GI- 1

Question 1

What are the layers of the esophagus?

Answer 1

Mucosa, submucosa, and muscularis propria

Question 2

Where does most important pathology occur?

Answer 2

GE junction, where the squamous epithelium gives way to the glandular epithelium

Question 3

The GE junction is AKA

Answer 3

The z-line

Question 4

What is the most common congenital anomaly?

Answer 4

A tracheo-esophgeal fistula

Question 5

Tracheo-esophageal fistula is associated with what in 90% of cases?

Answer 5

Esophageal atresia in the middle third

Question 6

When does tracheo-esophageal fistula present itself and how can it lead to death?

Answer 6

During the neonatal period

Death by aspiration pneumonia

Question 7

What are the 2 major types of hernias?

Answer 7

Hiatal and paraesophageal

Question 8

What is a hiatal hernia?

Answer 8

When the entire proximal stomach protrudes into the mediastinum

Question 9

What is a paraesophageal hernia?

Answer 9

Rolling when part of the fundus protrudes into the mediastinum

Question 10

What is the most important cause of esophagitis?

Answer 10

Reflux

Question 11

What happens in reflux esophagitis?

Answer 11

There is passage of gastric and duodenal contents through the lower esophageal sphincter

Question 12

What are common elements of reflux esophagitis?

Answer 12

Elongation of rete, basal cell hyperplasia, and intraepithelial eosinophils

Question 13

Intraepithelial eosinophils are seen in what other type of esophagitis? The pattern seen endoscopically is called?

Answer 13

Hypersensitivity esophagitis

Feline or trachealization

Question 14

Intestinalization of glandular epithelium occurs in?

Answer 14

Barret’s esophagus

Question 15

How does the color of the mucosa in barret’s compare to normal?

Answer 15

Red, velvety vs. pale pink

Question 16

Intestinalization refers to presence of what cells?

Answer 16

Goblet cells

Question 17

What is the most common cause of infectious esophagitis?

Answer 17

Candida like albicans or tropicalis

Question 18

How does candida related esophagitis present itself and how is it treated?

Answer 18

Dysphagia, treated with antifungals like fluconazole

Question 19

What is the 2nd most common cause of infectious esophagitis?

Answer 19

Herpes simplex virus

Question 20

Who gets infected with HSV related IE?

Answer 20

Immunocompromised adults and children

Question 21

HSV can cause what other then IE?

Answer 21

Ulcers

Question 22

How do you treat HSV?

Answer 22

Antivirals like acyclovir

Question 23

Cytomegalovirus is seen in who? What can it lead to?

Answer 23

Always in immunocompromised patients and leads to ulcers that resemble HSV ulcers

Question 24

CMV cells possess what type of nucleus?

Answer 24

Owl eye

Question 25

What is Mallory-Weiss syndrome?

Answer 25

When there are longitudinal tears in the lower esophagus that may also extend into the upper stomach

Question 26

What does MW syndrome lead to and who gets it?

Answer 26

Leads to hematemesis or vomiting blood, seen in alcoholics

Question 27

Are the tears perforating or superficial?

Answer 27

Superficial

Question 28

A syndrome that has transmural tears is?

Answer 28

Boerhaave syndrome

Question 29

Esophageal varices are a complication of?

Answer 29

Portal hypertension

Question 30

What is the cause of varices and what can it result in?

Answer 30

Caused by alcohol and leads to hematemesis and death

Question 31

Which vein is a major player in the formation of esophageal varices?

Answer 31

The left gastric vein or the cardiac vein

Question 32

What are the two types of esophageal carcinoma?

Answer 32

Squamous cell and adenocarcinoma

Question 33

Which type of esophageal carcinoma is most common the US? Worldwide?

Answer 33

In the US the numbers are about the same due to genetic and environment. Worldwide SCC is 90%

Question 34

What are the main causes of esophageal carcinoma in the US? Who gets it more often, men or women?

Answer 34

Smoking and alcohol, men get it 4x as often

Question 35

Almost all esophageal adenocarcinomas occur in the presence of?

Answer 35

Barret's esophagus

Question 36

Describes types A-E of atresia and fistulas

Answer 36

``` A is atresia without fistula B is atresia with proximal fistula C is atresia with distal fistula D is atresia with proximal and distal E is fistula without atresia ```

Question 37

Esophageal varices result from?

Answer 37

Increase in pressure in the portal vein which shunts blood into associated veins not meant to withstand the increased pressure