Esophageal & Gastric Pathology

Question 1

What is achalasia?

Answer 1

lack of peristalsis in the esophagus and no relaxation of the LES

Question 2

What causes achalasia?

Answer 2

inflammation in the myenteric plexus (Chagas disease)

Question 3

What does a barium swallow show in achalasia?

Answer 3

dilated esophagus with bird beak

Question 4

What is the treatment for achalasia?

Answer 4

botox or dilation of the LES, treat cause

Question 5

What is jackhammer esophagus?

Answer 5

hypercontractile peristalsis

Question 6

What is the treatment for esophageal spasm?

Answer 6

Ca-channel blockers, nitrates, surgery

Question 7

What is ineffective esophageal motility?

Answer 7

weak, but present peristalsis

Question 8

How does scleroderma manifest in the esophagus?

Answer 8

no peristalsis and NO LES tone

Question 9

What are the causes of esophagitis? (7)

Answer 9

candida, CMV, herpes, pills, chemicals, eosinophilic, GERD

Question 10

What is the result of alkaline and acidic ingestion?

Answer 10

alkaline: liquefactive necrosis
acidic: coagulative necrosis

Question 11

What is seen on endoscopy in eosinophilic esophagitis?

Answer 11

rings edema, linear furows, white plaques

Question 12

What are the two types of hiatal hernia?

Answer 12

sliding, paraesophageal

Question 13

What is the most common cause of hiatal hernia?

Answer 13

obesity

Question 14

What is a complication of hiatal hernia?

Answer 14

GERD (weakened LES)

Question 15

What are the possible complications of GERD?

Answer 15

erosion, ulceration, stricture, metaplasia, dysplasia, adenocarcinoma

Question 16

How is GERD diagnosed (without red flags)?

Answer 16

PPI test

Question 17

What are the red flag symptoms of GERD? (8)

Answer 17

weight loss, vomiting, bleeding, anemia, dysphagia, jaundice, abdominal mass, older age

Question 18

What is Barrett’s esophagus?

Answer 18

metaplasia to intestinal columnar epithelium (with protective mucus layer)

Question 19

What are the main risk factors for esophageal squamous cell carcinoma?

Answer 19

smoking, alcohol

Question 20

What is the main risk factor for esophageal adenocarcinoma?

Answer 20

GERD

Question 21

What is the most common cause of anaerobic infection?

Answer 21

Bacteroides fragilis

Question 22

What are the Clostridium pathogens and their associated diseases?

Answer 22

perfringens: gas gangrene
septicum: gas gangrene/sepsis
botulinum: botulism
difficile: colitis

Question 23

What antibiotics are always active against anaerobes? (3)

Answer 23

metronidazole, carbapenems, beta-lactam (w/ b-lactamase inh)

Question 24

What antibiotics are never active against anaerobes? (3)

Answer 24

aminoglycosides, bactrim, aztreonam

Question 25

What are the primary virulence factors for H. pylori? (3)

Answer 25

urease, flagella, mucinase

Question 26

Where are H. pylori virulence factor genes located?

Answer 26

cag pathogenicity island

Question 27

What causes dysphagia with solid food only?

Answer 27

obstruction

Question 28

What causes dysphagia with solids and liquids?

Answer 28

neuromuscular disorders

Question 29

What is the cause of intermittent mechanical dysphagia with bread/meat?

Answer 29

Schatzki ring

Question 30

What is the cause of progressive mechanical dysphagia with chronic heartburn?

Answer 30

peptic stricture

Question 31

What is the cause of progressive mechanical dysphagia with weight loss?

Answer 31

carcinoma

Question 32

What isthe cause of intermittent neuromuscular dysphagia with chest pain?

Answer 32

spasm

Question 33

what is the cause of progressive neuromuscular dysphagia with chronic heartburn?

Answer 33

scleroderma

Question 34

What is the cause of progressive neuromuscular dysphagia with regurgitation?

Answer 34

achalasia

Question 35

iron decifiency and webs

Answer 35

Plummer-Vinson syndrome

Question 36

What are the causes of acute gastritis?

Answer 36

drugs, H. pylori, virus, uremia, stress

Question 37

What ulcer results from burns?

Answer 37

Curling ulcer

Question 38

What ulcer results from brain trauma?

Answer 38

Cushing ulcer (increased vagal tone)

Question 39

What results from chronic gastritis?

Answer 39

mucosal atrophy, metaplasia

Question 40

What results from auto-parietal cell antibodies?

Answer 40

pernicious anemia (macrocytic, no IF)

Question 41

What are the possible complication of a peptic ulcer?

Answer 41

hemorrhage, perforation, obstruction

Question 42

What causes Zollinger-Ellison syndrome?

Answer 42

gastrinoma

Question 43

What is menetrier disease?

Answer 43

hyperplasia of gastric pit mucus cells (cerebriform pattern)

Question 44

What are the 4 main causes of acute n/v?

Answer 44

infection, toxin, obstruction, trauma

Question 45

What is a major cause of gasroparesis?

Answer 45

diabetes

Question 46

What are the 5 diagnostic tests for H. pylori?

Answer 46

``` urea breath test rapid urease histology serology stool antigen ```