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GI Week 1 > Esophageal Disorders > Flashcards

Esophageal Disorders Flashcards

1
Q

what is the characteristic appearance of squamous cell carcinoma on histo slide?

A

solid clusters of cells

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2
Q

what is the difference between erosion and ulcer?

A

erosion is superficial necrosis that heals with regeneration while ulcer is deep necrosis that heals with fibrosis

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3
Q

what are three ways GI malignancies can grow?

A

fungating
infiltration
ulceration

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4
Q

what is fungating malignancy growth?

A

when it grows up

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5
Q

what is infiltrating malignancy growth?

A

when it grows to sides

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6
Q

what is ulcerating malignancy growth?

A

when it grows down and chews out some tissue

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7
Q

what is another GI issue that fibrosis or scarring can actually lead to?

A

a stricture

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8
Q

what are the two causes of achalasia?

A

lack of peristalsis in smooth muscle of esophagus and non relaxation of LES

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9
Q

what bug can cause achalasia? where does the bug infiltrate?

A

T cruzi

myenteric plexus ganglion

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10
Q

what will you see with barium swallowing with achalasia?

A

dilated esophagus and a BIRD BEAK narrowing at distal end

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11
Q

how to treat achalasia?

A

botox or dilatation with balloon

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12
Q

what is jackhammer esophagus?

A

hypercontractility of esophagus

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13
Q

what are two symptoms with jackhammer esophagus?

A

chest pain and dysphagia

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14
Q

what is ineffective esophageal motility? what disease does it occur with?

A

peristalsis happening just not effective..like CHF…happens with reflux disease

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15
Q

what is a scleroderma esophagus? when does this occur?

A

lack of peristalsis in the esophagus due to scleroderma autoimmune disease

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16
Q

what happens to the LES with scleroderma esophagus?

A

sphincter hypotension so you get regurg

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17
Q

name three infectious agents that cause esophagitis

A

candida
herpes simplex 1
CMV

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18
Q

what three things are seen in candida plaques in esophagitis?

A

candida pseudohyphae
necrotic debris
PMNs

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19
Q

with HSV1 what are the three Ms you see on histo slides in the esophagus?

A

margination
multinucleation
molding

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20
Q

what cells does HSV1 infect in esophagus?

A

epithelial cells

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21
Q

CMV leads to what gross pathology in the esophagus?

A

ulcers or erosions

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22
Q

what cell does CMV infect in the esophagus?

A

endothelial and fibroblasts

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23
Q

what are two findings on histo slides of CMV in the esophagus?

A

nuclear intrusions and cytomegaly

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24
Q

what can stuck pills causes grossly in esophagus?

A

inflammation and ulcer/erosion

25
Q

what is eosinophilic esophagitis? how does it look grossly?

A

infiltration of eosinophils in the esophagus…leads to ring like structures that cause dysphagia

26
Q

what is a hiatal hernia?

A

protrusion of stomach into the thorax through an enlarged diaphragmatic hiatus

27
Q

what are the two types of hiatal hernias? which is most common?

A

sliding or rolling…sliding is most common

28
Q

what is a common issue associated with hiatal hernias?

A

GERD bc LES not working well

29
Q

is a hiatal hernia acquired or congenital?

A

acquired usually

30
Q

what two cells are commonly seen in distal esophageal epithelium with GERD?

A

PMNs and eosinophils

31
Q

what are extraesophageal symptoms of GERD?

A

chronic cough, laryngitis asthma and tooth decay

32
Q

what are esophageal symptoms of GERD?

A

heartburn
acid regurg
chest pain

33
Q

what can GERD lead to if it is persistent?

A

a stricture

34
Q

what do you give to treat GERD as empiric therapy?

A

PPI

35
Q

what are fivered flags of GERD?

A 
weight loss
vomiting
bleeding
anemia
jaundice
36
Q

what is the surgery for GERD called?

A

fundoplication…where they wrap part of the stomach around the esophagus

37
Q

GERD can lead to Barrett metaplasia…what is this?

A

when distal esophagus starts to change into simple intestinal columnar epithelium

38
Q

in Barretts…why does it change to intestinal columnar epithelium?

A

because it is used to stomach contents and has mucus to protect from the acid

39
Q

what are the two types of neoplastic injuries of the esophagus?

A

squamous epithelium and metaplasia intestinal adenocarcinoma

40
Q

what is the main cause of adenocarcinoma in the esophagus?

A

GERD/Barretts

41
Q

what are two risk factors for squamous cell carcinoma of esophagus?

A

tobacco and alcohol

42
Q

Barrett metaplasia has to go through one other step before it becomes adenocarcinoma…what is that step?

A

dysplasia…big pleomorphic nuclei

43
Q

what is the pattern of adenocarcinoma of esophagus?

A

fungating ulcerating or infiltrating…any of them

44
Q

where can squamous cell carcinoma occur in the esophagus?

A

any portion!

45
Q

how does esophageal cancer present? 2 things

A

dysphagia with solids progressing to liquids…and weight loss

46
Q

what appearance will esophageal cancer have on barium swallow?

A

raggedy appearance

47
Q

if you have esophageal dysphagia with intermittent issues with solid food only…what do you likely have?

A

lower esophageal ring…schatzki ring

48
Q

what is the cause of a lower esophageal ring?

A

unknown

49
Q

if you have esophageal dysphagia with progressive issues with solid food only and chronic heartburn…what do you likely have?

A

peptic stricture

50
Q

does a peptic stricture appear smooth or raggedy on barium swallow test?

A

smooth

51
Q

if you have esophageal dysphagia with progressive issues with solid food only and weight loss…what do you likely have?

A

carcinoma of esophagus

52
Q

if you have esophageal dysphagia with intermittent issues with solid and liquid food and chest pain…what do you likely have?

A

diffuse esophageal spasms

53
Q

what is the cause of esophageal spasms?

A

unknown

54
Q

if you have esophageal dysphagia with progressive issues with solid and liquid food and heartburn…what do you likely have?

A

scleroderma

55
Q

if you have esophageal dysphagia with progressive issues with solid and liquid food and bland regurg/weight loss…what do you likely have?

A

achalasia

56
Q

does scleroderms or achalasia have GERD? or both?

A

just scleroderma

57
Q

if you have progressively worsening dysphagia with solid or liquid food and there are rings in the esophagus on upper endoscopy…what do ya have?

A

eosinophilic esophagitis

58
Q

if you have iron deficiency and esophageal webs…what do you have?

A

plummer vinson syndrome

GI Week 1 (5 decks)

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