Esophagus

Question 1

Esophagitis

Answer 1

Infectious- candidal (fluconazole), HSV/CMV (Acyclovir), HIV (ganiciclovir)
Pill-induced (NSAIDs, bisphosphonates)
Eosinophilic (multiple corrigated rings)
GERD
*pregnant, smokers, obese, alcoholics

Question 2

Achalasia

Answer 2

• MC in 50s
• failure of relaxation at LES (auerbach plexus)
• bird’s beak tapering on barium swallow
• Manometry is diagnostic
• tx w botulinum, nitrates, CCBs, pneumatic dilation

Question 3

Boerrhave

Answer 3

• crepitus on palpation; chest pain worse w deep breath
• tx: abos, IV fluids, surgery
• contrast esophagram shows leakage gastrografin swallow

Question 4

Nutcracker

Answer 4

manometry is diagnostic

tx: nitrates and CCBs

Question 5

MW tear

Answer 5

UGI bleed at GE jxn

-superficial/longitudinal erosions

Question 6

Zenker’s

Answer 6

“lump in neck” feeling
surgery: diverticulectomy, cricopharyngeal myotomy
barium esophagram shows collection of dye behind esophagus

Question 7

Webs/Rings

Answer 7

Schatzki ring at squamocolumnar junction
Plummer-Vinson syndrome
- iron deficiency anemia
-atrophic glossitis
-angular cheilitis
-WW 30-60y
-MC assoc w hiatal hernias
tx: endo dilation if no reflux, if reflux then surgery
-dx: barium esophagram