Esophageal diseases Flashcards

1
Q

Atresia and TEF- Congenital causes? (2)

A

Down syndrome
Duodenal atresia

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2
Q

Atresia and TEF- Acquired causes? (4)

A

Trauma
Endotracheal tube
Esophageal TB
Malignant tumors (esophageous, trachea)

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3
Q

Atresia and TEF Presentation (4)

A

Abdominal distension (air in stomach)
Coughing, choking, cyanosis (with feeding)
Vomiting (with feeding)
Aspiration pneumonia (acquired)

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4
Q

Heterotopia (4)

A

Pancreatic tissue
Gastric mucosa

Mimic tumor endoscopy, mucosal ulceration (stomach acid)

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5
Q

Esophageal Webs and Rings- Presentation

A

Ring —> mucosa, submucosa, muscle
Web —> mucosa, submucosa (w/out muscle)

DYSPHAGIA

(‘most common structural abnormality)

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6
Q

Esophageal Webs and Rings- causes (4)

A

Congenital
Iron deficiency anemia
Esophagitis (inflammatory)
Autoimmune disorders

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7
Q

Esophageal Diverticulum

A

Outpouching of esophageal mucosa

(congenital or increased luminal pressure)

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8
Q

Esophageal Diverticulum- Presentation (5)

A

Dysphagia
Regurgitation of food
Aspiration pneumonia
Weight loss
Halitosis

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9
Q

Esophageal Diverticulum- Diagnosis and Treatment

A

Barium swallow NOT Endoscopy (may miss pouch)

Surgery to remove diverticula

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10
Q

Causes of Esophagitis (inflammatory disorders) (8)

A

Infections (candida, HSV)
Chemical (corrosive)
Eosinophilic
Graft vs host disease
Lymphocytic
Pill-induced
Radiation
Reflux (GERD)

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11
Q

Differentiate Candida and HSV

A

Candida —> Hyphae
HSV —> Large abnormal multinucleated cells

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12
Q

Presentation of Esophageal infections (3)

A

Dysphagia
PAIN on swallowing
Vomiting
(fever)

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13
Q

Underlying causes of Esophageal infections (3)

A

HIV
Chemotherapy
Organ transplantation

(IMMUNOSUPRESSED —> reduce immunosupression)

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14
Q

Chemical (corrosive) Esophagitis- Presentation (3)

A

STRICTURE
Barret’s esophageous
Squamous cell carcinoma

(massive and severe ulcerations)

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15
Q

Eosinophilic Esophagitis (2)

A

Chronic immune-mediated
Children with allergic diseases (eczema, asthma)

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16
Q

Eosinophilic Esophagitis- Presentation (4)

A

Food impaction
Dysphagia (adults)
Feeding intolerance (children)
GERD-like symptoms (children)

17
Q

Eosinophilic Esophagitis- Diagnosis

A

Endoscopy —> rings in upper esophageous

18
Q

Eosinophilic Esophagitis- Treatment

A

Good response —> steroids (predinoslone)
Poor response —> antacids and PPI

19
Q

Pill-induced Esophagitis (4)

A

Iron defeciency
Iron pill therapy
Esophageal ulcerations
Usually in women

20
Q

Lymphocytic Esophagitis (2)

A

Lymphocytic Gastritis, Colitis
Dysphagia (and pain on swallowing)

21
Q

Graft vs Host Disease (4)

A

Bone marrow transplantation
Inflammation
Damage to basal layer
(HO Organ transplant)

22
Q

Radiation Esophagitis (2)

A

Giant cells
Ulceration + necrosis
Atypical cells (pleomorphic cells)

23
Q

Reflux Esophagitis / GERD- Causes (3)

A

Most frequent cause of Esophagitis
Decrease LES tone
Increased abdominal pressure

24
Q

Reflux Esophagitis / GERD- Risk factors (7)

A

Alcohol
Tobacco
Obesity
CNS depressants
Pregnancy
Hiatal hernia
Delayed gastric emptying

25
Q

Reflux Esophagitis / GERD- Complications (4)

A

Ulceration
Stricture
Barret Esophagous (untreated acid reflux —> mucosa turns glandular due to metaplasia)
Iron defeciency anemia (chronic bleeding ulcer in GI tract, if elderly —> colon cancer bleed)

26
Q

Achalasia Triad

A

1- Incomplete LES relaxation
2- Increased LES tone
3- Esophageal aperistalsis

27
Q

Primary Achalasia (2)

A

Failure of distal esophageal inhibitory neurons
Idiopathic

28
Q

Secondary Achalasia (2)

A

Degenerative changes in intrinsic/extrinsic neural innervation
Chagas Disease (Trypanosoma cruzi infection)
(damages ganglion cells (myenetric plexus) of esophagus —> Achalasia)

29
Q

Chagas Disease

A

Achalasia
Colonomegaly
Heart failure

30
Q

Achalasia-like Disease (5)

A

Diabetic neuropathy
Infiltrative malignancy
Amyloidosis
Sarcoidosis
Surgical ablation

31
Q

True Achalasia

A

True —> due to Sphincter

Achalasia like —> Esophagus gets dilated, nothing to do with relaxation of sphincter

32
Q

Collagen Vascular Disease (2)

A

Chronic inflammation in connective tissues
FEVER, SKIN RASH, VASCULITIS, DYSPHAGIA, DILATED ESOPHAGUS

33
Q

Collagen Vascular Disease- Pathological changes (3)

A

Fibrosis
Inflammation
Vasculitis

34
Q

Collagen Vascular Disease- Effect on Esophagus (3)

A

Reduced peristalsis
Reduced sphincter tone
REFLUX esophagitis

35
Q

Collagen Vascular Disease- CREST Syndrome

A

Calcinosis
Raynaud’s phenomenon
Esophageal involvement (acid reflux + decreased motility)
Sclerodactylyl
Telengecstasia

36
Q

Collagen Vascular Disease- Examples (8)

A

Ankylosying spondylitis
Dermatomyotitis
Polyarteries nodosa
Polymyositis
Psoriatic arthritis
Rheumatoid arthritis
Scleroderma
SLE

37
Q

Autoimmune bullous (2)

A

Bullous pemphigoid
Pemphigus vulgaris

38
Q

Lichen planus

A

Inflammation of esophagus
Squamous cell carcinoma

(red-purple)