Esophageal DO

Question 1

What type of dysphagia is commonly seen with CVA and Parkinsons

Answer 1

Oropharyngeal dysphagia; difficulty initiating the swallowing reflex

Question 2

Which type of dysphagia is commonly seen with tumors, strictures, radiation, scleroderma

Answer 2

Esophageal dysphagia - due to mechanical cause

Question 3

Sharp substernal pain on swallowing

Answer 3

Odynophagia

Question 4

What is the LES?

Answer 4

3-4cm long segment of smooth muscle at distal esophagus

Question 5

What acts as an additional sphincter around the lower end of the esophagus?

Answer 5

Diaphragmatic hiatus

Question 6

What is the most common disorder of the esophagus?

Answer 6

GERD

Question 7

How do you manage a patient with Barrett’s esophagus?

Answer 7

Repeat endoscopy every 2 years with biopsy

Question 8

What are the 2 evidence based non-pharmacologic treatments for GERD?

Answer 8

Elevate head of bed - esp. with nocturnal symptoms; Lose weight

Question 9

What is the 1st and 2nd line treatment for GERD?

Answer 9

1st line = H2 blockers; 2nd line = PPI

Question 10

Treatment for CMV esophagitis

Answer 10

IV ganciclovir

Question 11

Who are the two people who get Mallory- Weiss syndrome

Answer 11

Alcoholics and people w/ hiatal hernias

Question 12

What is the most common cause of portal HTN?

Answer 12

Cirrhosis

Question 13

What is the most common site of esophageal varices?

Answer 13

Distal esophagus

Question 14

What type of varices are most likely to rupture?

Answer 14

Those at the GE junction

Question 15

A ring of tissue located at the junction of the esophagus and stomach

Answer 15

Schatzki’s ring

Question 16

What is plummer-vinson syndrome and what patients do you see it with?

Answer 16

Esophageal webs with iron deficiency anemia and glossitis; see it in patients w/ esophageal webs

Question 17

What is diagnostic for achalasia?

Answer 17

Barium swallow x-ray shows “birds beak” narrow segment at the end of esophageal body

Question 18

A majority of esophageal cancers are which types?

Answer 18

Squamous cell and adenocarcinoma

Question 19

What is one difference in risk factors for AC and SCC of the esophagus?

Answer 19

Alcohol intake is NOT linked to esophageal adenocarcinoma, but is linked to SCC; Obesity is linked to AC but NOT SCC

Question 20

Most esophageal adenocarcinoma arises from ??

Answer 20

Barrett’s metaplasia