Esophageal Disease Flashcards
What is dysphagia
trouble Swallowing
What are differential causes of Dyshpagia
achalasia, Diffuse Esophageal Spasm, Scleroderma, Carcinoma, Peptic stricture, Lower esophageal ring, Zenker diverticulum (Halitosis), Muscular dystrophy, Myasthenia gravis, Stroke
What is odynophagia
Painful Swallowing
What are the different causes of Odynopgaia
iron, Vitamin C, Tetracycline, Bisphosphonates, Radiation, CMV, Herpes, Candida, Caustic damage, Eosinophilic esophagitis, quinidine
What is Achalasia
failure of LES (lower esophageal sphincter) and smooth muscle fiber to relax.
What are the causes of Achalasia
It is due to the loss of auerback plexus ( provides motor innervation to both laters of the muscular layer).
How do you diagnose Achalasia
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)
What is Diffuse Esophageal Spasm
Normal movement but lack of nitric oxide (needed to relax)
How do you diagnose Diffuse Esophageal Spasm
Dx through Barium tortuous esophagus and through manometry,high intensity.
What si Scleroderma
Skin fibrosis- peristalsis and loss of LES tone
What are the characteristics of Scleroderma
it is characterized by the harding of the skin due to lymphocytes. it can affect internal organs.
What causes Scleroderma
due to Vasculitis ( inflammation of blood vessels)
What does CREST stand for
calcinosus, Raynaud phenomenon, esophageal dysfunction, sclerodactyl and telangiectasia)
What are rings and webs and what is associated with it?
Webs are (Upper thin membranes located in the amide or upper esophagus). Plummer Vinson Syndrome
What is Plummer Vinson Syndrome
Plummer Vinson( rare disease that is characterized by difficulty swallow, iron deficiency, glossitis, cheilosis and webs. - risk of hypopharangeal cancer. initial Barium.
What are the cancers of the esophageal
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.
How are the cancers diagnose
Thought Barium and most accurate is theEndoscopy
What is Zenker’s Diverticulum
out- pocketing of post pharyngeal muscle. Bad breath and food regurgitation
How do you diagnose the Zenker’s Diverticulum
Barium
What is a characteristic of Achalasia
Bird’s peak
What is Mallor Weiss Syndrome
forceful vomiting that show GI bleeding due to the repetition. there is a tear of the mucosa
How do you diagnose Mallory Weiss Syndrome
Through endoscopy
What is the treatment for Mallory Weiss Syndrome
Self resolve, epinephrine injection and electrocautery. is see in food poising, alcoholism and eating disorders.
What is Boerhaave’s Syndrome q
rupture of the esophagus due to excessive retching. full thickness tear.
How do you diagnose Boerhaave syndrome
crepitus on chest palpation can use water or fat soluble barium but water is better due to fat can cause more damage.
What is the treatment for Boerhaave’s
Need Emergent surgery and the complication are medianstinitis and sepsis
What is GERD
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.
What is one of the major causes of GERD
Hiatal Hernia
What is the presentation of GERD
Heartburn and regurgitation, atypical chest pain, bitter or acid test in mouth. water brash, sensation of lump in throat, frequent belching.
What are the manifestations of GERD
coughing (chronic), laryngitis, Asthma, Dental erosion, Chronic sinusitis.
What are the RED FLAGS of GERD and what test should your run
Anemia, Blood in stool, Dysphagia, weight loss. Endoscopy
What are some of the triggers substance of GERD
Chocolate, Friend and fatty foods, alcohol, coffee, Garlic, Ketchup, mine, soda, juices, pepper, onions and spicy foods
How do you Diagnose GERD
history, Trail of Proton pump Inhibitors ( PPI - omeprazole) 24 hr monitoring- most accurate test. Manometry before corrective surgery and Barium.
What is the treatment for GERD
lifestyle modifications, H2 receptors blockers, PPI, Promotability agents ( metoclopromide) and Nissen Fundoplication
What is Barrett’s Esophagus. what is the diagnose test
due to chronic GERD and change to columnar metaplasia Endoscopy
What is Candidiasis Esophagilits
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.
What is Viral Esophagitis
Multi-nucleation is a viral cytopathic Effect.
