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Gastroenterology > Esophageal Disorders > Flashcards

Esophageal Disorders Flashcards

1
Q

Hiatal Hernia Dx

A

endoscopy or barium studies.

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2
Q

Hiatal Hernia Tx best initial therapy

A

is weight loss and PPIs.

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3
Q

Hiatal Hernia Tx If symptoms persist

A

Qx: Nissen fundoplication

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4
Q

Alarm symptoms indicating endoscopy include

A

Weight loss
Blood in stool (heme-positive stool)
Anemia

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5
Q

Achalasia Dx “most accurate test

A

Manometry: failure of the lower esophageal sphincter to relax

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6
Q

Achalasia Dx best initial tests

A

Barium esophagram: “bird’s beak”

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7
Q

Achalasia Dx other tests

A

CXR: abnormal widening of the esophagus. BUT not sens-esp
endoscopy: normal mucosa AND rule out malignancy

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8
Q

Achalasia Tx

A

no cure

    • Pneumatic dilation:
    • Surgical sectioning or myotomy (more effective & dangerous)
    • Botulinum toxin injection c3-6m
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9
Q

Esophageal Cancer Dx

A

Endoscopy**

Barium might be the “best initial test,” never deffinitive

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10
Q

Esophageal Cancer Dx of extention

A

CT and MRI

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11
Q

PET scan utility at EsophCA

A

1.- to determine the contents of anatomic lesions if you are not
certain whether they contain cancer.
2.- to determine
whether a cancer is resectable (local). or not, wide MT

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12
Q

Esophageal Cancer Tx

A

Surgical resection*****

+ Chemotherapy and radiation

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13
Q

Esophageal Cancer palliative Tx

A

Stent placement is used for lesions that cannot be resected. to improve dysphagia.

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14
Q

Esophageal Spasm Dx

A

most accurate
test: manometry

Barium studies can show a corkscrew appearance

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15
Q

Esophageal Spasm Tx

A

CCB and Nitrates
CCB sino TCAntd sino Sildenafil.
PPIs can help

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16
Q

Eosinophilic Esophagitis Dx

A

Endoscopy shows multiple concentric rings

The most accurate diagnostic test is a biopsy finding eosinophils

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17
Q

Eosinophilic Esophagitis 1Ln Tx

A

best initial therapy is PPIs and eliminating allergenic foods.

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18
Q

Eosinophilic Esophagitis 2Ln Tx

A

swallowing steroid inhalers to allow the topical use of steroids

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19
Q

Infectious Esophagitis Etiologic agents

A
  • > 90% Candida in AIDS
  • CMV
  • Herpes
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20
Q

Infectious Esophagitis once suspected, best first step management

A

Empiric therapy with fluconazole

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21
Q

Infectious Esophagitis what to do if fluconazole didn’t work

A

Endoscopy

If Candidiasis confirmed-> IV amphotericin

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22
Q

Infectious Esophagitis Dx diff

A

Endoscopy:
Large ulcerations=CMV
small ulcerations=HSV

23
Q

Infectious Esophagitis

CMV, HSV tx

A 
CMV= ganciclovir or foscarnet
HSV= acyclovir
24
Q

Schatzki ring Cx Fx. And it is associated with what pathology?

A

acid reflux and intermittent dysphagia.

Asoc w hiatal hernia

25
Q

Schatzki ring Tx

A

pneumatic dilation in an endoscopic procedure

26
Q

Plummer-Vinson syndrome PAtho

A 
PVSx=Esoph Web
Asoc. iron deficiency anemia and can
rarely transform into squamous cell cancer.
The iron deficiency is not caused
by blood loss.
27
Q

Plummer-Vinson syndrome Dx

A

barium studies: more proximal rings.

28
Q

Plummer-Vinson syndrome Tx

A

iron replacement at first, may solve the lesion. Then endoscopy + biopsy to r/o CA

29
Q

Zenker Diverticulum Cx Fx

A

dysphagia, severe halitosis, and regurgitation of food particles**.

30
Q

Zenker Diverticulum Dx

A

Barium

31
Q

Zenker Diverticulum Tx

A

Only Qx. No medical therapy.

Never NG tube or upper endoscopy. Danger!

32
Q

Scleroderma Cx Fx

A

Reflux + scleroderma/sclerosis

33
Q

Scleroderma Dx

A

Manometry: decreased

lower esophageal sphincter pressure

34
Q

Scleroderma Tx

A

PPIs as it would be for any person with reflux symptoms

35
Q

Manometry is the answer for

A

Achalasia
Spasm
Scleroderma

36
Q

Mallory-Weiss Tear Patho

A

upper gastrointestinal bleeding after

prolonged or severe vomiting or retching

37
Q

Mallory-Weiss Tear Cx Fx

A

Repeated retching is followed by
hematemesis of bright red blood, or by black stool.
No dysphagia.

38
Q

Mallory-Weiss Tear Tx

A

no specific therapy,

and it will resolve spontaneously.

39
Q

Mallory-Weiss Tear Tx Severe cases

A

injection of epinephrine to stop bleeding or the use of

electrocautery

40
Q

Boerhaave syndrome ?

A

full penetration of the esophagus

41
Q

Cannabinoid Hyperemesis Syndrome Dx. Also called cyclic vomitting Sx

A

Hx Cannabis + hot shower “better”

OJO this is not intox nor withdraw, just a gen especific reaction

42
Q

Cannabinoid Hyperemesis Syndrome Tx

A

antiemetics (such as ondansetron) or benzodiazepines (such as lorazepam).

stop thc

43
Q

caustic esophagitis, cx fx

A

Larynx: hoarse. Stridor=urgent, may intubate
Esoph:drooling!

44
Q

caustic esophagitis dx

A

endoscopy to asses damage

45
Q

caustic esophagitis tx

A

low severity= liquid diet
high severity= NPO 72h, repeat EGD
NEVER neutralize pH
never induce emesis

46
Q

stricture path

A

GERD grade IV

1/3 bottom of esoph

47
Q

esopho CA path

A

adenoCA caused by GERD, 1/3 bottom of esoph

SCC: caused by smoking and EtOH at upper 1/3

48
Q

stricture cx fx

A

Gerd-> dysphagia -> weight loss

49
Q

ESO CA cx fx

A

Gerd-> dysphagia -> weight loss

50
Q

stricture Dx

A

Barium shows: symmetric circunferencial loss of the lumen.

EGD Dx ro CA

51
Q

CA Dx

A

Barium shows: asymmetric loss of the lumen.

EGD

PET scan or PAN CT to stage/ seek for MT

52
Q

stricture Tx

A

PPI high dose

Dilation

53
Q

CA -tx

A

Chemo Radiation and Qx

Gastroenterology (23 decks)

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