EXAM #2: ESOPHAGEAL DISORDERS Flashcards
What is an alternate name for heartburn?
Pyrosis
What is the definition of odynophagia?
Painful swallowing
vs. dysphagia that is non-painful difficulty with swallowing
What is Globus hystericus?
Dysphagia that is relieved with swallowing
- Seen in OCD
- Seen in anxiety
What is waterbrash?
Burped up acid into the esophagus causes an abnormal salivary reaction
What is EGD?
Esophagogastroduodenoscopy
What is the best test for visualizing the esophagus?
EGD
What is endoscopic US?
Using a swallowed probe to get a US view of the esophagus
- Used to see structures just OUTSIDE of the esophagus
What is esophageal manometry used for?
Observing contractility
Note that this often included with pH testing
What is reflux testing?
A pH probe that measures the pH in the distal esophagus
How do patients present with a hiatal hernia?
Complain of a fullness in the epigastrium + heartburn
What is the most common symptom of a esophageal diverticula?
Putrid breath
What is the hallmark sign of Achalasia on radiography?
Bird Beak sign
What are the common presenting symptoms with Achalasia?
- Solid food dysphagia
- Weight loss
- Chest pain
- Foul breath
What is the treatment for Achalasia?
Treatment is limited–this is incurable
What can help an esophageal spasm?
NO and smooth muscle dilators
What is eosinophilic esophagitis?
Recurrent dysphagia with food impaction
- Caused by eosinophilic dominant inflammation
- Allergic-type reaction
What patient population is eosiniphilic esophagitis common in?
Young white males
How does EGD appear in eosinophilic esophagitis?
Ringed esophagus
What is the treatment for Eosinophilic Esophagitis?
1) PPI
2) Allergy avoidance
3) Inhaled glucocorticoids
4) Dilation
What is the common presenting symptom of infectious esophagitis?
Odynophagia
What are the common etiologies of Infectious Esophagitis?
1) C. albicans
2) CMV
3) HSV
What clinical finding is common in Candida Esophagitis?
Oral Thrush
What stain is used for identifying Candida Esophagitis?
Silver stain–pseudohyphae
When do you perform an endoscopy BEFORE treatment in possible Candida Esophagitis?
No oral thrush but you suspect Candida Esophagitis
What are the signs and symptoms of CMV esophagitis?
LAD, cough, and mono-like presentation
How will the ulcers appear in CMV esophagitis?
Large serpigenous ulcers in mid-distal esophagus
How will CMV esophagitis appear under the microscope?
Owl eye
How is CMV esophagitis treated?
Gancyclovir
What is the mnemonic to remember the features of HSV esophagitis?
hsV
- V= volcano ulcers
- V= very painful
- V= AcycloVir
What is used to visualize HSV in the lab?
Tzanck smear
*Will show “Giant cell”
What is the most common cause of an esophageal perforation?
Iatrogenic i.e. endoscopy
What is radiation esophagitis?
Radiation induced “burning” of the esophagus
What is a common cause of corrosive esophagitis?
Battery ingestion
What patient populations is pill esophagitis most common in?
Elderly “polypharmacy” patients
What is Scleroderma?
CREST Syndrome
- causes esophageal dysfunction
What is Barrett’s Esophagus associated with?
Alcohol and tobacco use
What is the treatment plan for low grade Barrett’s?
Surveillance every 2-3 years
What is the treatment plan for intermedaite grade Barrett’s?
Survey every 6 months
What should you do with high grade Barrett’s?
1) 2nd opinion
2) Surgery/laser
