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Nutrition and Digestion > Disorders of Upper GI Tract > Flashcards

Disorders of Upper GI Tract Flashcards

1
Q

what is deglutition

A

swallowing

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2
Q

when does the lower oesophageal sphincter relax

A

as soon as swallow is initiated

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3
Q

common oeosphageal disorder

A

GORD
oesophageal motility disorders
eosinophilic oesophagitis
oesophageal cancer

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4
Q

common symptoms of oesophageal disease

A

dysphagia
odynophagia (painful swallowing)
heartburn
acid regurgitation
water brash

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5
Q

what is odynophagia

A
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6
Q

what is water brash

A

increased salivation

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7
Q

name for difficulty swallowing

A

dysphagia

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8
Q

less common symptoms of oesophageal disease

A

chest pain
food regurgitation
food bolus obstruction
globus
cough
dysphonia

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9
Q

what is globus

A

unusual sensation that something is stuck in oesophagus but isn’t

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10
Q

what is dysphonia and what is a cause

A

altered voice due to acid causing irritation of vocal cords

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11
Q

when does oeosphageal cancer tend to present

A

late
asymptomatic until late stage

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12
Q

how is dysphagia classified

A

oropharyngeal or oesophageal

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13
Q

learn difference between oropharyngeal and oesophageal dysphagia

A
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14
Q

signs of oesophageal disease

A

dental erosion
weight loss
anaemia
lymphadenopathy

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15
Q

which is more common
reflux with transient lower oesophageal relaxations
or
reflux with low lower oesophageal sphincter pressures

A

reflux with transient lower oesophageal relaxations

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16
Q

which is more severe
reflux with transient lower oesophageal relaxations
or
reflux with low lower oesophageal sphincter pressures

A

reflux with low lower oesophageal sphincter pressures

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17
Q

cause of daytime reflux

A

reflux with transient lower oesophageal relaxations

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18
Q

cause of nocturnal reflux

A

reflux with low lower oesophageal sphincter pressures

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19
Q

someone has daytime reflux, no hiatus hernia and no oesophagitis
what is the cause of their reflux

A

transient lower oesophageal relaxtions

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20
Q

someone has nocturnal reflux, a large hiatus hernia and severe oeosphagitis
what is the cause of their reflux

A

low lower oesophageal sphincter pressures

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21
Q

what type of reflux causes Barrett’s

A

low lower oeosphageal sphincter pressures

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22
Q

investigations in oesophageal disease

A

endoscopy and biopsy
barium swallow and x-ray
oesophageal function tests

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23
Q

what can be used to determine if the reflux material is acidic or not

A

oeosphageal function tests (e.g. pH and impedence monitoring)

24
Q

if oesophageal cancer is suspected what is required

A

urgent upper GI endoscopy and biopsy
CT
endoscopic ultrasound

25
Q

what is barrett’s oesophagus

A

where the squamous epithelium lining the oesophagus is replaced by columnar epithelium

26
Q

who gets barrett’s most

A

men
>50
obese

27
Q

relationship with barrett’s and cancer

A

barrett’s is premalignant so can progress to adenocarcinoma

most adenocarcinomas arise from barrett’s

28
Q

treatment of Barrett’s

A

long term proton pump inhibitor

29
Q

treatment of GORD

A

lifestyle (smoking, alcohol, diet, weight reduction)
mechanical (posture, loose clothing, elevate bed-head)
antacids
acid suppression (PPIs, H2RA)
surgical (fundoplication)

30
Q

example of PPI

A

omeprazole

31
Q

example of H2RA

A

ranitidine

32
Q

what is oesophageal achalasia

A

failure the lower oeosphageal sphincter to relax
and absence of peristalsis

33
Q

presentation of achalasia

A

dysphagia to liquids and solids
weight loss
chest pain

34
Q

complications of achalasia

A

oesophageal dilation
respiratory complications

35
Q

what does endoscopy show in achalasia

A

usually normal

36
Q

cause of achalasia

A

degenerative lesion of oesophageal innervation

37
Q

treatment of achalsia

A

botox - paralyse LOS
endoscopic dilation
surgical myotomy
POEM

38
Q

what is the down side of botox as treatment for achalasia

A

it is not long lasting

39
Q

why is dilated oesophagus a complication of achalsia

A

due to absence of peristalsis
and tighter sphincter so food gets stuck in oesophagus for longer

40
Q

food bolus obstruction and dysphagia is a common presentation of

A

eosinophilic oesophagitis

41
Q

risk factors for eosinophilic oesophagitis

A

younger age
male
history of atopy (hayfever and asthma)

42
Q

diagnosis of eosinophilic oeosphagitis

A

> 15 eosinophils/pof on biopsy

43
Q

eosinophilic oesophagitis association with cancer

A

no association

44
Q

what is eosinophilic oesophagitis

A

build up of eosinophils (WBCs) in the lining of the oesophagus in response to food or acid
leads to difficulty swallowing and eventually narrowing of the oeosphagus

45
Q

what can be seen on endoscopy in eosinophilic oesophagitis

A

lumps
(strictures, rings, exudates, furrows)

46
Q

treatment of eosinophilic oesophagitis

A

diet (elimination of trigger foods)
drugs (PPIs, topical steroids)
dilation (of strictures)

47
Q

causes of oesophageal strictures

A

benign - GORD, barrett’s, extrinsic compression, post radiotherapy, post surgery, toxic substance injestion

malignant - cancer

48
Q

treatment of benign oesophageal sphincter

A

PPIs
dilation

49
Q

what types of cancer can occur in oesophagus

A

adenocarcinoma
squamous cell carcinoma

50
Q

which part of oesophagus do squamous cell carcinomas occur

A

upper/mid

51
Q

which part of oesophagus do adenocarcinomas occur

A

lower

52
Q

who gets adenocarcinomas

A

60s-70s
Barrett’s
obesity

53
Q

who gets squamous cell carcinomas

A

80s-90s
smokers
alcohol

54
Q

what is intermittent dysphagia for liquids and solids suggestive of

A

motility problem (e.g. achalasia)

55
Q

intermittent tarry stool is suggestive of

A

chronic blood loss from upper GI tract

56
Q

h.pylori treatment

A

Abx and PPI for 1 week

Nutrition and Digestion (30 decks)

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