Esophageal Disorders Flashcards
1
Q
Diagnosis of Achalasia?
A
Barium Swallow
Mannometry
2
Q
Treatment of achalasia
A
- long acting nitrates
- calcium channel blockers
- pneumatic dilatation of LES
3
Q
What are symptoms of diffuse esophageal spasms and how do you diagnose?
A
- heartburn, chest pain or dysphagia often initiated by swallow
- barium swallow
4
Q
treatment for esophageal spasm
A
- long acting nitrates
- calcium channel blockers
5
Q
Which of the following studies are indicated for diagnosis of GERD?
- EGD
- Manometry
- 24 hour pH monitoring
- barium radiology
A
- 24 hour pH monitoring***: recommended to dx GERD in pts refractory to PPI or when dx in question
- EGD: used to dx complications of GERD
- Manometry: used in pre-op eval
- barium radiology: not recommended
6
Q
Approach to treating new onset GERD pt
A
- empiric trial of acid suppression therapy BID for 4-8 weeks
- if alarm symptoms obtain EGD
7
Q
What are potential risks associated with PPI?
A
- hypomagnesemia
- vit b12 deficiency
- C dif infection
- CAP (in short term use)
8
Q
Risk factors for Barrett’s
A
- men
- caucasian
- age > 50
- hiatal hernia
- increased BMI
- abdominal fat distribution
- cigarette smoking
9
Q
Is it likely that a tumor in the esophagus is cancer?
A
90% are cancerous
- squamous cell carcinoma more common, increased risk with heavy alcohol and tobacco use
- adenocarcinoma where GERD is a risk factor
