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F3E3 > Esophagus 1 > Flashcards

Esophagus 1 Flashcards

1
Q

the UES controls what

A

food entry into he esophagus

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2
Q

the LES prevents

A

reflux of gastric contents

relaxed during swallowing and under pressure at rest `

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3
Q

common infectious etiologies of esophagitis

A

fungal: candida
viral: CMV, HSV

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4
Q

patient demographics of esophagitis

A

immunosuppressed

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5
Q

patients with esophagitis present with Odynophagia, dysphagia, and possible fever and lymphadenopathy, which is the most significant symptom?

A

Odynophagia

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6
Q

esophagitis caused by CMV endoscopy shows

A

1 to several larger and deeper ulcers that are in a linear or longitudinal distribution

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7
Q

esophagitis caused by HSV endoscopy shows

A

multiple small shallow ulcers more clusters look “volcano-like” due to being well circumscribed

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8
Q

esophagitis caused by candida endoscopy shows

A

linear yellow white plaques that appear adherent to the esophagus

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9
Q

if someone comes in with esophagitis what should you test them for

A

HIV, if negative look for other underlying causes of immunodeficiency

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10
Q

definitive diagnosis for esophagitis

A

when getting an endoscope gather brushings and get at cytology or culture

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11
Q

treatment for esophagitis due to candida

A

fluconazole or ketoconazole

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12
Q

treatment for esophagitis due to HSV

A

acyclovir

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13
Q

treatment for esophagitis due to CMV

A

IV gancilovir or foscarnet

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14
Q

ingestion of household cleaners or bleach may lead to what

A

corrosive esophagitis

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15
Q

on endoscopy you see ulceration, necrosis and perforation in patches that extends from oropharynx to stomach, what is this?

A

corrosive esophagitis

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16
Q

2 complications of corrosive esophagitis

A

Healing may lead to fibrosis and stricture formation (dilate if present)
Increased risk of squamous cell carcinoma

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17
Q

corrosive esophagitis additional information

A

perforation may occur
obtain a CXRAY and CBC
patients abdomen will be rigid and they will often be unstable

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18
Q

a patient reports with retrosternal chest pain and odynophagia after taking doxy for a recent infection, what is a possible diagnosis?

A

medication induced esophagitis

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19
Q

3 common meds leading to medication induced esophagitis

A

NSAIDS, Bisphosphonates, Doxy

20
Q

chronic injury without treatment of medication induced esophagitis may lead what 3 complications

A

severe esophagitis with stricture
hemorrhage
perforation

21
Q

treatment for medication induced esophagitis

A

removal of medication, allow time to resolve, educate patient to take medication with enough fluid to clear medication

22
Q

Brain stem dz or CN disease, CVA, Parkinson’s, myasthenia gravis, botulism, muscular dystrophy, polymyositis are causes of what type of esophageal dysmotility?

A

neurogenic

23
Q

clinical symptoms of neurogenic esophageal dysmotility?

A

Dysphaisa, with possible olodyphasia

trouble with BOTH Liquids and solids

24
Q

a patient comes in complaining of emesis consisting of liquids and undigested foods what do you suspect?

A

zenker’s diverticulum

25
Q

where is the pouch located in zenker’s diverticulum

A

in the posterior hypopharynx above UES

26
Q

a patient has trouble swallowing solids and not liquids on endoscopy you note webbing, what do you suspect?

A

esophageal stenosis

27
Q

3 types of esophageal stenosis

A

webs rings and malignancy

28
Q

esophageal manometry and barium esophagram may be used for visualization of what on zenker’s diverticulum

A

posterior pouch

29
Q

Schatzki’s ring is a mechanical disorder that may be caused by GERD or congenital/devlopmental deformity may present with what 3 things?

A

Episodic dysphagia to solids (webs described as intermittent)
Large food boluses may become impacted
Abrupt onset of sub-sternal discomfort

30
Q

Plummer- Vinson syndrome is associated with what?

A

esophageal webs

also difficulty swallowing, iron-deficiency anemia

31
Q

Dilated esophagus tapering to distal obstruction the gives a parrot beak appearance on esophagus is related to what condition?

A

achalasia

32
Q

which dysmotility disorder may mimic a heart attack and therefore must be ruled out?

A

diffuse spasm of the esophagus

33
Q

patient presents with chest pain and difficulty swallowing after a stressful day at work, pain is radiating to arm and jaw, after ruling our a heart attack you perform a barium esophagram? you diagnosis your patient with a diffuse spasm, what did you see on the esophagram?

A

a corkscrew esophagus

34
Q

a diffuse spasm may also be cause by drinking what?

A

cold liquids

35
Q

how do you treat a diffuse spasm

A

smooth muscle relaxants
NTG: before meals and at bedtime
Isosorbide denigrate before meals
nifedipine before before meals

these may drop BP, warn patients

36
Q

esophageal dysmotility is associated with what rheumatoid disorder from exam 2?

A

scleroderma - CREST syndrome

37
Q

in what two ways does CREST syndrome lead to esophageal dysmotility?

A

1) atrophy and fibrous replacement of smooth muscle in distal esophagus
2) weakness of contraction in the lower esophagus and incompetence of LES

38
Q

which imaging study allows you to directly see abnormalities and allow for biopsy

A

endoscopy

39
Q

which imaging study can show structural and motor problems

A

barium swallow

40
Q

esophageal manometry allows what two things?

A

1) assess strength and coordination of peristalsis

2) Assesses pressures of LES

41
Q

aspiration pneumonia is common in which esophageal dysmotility?

A

neurogenic

42
Q

what is the test of initial investigation for esophageal dysmotility?

A

barium esophargram (barium swallow), endoscopy then allows for treatment

43
Q

a linear tear in the mucosa of the esophagus usually near the GE junction is refereed to as

A

a mallory Weiss tear and causes 10% of upper GI bleed

44
Q

a 10 week pregnant patient comes in stating that she vomits multiple times a day but is concerned because this morning started to notice blood in the vomit however she is in no pain, what do you suspect?

A

a Mallory Weiss tear

45
Q

a 23 year old female comes in a day after her birthday reporting that she blacked out while celebrating the night before, she states that her friends noticed blood in her vomit the night before, you suspect a a Mallory Weiss tear, how do you diagnosis and treat this patient?

A

dx- endoscopy
treatment- may resolve on its own, possible injection of epinephrine if bleeding persist, additionally might try thermal coagulation or surgery if the bleed is severe (arterial)

F3E3 (11 decks)

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