
27
Treatment of curable eso cancer
Surgery +/- chemoradiation
28
Treatment of INcurable eso cancer
Chemo/chemoradiation, local therapy for obstructions.
29
Two most important predictors of POOR survival in eso cancer
1. Adjacent mediastinal spread 2. Lymph node involvement
30
What is the suspected cause of Zenker's
Loss of elasticity of **UPPER** esophageal sphincter
31
What two things are associated with most Zenker's patients?
* Hiatal hernia * Reflux
32
What unique symptoms suggest Zenker's
* Halitosis * Nocturnal choking * Protrusion of neck
33
Diagnosis of Zenker's
Barium swallow
34
Tx of Zenker's
Myotomy of obstruction and excision of diverticulum
35
What is achalasia
Distal narrowing of esophagus (LES)
36
S/S of achalasia
* Gradual onset of dysphagia for solid foods and liquids * Specific manuevers to eat properly
37
Diagnose achalasia
* Esophageal manometry (#1)
38
Barium swallow result for achalasia
Symmetric bird's beak tapering of the distal esophagus
39
Tx of achalasia
1. **Pneumatic dilation (#1)** 2. Botox 3. Heller myotomy ## Footnote Botox and nitrates for non-surgical candidates
40
Diagnostic finding for diffuse esophageal spasms
Corkscrew esophagus with barium swallow
41
Tx of DES
* CCBs (Dilt) * TCA * SL NTG * Sildenafil * Botox
42
Non-pharm tx of scleroderma
* Eat upright * Drink liquids when swallowing solids
43
Pharm tx of scleroderma
1. PPI 2. Metoclopramide
44
Strong predisposing factor for mallory-weiss tears
Alcoholics
45
What is the most common historical finding in mallory weiss patients?
Lifting, straining, retching, vomiting
46
Diagnose mallory weiss tear
EGD with 0.4-0.5cm linear tear near GEJ or below
47
What makes someone more likely to keep bleeding from a mallory weiss tear
Portal HTN
48
Initial management of mallory-weiss tear
Fluids + transfusions
49
Management of continued bleeding in mallory weiss tears
* Epi * Cautery * Compression * Angiographic arterial embolization for last resort * PPIs
50
Where are webs MC found
Upper to mid esophagus
51
Where are rings MC found
Distal esophagus
52
Tx of a single ring or web
Dilators or incision
53
MCC of esophageal varices
Portal HTN
54
MCC of portal HTN
Cirrhosis
55
Bleeding risk factors for esophageal varices
1. Large > 5cm 2. Red wale markings 3. High child's score (liver severity) 4. Active alcohol abuse
56
Initial management of esophageal varices
1. Acute resucitation via fluids and transfusions. 2. NG tube 3. Supplemental O2
57
4 mainstays of esophageal varices besides stabilizing them
1. IV rocephin 2. Octreotide 3. Vit K 4. Lactulose (prevent ammonia buildup)
58
When is emergent endoscopy and banding indicated in esophageal varices treatment?
AFTER they are hemodynamically stable
59
How to prevent recurrent bleeding of esophageal varices
BBs and variceal band ligation | Propranolol
60
What kind of patients should be screened for esophageal varices and what do they give?
* Anyone w/ cirrhosis * BBs reduce first-time risk
61
When to refer for esophageal varices?
* Upper GI bleeding and suspected varices * Cirrhosis patients
62
When to admit for varices?
Acute upper GI bleed **and suspected cirrhosis** => ICU
63
Last resort treatments for varices
* Balloon tamponades * TIPS
64
MC risk factor to get infective esophagitis
Immunosuppressed
65
3 MC pathogens that cause infective esophagitis
* Candida * HSV * CMV
66
What pathogen can cause infective esophagitis in normal ppl
HSV
67
Diagnose infective esophagitis
EGD w/ biopsy and brushings
68
Tx of infective esophagitis
1. CMV: antiretrovirals 2. Candidal: systemic fluconazole 3. HSV: Oral acyclovir
69
What does esophageal manometry test?
Motility testing

GI (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions