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Gastro-Intestinal > Esoph CA, Disorders, GI motility Disorders > Flashcards

Esoph CA, Disorders, GI motility Disorders Flashcards

1
Q

What are the 2 principle types of esophageal carcinoma?

A

Adenocarcinoma

SCC

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2
Q

What are the main causes of each? (adenocarcinoma, SCC)

A

Adenocarcinoma- Chronic acid reflux

SCC- smoking and EtOH

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3
Q

What are the 2 gastroesophogeal barriers to stomach acid?

A

Crural diaphragm

LES

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4
Q

What is the difference btwn paraesophageal and hiatal hernias?
Which one can require surgical amendment?

A

With Hiatal hernias you have an increased risk of GERD
Paraesophageal hernias can lead to upside down stomach, gastric volvulus, strangulation of stomach
Can require surgical amendment

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5
Q

What is achalasia?

A

Achalasia is tonically contracted LES that fails to relax appropriately during swallows along with dilated, peristaltic esophagus

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6
Q

How is achalasia diagnosed?

A

Manometry

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7
Q

What are the basic surgical techniques and pharmacological treatments for achalasia?

A

Heller myotomy
Balloon dilation
Nitrates/CCBs

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8
Q

What are the esophageal manifestations of systemic scleroderma?

A

Dilated
Aperistaltic esophagus
Free reflux
Peptic stricture

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9
Q

How is scleroderma it treated?

A

Treated with PPI to reduce reflux/gastritis

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10
Q

What is the composition of a Schazki’s ring?

A

Circumferential mucosal ring in the setting of hiatal hernia

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11
Q

How does a Schazki ring manifest and how is it treated?

A

Dysphagia upon swallowing (steakhouse syndrome)

Dilation with EGD

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12
Q

What is Plummer-Vinson syndrome?

A

Esophageal webs that form in the proximal esophagus in association with iron deficiency anemia

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13
Q

What are the symptoms for Plummer-Vinson syndrome?

A

Web
Fatigue
Pica

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14
Q

What is the most common disorder of the esophagus?

A

GERD

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15
Q

How is GERD documented and graded?

A

Based on severity and classification by the Los Angeles classifications

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16
Q

How do you classify by LA classifications?

A

By EGD and 24-48 hr pH probe placed above the Z ling (GJ junction)

17
Q

What are the symptoms and complications of GERD?

A 
Hearburn
Epigastric pain
Dysphagia
Odynophagia 
Water brash
18
Q

How are mild, moderate and severe GERD treated?

A

Mild/moderated- H2-antagonists/PPIs, antacids temporarily, lifestyle changes
Severe- Laparascopic fundoplication

19
Q

What is Gastroparesis?

A

Delayed gastric emptying

20
Q

What are the symptoms for gastroparesis?

A 
Early satiety
Bloating
N/V 
Anorexia
Wt loss
Endocrine/metabolic disorders (DM)
CNS
21
Q

What are effective treatments for gastroparesis?

A

Low fat diet

Meds- erythromycin, zithromax, domperidone, metaclopramide

22
Q

Simple (lifestyle) Measures for GERD

A 
Elevate head of bed
Avoid food/liquid 2-3 hrs before bedtime
Avoid fatty/spicy foods
Avoid alcohol/cigarettes
Weight loss
Liquid antacid 30mL, 30 mins after meals and at bedtime
OR otc H2 antagonist
23
Q

What is the radiological appearance of achalasia?

A

Dilated, fluid-filled esophagus, distal bird-beak stricture

24
Q

What is the radiological appearance of Scleroderma?

A

Aperistaltic esophagus
free reflux
peptic stricture

25
Q

What is the radiological appearance of diffuse esophageal spasm?

A

Simultaneous non-coordinated contractions

26
Q

What are the manometric findings of achalasia?

A

LES- High resting pressure
Incomplete/abnormal relaxation w/ swallow

Body- low amp, simultaneous contractions AFTER swallowing

27
Q

What are the manometric findings of scleroderma?

A

LES- Low resting pressure

Body- low amp peristaltic contraction or no peristalsis

28
Q

What are the manometric findings of diffuse esophageal spasm?

A

LES- normal pressure

Body- Some peristalsis
Diffuse and simultaneous non-peristaltic contractions, occasionally high amp

29
Q

What are the symptoms for diffuse esophageal spasm?

A

Substernal chest pain (angina-like)

Dysphagia with pain

Gastro-Intestinal (13 decks)

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