Esophageal disorders, Darrow 12/9

Question 1

Transfer (oropharyngeal) dysphagia

Answer 1

problem with food getting from mouth to esophagus

Question 2

causes or oropharyngeal dysphagia

Answer 2

parkinsons, stroke, corticobulbar problems

Question 3

Tx for oropharyngeal dysphagia

Answer 3

thickening agents

Question 4

what is transmit dysphagia

Answer 4

problem getting food though esophagus to stomach

Question 5

Causes of dysphagia for solids AND liquids

Answer 5

scleroderma
achalasia
diffuse esophageal spasm “corkscrew”

Question 6

causes of dysphagia for solids only (mechanical)

Answer 6

carcinoma
rink (Schatski’s) / webs
eosinophilic esophagitis
peptic stricture

Question 7

mid or upper esophageal webs are assoc with what?

Answer 7

congenital conditions
epidermylosis bullosa
GVHD
pephigus
pephigoid
Plummer Vinson syndrome

Question 8

Sx eosinophlic esophagitis

Answer 8

GERD - food impaction

Question 9

Hx eosinophilic esophagitis

Answer 9

allergies/atopy-peripheral eosinophilia

Tx eosinophilic esophagitis

Question 10

Tx eosinophilic esophagitis

Answer 10

swallowed fluticasone

Question 11

birds beak

Answer 11

achalasia

Question 12

path of achalasia

Answer 12

elevated LES and the intraesophageal P > gastric P
decreased neurons in myenteric plexus probably by NO producing inhibitory neurons that effect relazation of esophageal smooth mm

Question 13

what is pseudoachalasia

Answer 13

chagas, reduviid or kissing bug

usually presents first with megacolon

Question 14

area that SCC of esophagus

Answer 14

middle

Question 15

risk factors SCC of esophagus

Answer 15

ETOH, smoking, HPV, nitrates, lye, achalasia, hot liquids, tylosis and PV syndrome

Question 16

what are risk factors for adenocarcinoma of esophagus

Answer 16

GERD, Barretts and obesity

Question 17

low TIBC what type of anemia?

Answer 17

anemia of chronic disease

Question 18

anemia of chronic disease with increased Urinary sodium omsolality
most likely?

Answer 18

SIADH

Question 19

anemia, thrombocytopenia, SIADH, esophageal achalasia

most likely find on bx

Answer 19

SCC

Question 20

markers for sCC

Answer 20

CAM5.2
thyroid transcription factor 1
chromogranin A
CD56
anti Hu/ANNA-1

Question 21

role of ANNA1 Ab

Answer 21

destroy myenteric plexus, stimulating achalasia

Question 22

what is ddx for folliculitis in HIV patient

Answer 22

staph
gram -
pityrosporum
eosinophilic
traumatic
pesudomonal

Question 23

what is trichophyton rubrum

Answer 23

hyperkeratosis on fingernails

Question 24

HIv patient with fever, confusion, cough, dyspnea, dyspepsia, odynophagia, anorexia, abdominal pain, diarrhea, blurred vision and weight loss
CD4 48
most likely causes of dysphagia and odynophagia

Answer 24

esophagitis

• GERD with peptic stricture
• pills
• infections: herpease, candida, CMV

Question 25

organs affected by CMV in HIV patient

Answer 25

CNS, lung, colon, retina

Question 26

owl eyes

Answer 26

CMV

Question 27

Tx for CMV infection

Answer 27

ganciclovir & steroids!

Question 28

the "A" Sx of Addison disease

Answer 28

``` anorezia weight loss asthenia weakness arterial hypotension and fatigue abdominal pain with N, V, D anxiety and personality change aglycemia and anatremia aching muscles apigmentation axillary areolar and anal pigmentation ```

Question 29

red wale sign

Answer 29

esophageal varices

Question 30

infectious causes of chronic gastritis

Answer 30

H pylori H heilmannie, mycobacterium, syphillis, histoplasmosis, mucormycosis, blastomycosis, anisakiasis stronglyoides, schistosomiasis, diphyllobothrium, CMV and HSV

Question 31

noninfectious causes chronic gastritis

Answer 31

``` autoimmune chemical (NSAIDs, ASA, bile reflux) uremic crohns, sarcoid, wegenrs, CGD, eosinophilic granuloma lymphocytic eosinophilic radiation GVDH ischemic ```

Question 32

what is dermopathy

Answer 32

vitiligo with CD8 T cells and Ab to tyrosinase | may be assoc with automimune thyroid disease, Addisons, PA, sKE

Question 33

Ddx macrocytosis

Answer 33

``` megaloblastic anemia elevated reticulocyte count alcohol liver disease hypothyroidism myelodysplastic and myelophthisic anemia COPD ```

Question 34

what are common causes megaloblastic anemias

Answer 34

includes B12 and folate deficiency, homocystinuria, antimetabolite drugs, AZT, hydroxyuria