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Surgery EOR > Esophageal disorders > Flashcards

Esophageal disorders Flashcards

1
Q

what is the MC infectious cause of infectious esophagitis

A

candida

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2
Q

classic sx all types of esophagitis

A

odynophagia
dysphagia
retrosternal chest pain

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3
Q

in what population is eosinophilic esophagitis most common

A

white males between 30 and 40

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4
Q

test of choice for any form of esophagitis

A

upper endoscopy

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5
Q

what meds are most likely to cause pill-induced esophagitis

A

NSAIDs
bisphosphonates

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6
Q

medical term for heartburn

A

pyrosis

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7
Q

what is the most common cause of non cardiac chest pain in patients w a negative cardiac workup

A

GERD

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8
Q

alarm features with GERD

A

dysphagia
odynophagia
anorexia
unexplained weight loss
evidence of GI bleed - occult blood in stool, melena, hematemesis, hematochezia, findings of IDA
persistent vomiting
age > 60
GI cancer in first degree relative

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9
Q

if there are alarm sx present in patient w GERD, what test should you do

A

upper endoscopy

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10
Q

what is the MC cause of esophagitis

A

GERD

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11
Q

what is the MC type of esophageal cancer in the US

A

adenocarcinoma

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12
Q

what is the MC type of esophageal cancer in the world

A

squamous cell

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13
Q

what is not a risk factor for adenocarcinoma of the esophagus but IS a risk factor for squamous cell

A

alcohol

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14
Q

most important risk factor for adenocarcinoma of esophagus

A

Barretts from GERD

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15
Q

what may protect against esophageal CA

A

NSAIDs
Aspirin

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16
Q

hallmark sx of esophageal CA

A

progressive dysphagia – starts w solids then liquids

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17
Q

diagnosis of esophageal CA

A

upper endoscopy w biopsy

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18
Q

where is adenocarcinoma of the esophagus MC found

A

distal esophagus and esophagogastric junction

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19
Q

where is squamous cell CA of the esophagus MC found

A

mid to upper third of the esophagus

20
Q

what is used to diagnose achalasia

A

manometry

21
Q

what is used to diagnose achalasia if results from manometry are inconclusive

A

barium esophagram

22
Q

describe achalasia

A

idiopathic motility disorder characterized by impaired relaxation of the LES and loss of peristalsis in the distal two thirds (smooth muscle) of the esophagus

23
Q

pathophysiology of achalasia

A

idiopathic progressive degeneration and loss of ganglion cells in the myenteric (Auerbach’s) plexus in the esophageal wall

24
Q

treatment options for achalasia

A

pneumatic dilation, surgical myotomy, peroral endoscopy myotomy

botox injections or oral nitrates if failed other options or not good surgical candidates (nitrates are kinda a last resort)

25
Q

is Zenkers diverticulum a true or false diverticulum

A

false - only involves mucosa and submucosa

26
Q

where does zenkers diverticulum occur

A

Killians triangle - between cricophargyneal muscle and lower inferior pharyngeal constrictor muscle

27
Q

common sx zenkers diverticulum

A

dysphagia
halitosis
regurgitation
cough
feelings as if lump in neck

28
Q

how to diagnose zenkers

A

barium esophagram

29
Q

common symptoms of distal (diffuse) esophageal spasm

A

stabbing, nonexertional, non cardiac chest pain worse with hot or cold liquids or food

intermittent dysphagia to both solids and liquids

30
Q

how to diagnose distal diffuse esophageal spasm

A

esophagram
then manometry

31
Q

what will esophagram show for distal diffuse esophageal spasm

A

corkscrew or rosary bead appearance; severe non-peristaltic spastic contractions of the circular muscle in the esophageal wall

32
Q

are contractions coordinated or uncoordinated in distal diffuse esophageal spasm

A

uncoordinated

33
Q

treatment for distal diffuse esophageal spasm

A

CCB or nitrates
if failed –> TCA

if failed –> botox or pneumatic esophageal dilation

34
Q

what are some other names for hyper contractile esophagus

A

jackhammer
nutcracker

35
Q

dx for hyper contractile esophagus

A

manometry - increased pressure during peristalsis > 180 mm Hg; or duration > 7.5 s

36
Q

tx hyper contractile esophagus

A

CCB, nitrates
Botox, TCAs
Myotomy if refractory

37
Q

what is an esophageal web

A

a noncircumferentialz thin membrane in the MID-UPPER esophagus

38
Q

what is plummer-vinson

A

dysphagia
cervical esophageal web
IDA

39
Q

what are ppl w Plummer-vinson at an increased risk of

A

squamous cell carcinoma

40
Q

sx of esophageal web

A

intermittent dysphagia to solids

41
Q

dx esophageal web

A

barium swallow

42
Q

tx esophageal web

A

endoscopic dilation

43
Q

what is an esophageal (schatzki) ring

A

circumferential membrane in the lower esophagus/squamocolumnar junction

44
Q

what other abnormality is seen in most patients w an esophageal (schatzki) ring

A

hiatal hernia

45
Q

sx and dx and tx for esophageal (schatzki) ring

A

same as for esophageal web

say them!!!!

46
Q
A

Surgery EOR (7 decks)

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