Esophagus And Stomach Disorders - McGowan Flashcards
What type of scleroderma affects children and has morphea patches?
Localized
what causes steakhouse syndrome?
Schatzki ring
Biggest complication of eosinophilic esophagitis?
Esophageal perforation
What can hot beverages, alcohol, smoking or HPV cause?
SCC
Bird beak sign seen with what?
Achalasia
What causes the antigenic variation of African sleeping sickness?
T. Gambiense
What causes esophageal dysphagia to mainly solids but some liquids?
Scleroderma
Mallory-weiss tear occurs where?
Common cause of what?
Dx how?
Nontransmural tear at GE junction
Upper GI bleed
EGD, hx
Nutcracker esophagus has a ______ that relaxes normally but an _____ at baseline?
LES
Elevated pressure
What gets worse within 30min after eating?
Risk factor?
Gastric ulcer
H. Pylori and smoking
Best tests for H. Pylori?
Stool Ag immunoassay
C13/14 urea breath test
Burn patients are at risk for what?
Tx how?
Stress ulcers
PPI
Esophageal stricture has what features?
Dysphagia that is progressive from Solids –> liquids
Histologic exam for H. Pylori?
Serology?
EGD w/biopsy or rapid CLO
Serum h. Pylori antibodies, IgA
What should you suspect in a pt w/dysphagia and esophageal food impactions?
Eosinophilic esophagitis
Clinical course of diffuse esophageal spasm?
Diagnose how?
What radiograph buzz word?
Intermittent, NOT progressive
Manometry, EGD
Rosary bead esophagus
How do you diagnose GERD?
Ambulatory 24-48 hr esophageal pH recording
What anatomic location does ZE occur at?
What area of natural weakness?
Diagnose how?
Bw cricopharyngeus and inferior pharyngeal constrictor muscles
Killian’s triangle
Barium swallow
What type of scleroderma has the worst prognosis?
Best?
Diffuse
Limited (HAS anticentromere antibodies)
What is known to cause vaginal dryness, dental caries, and parotid/other salivary gland enlargement?
Sjogren’s
What presents as a gnawing pain 1-3 hours after eating but is relieved by food?
Duodenal ulcer (anterior wall of prox D)
What causes Tardive dyskinesia?
What clinical sign does it show?
Drug related: metoclopramide
Lip smacking
Give H. Pylori microbio description
curved g(-) rod (microaerophilic baccili w/flagella)
What is crunching sound upon auscultation of the heart due to pneumomediastinum?
Occurs with what?
Hamman’s sign
Boerhaave’s syndrome
ZE syndrome occurs where?
Inheritance pattern?
What gene?
Prox duodenum (45%) and pancreas (25%), LNs (5-15%)
AD, MEN1
What has greater amplitude and duration but normal coordinated contraction in the esophagus?
Nutcracker esophagus (Hypertensive peristalsis)
What has a strong association with B cell non-Hodgkin lymphoma?
Sjogren’s syndrome
What disease is ANA present in 90% - speckled or centromere?
Scleroderma
What are risk factors for candidiasis?
Uncontrolled diabetic
Steroid use
What kind of disorder is achalasia?
Problem with what?
Loss of what?
Motility disorder that is progressive (solids and liquids)
Propulsion (absent peristalsis)
Loss of ganglion cells w/in esophageal myenteric plexus
Red flags for GERD?
Laundry list
Weight loss persistent Vom Constant/severe pain Dysphagia Hematemesis Melena Anemia
Scleroderma occurs in what age group?
More in men or women?
Clinical course?
Hallmark?
30-50
W > M
Progressive (more severe in AA)
Thickening and hardening of the skin (microangiopathy and fibrosis of skin and visceral organs)
What is the most common esophageal stricture?
Secondary to what?
Peptic
GERD
Where does Zenker’s Diverticulum occur most often?
Is what kind of diverticulum?
Oropharyngeal (upper esophagus)
False diverticula
How to diagnose esophageal perforation?
Tx?
CT of chest look at mediastinum
NGT suction, NPO, surgery, Abx
Where do gastric ulcers occur?
Associated with what?
What type of pain?
Lesser curvature of the antrum of the stomach
H. Pylori
Burning epigastric
What is the definitive method for diagnosing achalasia?
What deformity may be present?
Esophageal manometry
“Sigmoid deformity”
When does Schatzki ring occur?
Diagnose how?
Tx?
> 40 y/o, aquired
Barium swallow/EGD
Dilation
What is very effective at relieving dysphagia in pts with fibrostenosis from EOE?
Esophageal dilation
What results from spastic contraction of the circular muscle in the esophageal wall, and LES function is normal?
Corkscrew esophagus
What causes African sleeping sickness?
Vector?
T. Brucei
Tsetse fly
What group is at the greatest risk for Barrett Esophagus?
Obese white males older than 50
Complications like esophagitis, stricture, Barrett’s and adenocarcinoma can result from what?
GERD
What is a bad taste in your mouth called?
Walter Brash
What is trichonisis?
What causes it?
Fever, myalgia, splinter hemorrhage
T. Spiralis
What condition is associated with Anti-Scl-70 (Anti-topoisomerase I Ab)?
Scleroderma
What has esophageal webs, iron-deficiency anemia, angular chelitis, glossitis, and koilonychia?
Plummer-Vinson syndrome
Failure to respond to 4-8 weeks of PPI tx or frequent sx relapse after PPI discontinuation in GERD indicates what?
Endoscopy
How do you diagnose eosinophilic esophagitis?
Would see what?
EGD
Multiple circular esophageal rings creating a corrugated appearance