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GI > esoph > Flashcards

esoph Flashcards

1
Q

dysphagia

A

diff swalllowing

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2
Q

odynophagia

A

painful swallowing

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3
Q

globus

A

sensation of fullness in upper throat–improvse w/ swallowing

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4
Q

pyrosis

A

heart burn; substernal pain

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5
Q

regurgitation

A

return of sour gastric content

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6
Q

watre brash

A

sponaneous salivation from reflux

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7
Q

rumination

A

chewing ones cud

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8
Q

c6

A

begin upper eso spincter

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9
Q

t3

A

aortic arch presses on eso

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10
Q

t10

A

passes through diaphragmatic hiatus to reach te stomach

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11
Q

UES inn

A

pharyn branch vagus

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12
Q

inhib NT

A

NO

vip

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13
Q

excit nt

A

ach

sub p

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14
Q

swallowing

A

bolus masticated–>food pushed backwards–> soft palate elevates, vocal cords close, epiglottis tipped forward–>UES opens, LES opens, pharynx contracts–>peristalisis

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15
Q

layers of esoph

A

mucosa
submucosa
muscularis propia
adventitia

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16
Q

the esoph has no

A

serosal lining

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17
Q

upper esoph blood supply

A

inf thyroid artery

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18
Q

middle esoph blood supply

A

R and L bronchial arteries

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19
Q

mid distal and distal blood supply

A

direct branches from thoracic aorta and esoph branch of L gastric artery

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20
Q

sensory receptors and eso

A

chemo in mucosa and submucosa- chemical irritants

mechanoR- submucosa–>adventitia; distention but not tearing

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21
Q

primray peristatliss

A

initiated by swallow

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22
Q

2nd peri

A

luminal distention

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23
Q

sensory input swallowing

A

pharynx via CN5, 10,11

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24
Q

motor output swallowing

A

CN 5,7,9,10,12

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25
Q

ddx globus

A

UES issue- spasm, incomplete relax., hypertensive UES

GERD

visceral hypersensitivity

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26
Q

ddx odynophagia

A

injury to mucosal lining by
viral infx
meds
gerd

27
Q

oropharyngael dysphagia

A

difficulty initiating a swallow or transferring food from mouth to esoph– food “sticks in throat”

28
Q

ddx OD

A

neuro
skeleal muscle
srucural

29
Q

best test for OD

A

cineradiography–frame by frame analysis of pt swallowing

30
Q

tx OD

A

work w/ speech pathologist + entubation if aspiration riskt oo high

31
Q

esoph dysphagia

A

food sticks in throat–usually lower than what pt thinks but due to intra-luminal obstuction

32
Q

achlasia patho

A

inflamm injury to myenteric plexus–> loss of NO producing cells–>LES fails to relax–>change in peristalisis/aper

33
Q

gold standard dx achalasia

A

esoph mamomry–ess before surgery/dilation

incomplete relax- achlasia
no change in motor fx- vigorous ach

34
Q

tx achalasia

A

drugs- nitrates, ca channel blockers, botox
pneumatic dilation
surg myotomy
POEM

35
Q

diffuse esoph spasm manometry

A

increase in repetitive and high amplitude contractions–incomplete LES relax

36
Q

CREST pathophys

A

vascular oblit–> fibrosis in SM–> weak LES, poor eso contract, delayed gastric emptying

37
Q

barium swallow adenocarcinoma

A

shelf

38
Q

spiculated barium swallow

A

candidia (aids!)

39
Q

A rings

A

muscular

40
Q

B rings

A

schazskis (mucosal)

41
Q

ddx gred

A

transient LES relax
ineffective esoph motility
gastric acid hypresec
delayed stomach emptying (gastroparesis)

42
Q

gold standard dx GERD

A

impdece eso catheter

43
Q

meds for people w/ delayed gastric emptying

A

domperidone–prokinetic

44
Q

barretts metaplasia

A

metaplasia normal esophageal stratified squamous epithelium to intestinal columnar epithelium

goblet cells, surface maturation (dec N:C ratio)
–>intestinal type metaplasia

suspceted by endo, confirmed by biopsy

45
Q

tzanck test

A

scrape herpes lesion and lok for multinodular giant cells under oil immersion

smudy/steel grey inclusions

46
Q

aspergillus vs mucor

A

aspergillus-45 degree angle

mucor- 90 degree angle

47
Q

pyogenic granuloma

A

lobular cap hemangioma w/ surface ulceration- inflam seconday

48
Q

aphtous ulcer

A

idiopathic shalow painful

49
Q

leukoplakia

A

clinical term: nonspecific squamous cell hyperplasia–precance

50
Q

hairy leukoplakia

A

immunocomp pts- fluffy can scrape of

hyperkeratosis, acanthosis, balloon cells

51
Q

erythroplakia

A

lower lip, buccal mucosa, soft palate

more likely to progess to oral cancer

52
Q

SCC

A

95% oral cancer, ass w/ HPV

53
Q

main site of salivary gland neoplasm

A

parotid gland

54
Q

main site of salivary malignancy

A

sublingual

55
Q

MC benign

A

pleomorphic adenoma

56
Q

MC malignant

A

mucoepidermoid

57
Q

2 components warthin’s

A

epithelial- dense eosino

lymphoid component

58
Q

mucoepidermoid

A

mucus secreting

squamous cells

59
Q

squamous cells predom in

A

high grade

60
Q

plummer vinson syndrome

A 
web/stricture
Fe def anemia
glossitis
cheilosis
risk for carcinoma
61
Q

main cause SCC

A

alcohol, smoking

62
Q

main cause adenocarcinoma

A

GERD

63
Q

barrrett’s esoph- high grade dysplasia

A

intestnalized mucosa w/ villous arch

mucin depletion

GI (12 decks)

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