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Esophagus GI issues Flashcards

1
Q

What is esophagitis?

A

Inflammation of the esophagus primarily affecting the mucosa. Associated with GERD or other not infectious causes.

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2
Q

What is dysphagia?

A

Difficulty in swallowing caused by a number of underlying causes: stroke, local trauma, muscle dysfunction, tumor or swelling that obstructs the passage of food

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3
Q

List some neuromuscular causes of oropharyngeal dysphagia

A 
CVA
MS
Thyroid dysfunction
CP
Head trauma 
Bells palsy
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4
Q

List some structural disorders that cause oropharyngeal dysphagia

A 
Oropharyngeal tumors
Zenker's diverticulum 
Thyroidomegaly
Prior surgery/radiation
Prox. esophageal webs 
Cleft palate
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5
Q

List some neuromuscular causes of esophageal dysphagia?

A

achalasia
diffused esophageal spasm
nutcracker esophagus
scleroderms

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6
Q

List some structural disorders that cause esophageal dysphagia?

A 
peptic stricture
esophageal rings and webs
diverticula
carcinoma
foreign bodies
mucosal injuries ---> infections or GERD
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7
Q

List dysphagia red flags

A 
weight loss 
odynophagia
vomiting
early satiety 
GI bleeding 
Iron deficiency
---> carcinoma
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8
Q

When does oropharyngeal dysphagia begin?

A

begins within 2 seconds of swallowing

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9
Q

When does esophageal dysphagia begin?

A

begins several seconds after swallowing and often in a feeling of food being stuck in lower sternal area

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10
Q

What is the best test for esophageal dysphagia?

A

Esophagogastroduodenoscopy (EGD)

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11
Q

What is achalasia?

A

Motliltiy disorder of the esophagus characterized by incomplete relaxation of the lower esophageal sphincter and peristalsis of esophagus smooth muscle.
—-> failure to relax

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12
Q

Short term symptom relief of achalasia?

A

CCB and Nitrates

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13
Q

What is esophageal spasm?

A

increase number of uncoordinated peristaltic waves

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14
Q

What is esophageal stricture?

A

narrowing of the esophagus usually due to gastric reflux can be d/t toxic liquids or solids

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15
Q

What is an esophageal ring (schatzki ring)

A

narrowing of the diameter of the esophageal lumen usually at the level of the lower esophageal sphincter. This mucosal ring is a thin annual web-like tissue usually at the level of the squamocolumnar junction

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16
Q

What is esophageal web?

A

a thin membrane that may develop across the lumen of the esophagus usually at the level of the cricoid cartilage

17
Q

What is esophageal web associated with?

A

iron def. anemia.

18
Q

What is Zenker’s Diverticulum?

A

obstruction of the esophageal introitus that results from mucosal herniation posteriorly between the cricopharyngeus muscle and the inferior pharyngeal constrictor muscle.

19
Q

S/Sx of Zenker’s Diverticulum?

A

dysphagia to solids and liquids (MC)

regurgitation

sensation of lump/fullness

cough

halitosis

aspiration pneumonia

weight loss

voice changes

sialorrhea

20
Q

What is the test of choice to diagnose Zenker’s diverticulum?

A

Barium swallow

21
Q

What is a hiatal hernia?

A

protrusion of intra-abdominal contents through an enlarged esophageal hiatus of the diaphragm

22
Q

Barrett’s esophagus is predisposed to develop what?

A

esophageal adenocarcinoma

23
Q

Clinical sxs and findings of Barretts esophagus?

A

chronic hearburn

dysphagia w/ solid foods

epigastric TTP

24
Q

Etiology of Barretts esophagus?

A

metaplasia is thought to result from re-epithelialization of esophageal tissue injured as a result of chronic GERD

25
Q

Red flag sxs with Barretts esophagus?

A

dysphagia

odynophagia

weight loss

vomiting

early satiety

GI bleeding

Iron deficiency

26
Q

What is Mallory Weiss tear?

A

longitudinal mucosal laceration in the region of the gastroesophageal junction

OR

nonpenetrating tear of the gastroesophageal junction w/ hx of vomiting

27
Q

Mallory Weiss tear DDx?

A

esophageal or gastric varices

esophageal, gastric, duodenal ulcers

gastric erosions

A-V malformation

neoplasms

28
Q

Mallory Weiss tear hx/clinical findings?

A

hematemesis

vomiting, retching, or vigeous coughing

tachy

hyoTN

melana

hematochezia

Alcoholics

29
Q

What are esophageal varices?

A

dilated submucosal vein that occurs in pts w/underlying portal HTN. Can results in sever upper GI hemorrhage

30
Q

Clinical presentation of esophageal varices?

A

hematemesis

hypovolemia

palmar erythema

telangiectasis

gynecomastia

caput medusea (abdominal varices)

31
Q

What is some clinical presentation of Budd-Chiari syndrome?

A

IVC thrombosis w/ subsequent hepatocellular carcinoma (Africa and south Asia)

primarily myeloproliferative disorders and underlying hypercoagulable states (United States)

32
Q

Diagnostic/work up for Budd-Chiari syndrome?

A

US and color and pulsed doppler

33
Q

Etiology of squamous cell esophageal neoplasm?

A

MC in African Americans

34
Q

Etiology of adenocarcinoma esophageal neoplasm?

A

MC in whites

35
Q

esophageal neoplasm ratio of males vs females?

A

3-4:1 —> highest in the Hispanic population

36
Q

Link between barretts esophagus and esophageal adenocarcinoma?

A

familiar clustering –> genetic link between the two

37
Q

Clinical presentation of esophageal neoplasm?

A

Dysphagia (MC)

Unintentional weight loss

Hoarseness

Cervical adenopathy

Iron def. anemia

hypercalcemia

38
Q

Etiology of esophageal neoplasm?

A

Excess alcohol

Tobacco

obesity

hiatal hernia

high fat diet

mucosal damage

achalasia

chronic GERD

celiac sprue

39
Q

How common is esophageal neoplasm and where does it rank in number of deaths worldwide?

A

8th MC cancer, 7th leading cause of cancer death worldwide.

GI (16 decks)

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