Esophageal And Mediastinal Diseases

Question 1

Explain Esophageal manometry?

Answer 1

Test that evaluates motility and function of LES and UES

Question 2

What is Achalasia?

Answer 2

The failure of LES relaxation when swallowing

Question 3

Achalasia investigations?

Answer 3

Endoscopy and Barium swallow

Question 4

Medical management of Achalasia?

Answer 4

Nitrates to relax the LES

Question 5

What does Botulinum toxin do to treat Achalasia?

Answer 5

Weakens the LES when injected into it

Question 6

What is the surgical treatment for Achalasia SHOULD, balloon dilation fail.

Answer 6

Esophagocardiomyotomy (Heller Myotomy )

Question 7

What should we do to treat Achalasia, should the Heller procedure fail?

Answer 7

Esophageal resection and reconstruction

Question 8

First line treatment for Esophagitis?

Answer 8

Oral and parental broad spectrum antibiotics

Question 9

In Esophagitis, what do we give to relive Laryngeal edema?

Answer 9

Corticosteroids

Question 10

How do we treat First Degree burn esophagitis?

Answer 10

Continue Antibiotics for 10 Days.

Question 11

How do we treat Second/Third Degree burn esophagitis?

Answer 11

Install silicon catheter down esophagus for feeding, until the patient heels, which takes 1-4 months.

Question 12

What is the surgical resection procedure for Esophageal cancer?

Answer 12

Esophagectomy with gastric pull up

Question 13

What is Barrett’s esophagus?

Answer 13

The lining of lower esophagus with columnar epithelium

Question 14

How to diagnose Barrett’s esophagus?

Answer 14

Endoscopy

Question 15

What is Barrett’s believed to result from?

Answer 15

Chronic GERD

Question 16

What is Barrett’s importance?

Answer 16

Predisposes to esophageal cancer

Question 17

How is Barrett’s treated?

Answer 17

Control the GERD

Question 18

Where does Squamous cell carcinoma arise?

Answer 18

Upper and middle thirds. For black people

Question 19

Where does Adenocarcinoma arise?

Answer 19

In the Lower third. Predominantly white males

Question 20

Esophageal tumors are are diagnosed via?

Answer 20

Barium swallow initially, then confirmed is endoscopy or biopsy

Question 21

How do we assess esophageal cancer staging?

Answer 21

Via endoscopic ultrasonography

Question 22

What’s the approach for tumor resection?

Answer 22

Right or left thoracotomy

Question 23

Which esophageal tumor could be treated via radiotherapy, should resection fail?

Answer 23

Squamous cell carcinoma

Question 24

What is Barrett’s esophagus believed to pre-dispose?

Answer 24

adenocarcinoma

Question 25

Clinical features of GERD?

Answer 25

Heart burn, regurgitation

Question 26

GERD treatment generally, and surgical

Answer 26

Lifestyle modification, Fundoplication

Question 27

What is the indication to do surgery for GERD?

Answer 27

When medical therapy (more than 6 months) fails.

Question 28

What is the approach for Nissen Fundoplication

Answer 28

Trans-abdominal

Question 29

What is an Esophageal Diverticulae?

Answer 29

A sack or pouch protruding from the esophagus, like a ball sack

Question 30

Esophageal divertiucalae treatment?

Answer 30

Larger ones are excised, Cricopharyngeal myotomy is essential

Question 31

What is a Hiatal Hernia?

Answer 31

An abdominal protrusion into the esophagus, from the stomach

Question 32

Most common type of Hiatal Hernia?

Answer 32

Sliding hernia I.e Type 1

Question 33

Commonest sign of Hiatal Hernia?

Answer 33

Regurgitation obviously, due to the hernia being there

Question 34

How do we know if the hernia is para-esophageal?

Answer 34

Chest X-ray confirms its position

Question 35

Surgical treatment of para-esophageal hernia?

Answer 35

Fundoplication

Question 36

What is the most common tumor of the anterior mediastinum?

Answer 36

Thymoma

Question 37

Thymoma treatment if stages 1/2?

Answer 37

Total resection

Question 38

Thymoma treatment if stage 3

Answer 38

Resection and post op chemotherapy

Question 39

Thymoma treatment if stage 4a and b?

Answer 39

Chemo

Question 40

How do we treat Pericardial cysts?

Answer 40

Percutaneous drainage and resection

Question 41

How do we treat an enteric cyst?

Answer 41

Resection

Question 42

How do we treat mediastinitis?

Answer 42

Surgical debridement

Question 43

Where do we find teratomas?

Answer 43

Anterior mediastinum

Question 44

What is a rare cause of posterior mediastinal mass?

Answer 44

Meningocele

Question 45

What is Collis Gastroplasty?

Answer 45

The lengthening of the esophagus, done for GERD in case of short esophagus.

Question 46

Complications of Anti-Reflux surgery?

Answer 46

Technical failures, dysphagia (difficulty swallowing)