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Path 2 > Esophageal Disease > Flashcards

Esophageal Disease Flashcards

1
Q

What is dysphagia

A

trouble Swallowing

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2
Q

What are differential causes of Dyshpagia

A

achalasia, Diffuse Esophageal Spasm, Scleroderma, Carcinoma, Peptic stricture, Lower esophageal ring, Zenker diverticulum (Halitosis), Muscular dystrophy, Myasthenia gravis, Stroke

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3
Q

What is odynophagia

A

Painful Swallowing

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4
Q

What are the different causes of Odynopgaia

A

iron, Vitamin C, Tetracycline, Bisphosphonates, Radiation, CMV, Herpes, Candida, Caustic damage, Eosinophilic esophagitis, quinidine

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5
Q

What is Achalasia

A

failure of LES (lower esophageal sphincter) and smooth muscle fiber to relax.

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6
Q

What are the causes of Achalasia

A

It is due to the loss of auerback plexus ( provides motor innervation to both laters of the muscular layer).

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7
Q

How do you diagnose Achalasia

A

to diagnose, you can do the Barium Swallow ( patient swallow a barium solution and you observe the flow of the fluid through the esophagus), Manometry (measures the contractions of the esophagus)

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8
Q

What is Diffuse Esophageal Spasm

A

Normal movement but lack of nitric oxide (needed to relax)

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9
Q

How do you diagnose Diffuse Esophageal Spasm

A

Dx through Barium tortuous esophagus and through manometry,high intensity.

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10
Q

What si Scleroderma

A

Skin fibrosis- peristalsis and loss of LES tone

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11
Q

What are the characteristics of Scleroderma

A

it is characterized by the harding of the skin due to lymphocytes. it can affect internal organs.

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12
Q

What causes Scleroderma

A

due to Vasculitis ( inflammation of blood vessels)

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13
Q

What does CREST stand for

A

calcinosus, Raynaud phenomenon, esophageal dysfunction, sclerodactyl and telangiectasia)

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14
Q

What are rings and webs and what is associated with it?

A

Webs are (Upper thin membranes located in the amide or upper esophagus). Plummer Vinson Syndrome

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15
Q

What is Plummer Vinson Syndrome

A

Plummer Vinson( rare disease that is characterized by difficulty swallow, iron deficiency, glossitis, cheilosis and webs. - risk of hypopharangeal cancer. initial Barium.

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16
Q

What are the cancers of the esophageal

A

Squamous ( upper 1/3) due to smoking and alcohol and Adenocarcinoma ( lower 1/3) GERD Barrett. the rate of both is 50/50 now with the increase in GERD.

17
Q

How are the cancers diagnose

A

Thought Barium and most accurate is theEndoscopy

18
Q

What is Zenker’s Diverticulum

A

out- pocketing of post pharyngeal muscle. Bad breath and food regurgitation

19
Q

How do you diagnose the Zenker’s Diverticulum

A

Barium

20
Q

What is a characteristic of Achalasia

A

Bird’s peak

21
Q

What is Mallor Weiss Syndrome

A

forceful vomiting that show GI bleeding due to the repetition. there is a tear of the mucosa

22
Q

How do you diagnose Mallory Weiss Syndrome

A

Through endoscopy

23
Q

What is the treatment for Mallory Weiss Syndrome

A

Self resolve, epinephrine injection and electrocautery. is see in food poising, alcoholism and eating disorders.

24
Q

What is Boerhaave’s Syndrome q

A

rupture of the esophagus due to excessive retching. full thickness tear.

25
Q

How do you diagnose Boerhaave syndrome

A

crepitus on chest palpation can use water or fat soluble barium but water is better due to fat can cause more damage.

26
Q

What is the treatment for Boerhaave’s

A

Need Emergent surgery and the complication are medianstinitis and sepsis

27
Q

What is GERD

A

inappropriate relaxation of LES. IT is a chroicn of mucosal damage caused by stomach acid coming up from the stomach and into the esophagus. Gastric acid back flow, acid hypersecretion.

28
Q

What is one of the major causes of GERD

A

Hiatal Hernia

29
Q

What is the presentation of GERD

A

Heartburn and regurgitation, atypical chest pain, bitter or acid test in mouth. water brash, sensation of lump in throat, frequent belching.

30
Q

What are the manifestations of GERD

A

coughing (chronic), laryngitis, Asthma, Dental erosion, Chronic sinusitis.

31
Q

What are the RED FLAGS of GERD and what test should your run

A

Anemia, Blood in stool, Dysphagia, weight loss. Endoscopy

32
Q

What are some of the triggers substance of GERD

A

Chocolate, Friend and fatty foods, alcohol, coffee, Garlic, Ketchup, mine, soda, juices, pepper, onions and spicy foods

33
Q

How do you Diagnose GERD

A

history, Trail of Proton pump Inhibitors ( PPI - omeprazole) 24 hr monitoring- most accurate test. Manometry before corrective surgery and Barium.

34
Q

What is the treatment for GERD

A

lifestyle modifications, H2 receptors blockers, PPI, Promotability agents ( metoclopromide) and Nissen Fundoplication

35
Q

What is Barrett’s Esophagus. what is the diagnose test

A

due to chronic GERD and change to columnar metaplasia Endoscopy

36
Q

What is Candidiasis Esophagilits

A

present as white exudate patches over the length of the esophagus. adherent to the mucosa. Histologically, there is a necroinflammatory background with yeast and pseudo-hypheae present in the superficial Epithelial layer.

37
Q

What is Viral Esophagitis

A

Multi-nucleation is a viral cytopathic Effect.

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