Esophageal Disorders

Question 1

what type of muscle is in the upper esophageal sphincter and upper quarter of esophagus, and what type of muscle in the LES and lower half?

Answer 1

upper: striated
lower: smooth

Question 2

dx: dysphagia to solids and liquids, high lower esophageal sphincter resting pressure, barium swallow shows dilated esophagus with an area of distal stenosis

Answer 2

achalasia

Question 3

causes of secondary achalasia (2)

Answer 3

Chagas disease (trypanosoma cruzi), malignancy

Question 4

achalasia patients are at increased risk for what?

Answer 4

esophageal squamous cell carcinoma

Question 5

dx: complete aperistalsis of the esophagus

Answer 5

scleroderma esophagus

Question 6

GERD: is tone of the lower esophageal sphincter increased or decreased?

Answer 6

decreased

Question 7

most common cause of food impaction in adults

Answer 7

eosinophilic esophagitis

Question 8

dx: GERD symptoms but no response to GERD therapy

Answer 8

eosinophilic esophagitis

Question 9

dx: punched out ulcers in esophagus

Answer 9

HSV esophagitis

Question 10

dx: shallow linear ulcers in esophagus

Answer 10

CMV esophagitis

Question 11

what type of epithelium should you see in the distal esophagus in Barrett esophagus?

Answer 11

intestinal epithelium (nonciliated columnar with goblet cells)

Question 12

Barrett esophagus: patients are at increased risk for what?

Answer 12

esophageal adenocarcinoma

Question 13

genes implicated in Barrett esophagus (3)

Answer 13

Cdx, cyclin D1 and p53

Question 14

what portion of esophagus is squamous cell carcinoma found?

Answer 14

upper 2/3

Question 15

what portion of esophagus is adenocarcinoma found?

Answer 15

lower 1/3

Question 16

unique risk factors for esophageal squamous cell carcinoma

Answer 16

alcohol, Zenker diverticula, esophageal web, hot liquids