Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI Week 1 > Esophageal Disorders/GERD - Erickson > Flashcards

Esophageal Disorders/GERD - Erickson Flashcards

1
Q

Define odynophagia

A

Pain on swallowing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define dysphagia

A

Symptom resulting from the failure to move a food bolus from the mouth to the stomach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some factors that can contribute to dysphagia?

A
  • reduced saliva/mastication
  • Neuromuscular disorders
  • Impaired mental function
  • Motility disturbances
  • Mechanical obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are symptoms of dysphagia?

A
  • difficulty swallowing

- food stops/ “sticks” after swallowing is initiated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Difficulty initiating swallowing would indicate what type of dysphagia?

A

Oropharyngeal dysphagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Food stops/or sticks after swallowing in initiated would indicate what type of dysphagia?

A

Esophageal Dysphagia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the 3 goals of treatment for oropharyngeal dysphagia?

A
  1. Protect Airway
  2. Maintain nutrition
  3. Relieve Dysphagia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is achalasia?

A

Loss of inhibitory innervation to the LES (tonically contracted LES)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

In what condition would you see a bird’s beak narrowing at LES, and a dilated esophagus on a barium swallow?

A

Achalasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the 4 treatment options for Achalasia?

A
  • Nifedipine (calcium channel blocker)
  • Botulinum Toxin (blocks ACh release)
  • Balloon Dilation
  • Esophagogastric Myotomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Esophageal dysphagia intermittent with solids only

A

Lower esophageal ring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Progressive esophageal dysphagia with solids only

A

Peptic Stricture

Cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Intermittent esophageal dysphagia with solids and liquids

A

Diffuse spasm
NEMD
Nutcracker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Progressive esophageal dysphagia with solids and liquids

A

Achalasia

Scleroderma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the classic symptom of GERD? Other common symptoms?

A

Heartburn = classic
Regurgitation
Belching
Water brash (regurgitation of excess saliva from lower esophagus often with lots of stomach acid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are 3 symptoms associated with complications of GERD?

A

Dysphagia
Odynophagia
Bleeding

17
Q

What 2 ways do hiatal hernia contribute to reflux?

A
  1. No diaphragmatic support of LES
  2. HH is reservoir for gastric contents

Note: many hiatal hernias are not associated with reflux

18
Q

What diagnostic studies should you order to diagnose GERD?

A

Trick questions!

Diagnostic studies are NOTneeded with classic history, start empiric treatment

19
Q

What is the best initial diagnostic study for patients with reflux symptoms and dysphagia?

A

Barium Swallow

20
Q

What is the best diagnostic study for evaluating mucosal injury? (like esophagitis, barrett’s epithelium, hiatal hernia, strictures)

A

Endoscopy

21
Q

What is the best study to confirm GERD?

A

Ambulatory pH monitoring

22
Q

What is the cornerstone of GERD therapy?

A

Life-style modifications!!

  • elevate bed
  • no food 3 hours before bed
  • stop smoking
  • modify diet
  • check medications
  • OTC med prn
23
Q

What medications can decrease LES pressure?

A

Theophylline
Anticholinergics
Ca Channel blockers
Nitrates

24
Q

What medications can injure mucosa?

A 
Tetracyclines
Quinidine
NSAIDS
K+ tablets
Iron Salts
25
Q

Cimetidine
Ranitidine
Famotidine
Nizatindine

Are all examples of what? to treat?

A

H2 receptor antagonists

GERD therapy

26
Q

Omeprazole
Lansoprazole

Are examples of what? to treat?

A

Proton pump inhibitors to treat GERD

27
Q

Define Barrett’s Esophagus

A

Columnar epithelium replaces squamous epithelium in distal esophagus

DER injures squamous epithelium and promotes repair by columnar metaplasia

28
Q

What is a major risk factor for esophageal adenocarcinoma?

A

Barrett’s Esophagus!!!!

29
Q

What is the pathogenesis for peptic esophageal strictures?

A

Ulcerations stimulate fibrosis often associated with NSAIDS

30
Q

What neurotransmitters are missing in Achalasia?

A

VIP, NO

31
Q

Is the difficulty in swallowing solids and liquids intermittent or progressive in Achalasia?

A

Progressive

32
Q

Why is botulinum toxin effective in Tx of Achalasia?

A

Inhibits ACh release…allowing the LES to relax

33
Q

Most common cause of GERD?

A

Transient LES relaxations

34
Q

Is it hard to swallow solids only or solids & liquids with esophageal cancer or a peptic stricture?

A

Solids only

Progressive

35
Q

What is water brash?

A

Saliva over production!

36
Q

Prototype patient for eosinophilic esophagitis?

A

Young male with history of atopic disease

GI Week 1 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions