Esophageal Disease

Question 1

What is dysphagia

Answer 1

trouble Swallowing

Question 2

What are differential causes of Dyshpagia

Answer 2

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

Question 3

What is odynophagia

Answer 3

Painful Swallowing

Question 4

What are the different causes of Odynopgaia

Answer 4

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

Question 5

What is Achalasia

Answer 5

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

Question 6

What are the causes of Achalasia

Answer 6

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

Question 7

How do you diagnose Achalasia

Answer 7

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)

Question 8

What is Diffuse Esophageal Spasm

Answer 8

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

Question 9

How do you diagnose Diffuse Esophageal Spasm

Answer 9

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

Question 10

What si Scleroderma

Answer 10

Skin fibrosis- peristalsis and loss of LES tone

Question 11

What are the characteristics of Scleroderma

Answer 11

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

Question 12

What causes Scleroderma

Answer 12

due to Vasculitis ( inflammation of blood vessels)

Question 13

What does CREST stand for

Answer 13

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

Question 14

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

Answer 14

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

Question 15

What is Plummer Vinson Syndrome

Answer 15

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

Question 16

What are the cancers of the esophageal

Answer 16

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.

Question 17

How are the cancers diagnose

Answer 17

Thought Barium and most accurate is theEndoscopy

Question 18

What is Zenker’s Diverticulum

Answer 18

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

Question 19

How do you diagnose the Zenker’s Diverticulum

Answer 19

Barium

Question 20

What is a characteristic of Achalasia

Answer 20

Bird’s peak

Question 21

What is Mallor Weiss Syndrome

Answer 21

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

Question 22

How do you diagnose Mallory Weiss Syndrome

Answer 22

Through endoscopy

Question 23

What is the treatment for Mallory Weiss Syndrome

Answer 23

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

Question 24

What is Boerhaave’s Syndrome q

Answer 24

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

Question 25

How do you diagnose Boerhaave syndrome

Answer 25

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

Question 26

What is the treatment for Boerhaave's

Answer 26

Need Emergent surgery and the complication are medianstinitis and sepsis

Question 27

What is GERD

Answer 27

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.

Question 28

What is one of the major causes of GERD

Answer 28

Hiatal Hernia

Question 29

What is the presentation of GERD

Answer 29

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

Question 30

What are the manifestations of GERD

Answer 30

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

Question 31

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

Answer 31

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

Question 32

What are some of the triggers substance of GERD

Answer 32

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

Question 33

How do you Diagnose GERD

Answer 33

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

Question 34

What is the treatment for GERD

Answer 34

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

Question 35

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

Answer 35

due to chronic GERD and change to columnar metaplasia Endoscopy

Question 36

What is Candidiasis Esophagilits

Answer 36

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.

Question 37

What is Viral Esophagitis

Answer 37

Multi-nucleation is a viral cytopathic Effect.