Esophagus 🗣 Flashcards
Q: Elderly smoker with dysphagia, showed high grade dysplasia,
management?
A:
1. Add ranitidine
2. Ask him to stop smoking
3. congenital behavior therapy
4. endoscopic mucosal resection
Endoscopic mucosal resection ✅💛
Q: Old man has progressive dysphagia e mass in mid esophagus
chest x-ray normal . What is the most likely cause?
A:
1. adenocarcinoman
2. SSC
3. Lymphoma
SSC ✅💛
Q: A patient with achalasia underwent pneumatic dilation. Postoperatively he is hemodynamics unstable. Imaging show leakage. What is your management?
A:
1. Endoscopic Repair
2. Endoscopic Stent
3. Surgical Repair and drainage
Endoscopic Stent ✅💛
Note :
Esophageal perforation Mx :
- HD unstable > Stent.
- HD Stable > Endoscopic repair.
Patient presented with dysphagia to liquids more than solid. Which is the most appropriate initial investigation:
A- endoscopy
B- barium swallow
C- US
D- biopsy
Endoscopy ✅💛
Note ;. The use of barium swallow is indicated in certain cases and is known to be a controversial initial investigation.
Complication of esophageal atresia repair
A. GERD
B. Recurrent laryngeal nerve damage
GERD ✅💛
Female 45 c/o continues progressive solid liquid dysphagia x 9 ms + vague epigastric pain with eating Laps all normal except hgb slightly low dx
A-Achalsia
B-Esophageal web
C-Squamus c c
D-PUD i think
Squamous cell carcinoma ✅💛
Note :
SCC + Achalasia can presented with progressive dysphasia
Go with SCC since we have anaemia
A 73YM complaining from 4kg weight loss for 1month. He has not been able to eat more than one bite without coughing immediately and sometimes he
regurgitates food through his nose. Symptoms are worse with liquids. He had a stroke in the right MCA. Next?
A. Esophagram.
B. Videofluoroscopy.
C. Esophageal Manometry.
D. Upper Endoscopy.
Video-fluoroscopy ✅💛
Note :
He had oropharyngeal dysphagia the source of it is neuro 😉
Pt diagnosed as achalasia, most appropriate management
A. Fundoplication
B. Pneumatic dilatation
A case of achalasia.
Lower esophageal myotomy with fundiplication✅💛
Best = most effective, not initial
Heller myotomy with fundplication
A male patient who is a known alcoholic for many years presents with
abdominal pain, vomiting and hematemesis. He was recently managed as a case
of perforated peptic ulcer. On exam, there is epigastric tenderness. Liver
enzymes are normal. Diagnosis is ?
A) Acute pancreatitis
B) Chronic pancreatitis
C) Varicose
D) Mallory-weiss
Mallory-weiss ✅💛
Women with worsening dysphagia for 9 months for both liquid and solids, she recently have ill defined central chest pain, no other past history. Clinical examination was unremarkable, labs was unremarkable, except of ESR = 13 ( the normal was up to 10 ), what is the diagnosis?
A. Pharyngeal pouch
B. Achalasia
C. Esophageal web
D. Squamous cell carcinoma of the esophagus
Achalasia ✅💛
A case of achalasia. What is the best management choice? -
A. Calcium channel Blocker
B. botulism toxin injection at LOS
C.Pnuemonatic dilatation
D. Lower esophageal myotomy
Note :
D. Lower esophageal myotomy ✅💛
UTD
Laparoscopic Heller myotomy is superior to a single pneumatic dilation in terms of efficacy and durability.
Post dilatation of esophageal stricture came back with chest pain and
change of voice./ Patient after esophageal balloon dilation for esophageal
varices started to complain of difficulty in breathing and voice change.
What is the complication?
A- Bleeding
B- Perforation
C- Aspiration -
Perforation ✅💛
Note :
●Cervical perforation may be associated with neck pain, tenderness of the sternocleidomastoid muscle, dysphonia, hoarseness, cervical dysphagia, and cervical subcutaneous emphysema.
Patient undergoes esophageal dilation for achalasia came after (6 or 12 hours) with chest pain, subcutaneous crepitus and labs showed WBC 21000, what is your management?
A. Total Parenteral Nutrition (TPN)
B. Nasogastric Tube (NGT)
C. Stent
D. Drainage and surgery
Note :
Conservative include : ( NPO , TPN , Ab , PPI )
Medical ( stent ) :
1. Stable , no sepsis ,
2. Small perforation ( in the neck)
Otherwise go for surgical
