Esophagus

Question 1

L1: Esophageal ______ disorders cause dysphagia to solids first with dysphagia to liquids only late in the course

Answer 1

structural

Question 2

L1: Esophageal _______ disorders cause dysphagia to both solids and liquids.

Answer 2

motility

Question 3

L1: In the Barrett Esophagus > Adenocarcinoma progression, what stage is defined by elongated nuclei and pencillate cells?

Answer 3

Low-grade dysplasia

Question 4

L1: In the Barrett Esophagus > Adenocarcinoma progression, what stage is defined by rounded nuclei and crowded glands?

Answer 4

High-grade dysplasia

Question 5

L1: Which pathologic pattern? Columnar metaplasia of the esophagus with “intestinalization”

Answer 5

Barrett’s Esophagus

Question 6

L1: Which pathologic pattern? Esophageal cancer associated with age and alcohol/tobacco use arising anywhere along the length of the esophagus

Answer 6

Squamous Cell Carcinoma

Question 7

L1: Which pathologic pattern? Esophageal cancer usually arising in the distal esophagus

Answer 7

Adenocarcinoma

Question 8

L1: Which pathologic pattern? Esophageal cancer with decreasing incidence in the US

Answer 8

Squamous Cell Carcinoma

Question 9

L1: Which pathologic pattern? Esophageal cancer with increasing incidence in the US

Answer 9

Adenocarcinoma

Question 10

L1: Which pathologic pattern? Multisystem disorder with small vessel obliterative vasculitis leading to fibrosis of multiple organs

Answer 10

Scleroderma/PSS

Question 11

L2: Esophageal ______ disorders are more likely to manifest with weight loss.

Answer 11

structural

Question 12

L2: In Barrett’s Esophagus, what is appearance on endoscopy?

Answer 12

Salmon-colored patchiness

Question 13

L2: In Barrett’s Esophagus, which abnormal cell type is likely to be identified on histology?

Answer 13

Goblet cell

Question 14

L2: What is seen on endoscopy and histology in eosinophilic esophagitis?

Answer 14

Ringed pattern; eosinophilic infiltrate

Question 15

L2: What is the preferred diagnostic tool for evaluating esophageal diverticula?

Answer 15

Barium study

Question 16

L2: Which pathologic pattern? Child with recurrent bouts of pneumonia and regurgitation

Answer 16

Tracheoesophageal Fistula

Question 17

L2: Which pathologic pattern? Congenitally caused esophageal stricture

Answer 17

Schatzki’s Ring

Question 18

L2: Which pathologic pattern? Impaired relaxation of lower esophageal sphincter

Answer 18

Achalasia

Question 19

L2: Which pathologic pattern? Infectious cause of esophagitis with punched out ulcers

Answer 19

HSV

Question 20

L2: Which pathologic pattern? Infectious cause of esophagitis with white plaques

Answer 20

Candida

Question 21

L2: Which pathologic pattern? LES tearing, severe vomiting associated with alcohol intoxication

Answer 21

Mallory-Weiss Tear

Question 22

L2: Which pathologic pattern? Outpouching of esophagus leading to food regurgitation or bacterial colonization

Answer 22

Zenker’s Diverticulum

Question 23

L2: Which pathologic pattern? Type ___ achalasia: abnormal lumen obliterating contractions in the esophagus with poor response to botox injection, myotomy, and pneumatic dilatation

Answer 23

III

Question 24

L2: Which pathologic pattern? Type ___ achalasia: simulatneous pressurization along length of esophagus with response to botox injection, myotomy, and pneumatic dilatation

Answer 24

II

Question 25

L3: Name 3 esophageal motility disorders.

Answer 25

Achalasia, Scleroderma, Spastic Disorders

Question 26

L3: Name both complications of GERD.

Answer 26

Barrett’s Esophagus and Erosive Esophagitis

Question 27

L3: What is the differential for a patient presenting with dysphagia to solids and liquids?

Answer 27

Achalasia, Scleroderma, Spastic Disorders

Question 28

L3: What is the treatment? Achalasia (3)

Answer 28

Botulinum Injection, Pneumatic balloon dilatation, Myotomy

Question 29

L4: Name 4 possible sequelae of reflux esophagitis/GERD

Answer 29

Ulcerations, strictures, Barrett’s Esophagus, Adenocarcinoma

Question 30

L4: Name 5 risk factors for GERD.

Answer 30

obesity, pregnancy, tobacco use, medications, concurrent disorders (ZE, PSS, gastroparesis)