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GI Week 1 - WLB > Esophagus - Pathoma > Flashcards

Esophagus - Pathoma Flashcards

1
Q

What is an esophageal web?

A
  • Thin protrusion of esophageal mucosa
    • most often in the upper esophagus
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2
Q

How do patient’s with an esophageal web present?

A
  • Dysphagia for poorly chewed food
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3
Q

Esophageal web is associated with what neoplasm?

A

Esophageal Squamous Cell Carcinoma

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4
Q

What three things are present in Plummer-Vinson Syndrome?

A
  • Severe iron deficiency anemia
  • Esophageal web
  • Big beefy red tongue due to atrophic glossitis
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5
Q

What is a Zenker Diverticulum?

A
  • Outpouching of pharyngeal mucosa through an acquired defect in the muscular wall
    • “false” diverticulum
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6
Q

Where does a Zenker Diverticulum arise?

A

Just above the upper esophageal sphincter at the junction of the pharynx and esophagus

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7
Q

How do patient’s with a Zenker Diverticulum present?

A
  • Dysphagia
  • Obstruction
  • Halitosis
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8
Q

What is Mallory-Weiss Syndrome?

A
  • Longitudinal laceration of mucosa at the gastroesophageal junction
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9
Q

What causes Mallory-Weiss Syndrome?

A
  • Severe vomiting
    • usually due to alcoholism or bulimia
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10
Q

How does Mallory-Weiss Syndrome present?

A
  • Painful hematemesis
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11
Q

What condition are people with Mallory-Weiss Syndrome at risk for?

A

Boerhaave Syndrome

(esophageal rupture)

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12
Q

What are Esophageal Varices?

A
  • Dilated submucosal veins in the lower esophagus
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13
Q

Esophageal Varices often arise secondary to what condition?

A

Portal Hypertension

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14
Q

How do patients with Esophageal Varices present?

A

Asymptomatic OR Painless hematemesis

(risk of rupture always exists)

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15
Q

What is the most common cause of death in Alcoholic Cirrhosis?

A

Rupture of Esophageal Varices

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16
Q

What is Achalasia?

A
  • Disordered esophageal motility with inability to relax the lower esophagael sphincter
17
Q

What is Achalasia due to?

A
  • Damaged ganglion cells in the myenteric plexus
    • can be idiopathic or secondary to known insult
      • Chagas disease
18
Q

What are the clinical features of Achalasia?

A
  • Dysphagia for solids and liquids
  • Putrid breath
  • High LES pressure on esophageal manometry
  • “Bird-beak” sign on barium swallow
19
Q

Achalasia is associated with an increased risk for what condition?

A

Esophageal squamous cell carcinoma

20
Q

What is GERD due to?

A

reduced LES tone

21
Q

What are the risk factors for GERD?

A
  • Alcohol
  • Tobacco
  • Obesity
  • Fat-rich diet
  • Caffeine
  • Hiatal hernia
22
Q

What kind of cells normally line the esophagus?

A

Non-keratinizing Squamous Epithelium

23
Q

What are the clinical features of GERD?

A
  • Heartburn (mimics chest pain)
  • Asthma (adult onset)
  • Cough
  • Damage to enamel of teeth
24
Q

What are late complications of GERD?

A
  • Ulceration with stricture
  • Barrett esophagus
    • metaplasia to non-ciliated columnar epithelium with goblet cells
25
Q

What are the two types of Esophageal Carcinoma?

A
  • Adenocarcinoma
  • Squamous cell carcinoma
26
Q

How does Esophageal Adenocarcinoma arise?

A
  • Don’t normally have glands in esophagus
  • Get metaplasia in lower 1/3 of esophagus​ (e.g. Barrett esophagus)
    • cells become glandular
27
Q

What is the most common type of Esophageal Carcinoma in the WEST?

A

Adenocarcinoma of the Esophagus

28
Q

What is the most common type of Esophageal Cancer worldwide?

A

Squamous Cell Carcinoma

29
Q

Where in the esophagus does Squamous Cell Carcinoma arise?

A

middle or upper 1/3

30
Q

What are the risk factors for Squamous Cell Carcinoma?

A
  • IRRITATION:
    • Alcohol
    • Tobacco
    • Very hot tea
    • Achalasia (rotting food)
    • Esophageal web (e.g. Plummer-Vinson Syndrome)
    • Esophageal injury (e.g. lye ingestion)
31
Q

When does esophageal cancer present?

A
  • Presents late
    • progressive dysphagia
    • weight loss
    • pain
    • hematemesis
32
Q

What type of cancer may additionally present with a hoarse voice and cough as key clinical features? Why?

A

Squamous Cell Carcinoma

  • hoarseness → invasion of recurrent laryngeal nerve
  • cough → irritated trachea
33
Q

What regions of the esophagus spread to the Cervical lymph nodes? Mediastinal/Tracheobronchial? Celiac/Gastric?

A
  • Upper 1/3 → Cervical lymph nodes
  • Middle 1/3 → Mediastinal/Tracheobronchial nodes
  • Lower 1/3 → Celiac/Gastric Nodes

GI Week 1 - WLB (11 decks)

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