GI- 1 Flashcards

1
Q

What are the layers of the esophagus?

A

Mucosa, submucosa, and muscularis propria

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2
Q

Where does most important pathology occur?

A

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

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3
Q

The GE junction is AKA

A

The z-line

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4
Q

What is the most common congenital anomaly?

A

A tracheo-esophgeal fistula

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5
Q

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

A

Esophageal atresia in the middle third

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6
Q

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

A

During the neonatal period

Death by aspiration pneumonia

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7
Q

What are the 2 major types of hernias?

A

Hiatal and paraesophageal

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8
Q

What is a hiatal hernia?

A

When the entire proximal stomach protrudes into the mediastinum

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9
Q

What is a paraesophageal hernia?

A

Rolling when part of the fundus protrudes into the mediastinum

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10
Q

What is the most important cause of esophagitis?

A

Reflux

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11
Q

What happens in reflux esophagitis?

A

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

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12
Q

What are common elements of reflux esophagitis?

A

Elongation of rete, basal cell hyperplasia, and intraepithelial eosinophils

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13
Q

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

A

Hypersensitivity esophagitis

Feline or trachealization

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14
Q

Intestinalization of glandular epithelium occurs in?

A

Barret’s esophagus

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15
Q

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

A

Red, velvety vs. pale pink

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16
Q

Intestinalization refers to presence of what cells?

A

Goblet cells

17
Q

What is the most common cause of infectious esophagitis?

A

Candida like albicans or tropicalis

18
Q

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

A

Dysphagia, treated with antifungals like fluconazole

19
Q

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

A

Herpes simplex virus

20
Q

Who gets infected with HSV related IE?

A

Immunocompromised adults and children

21
Q

HSV can cause what other then IE?

A

Ulcers

22
Q

How do you treat HSV?

A

Antivirals like acyclovir

23
Q

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

A

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

24
Q

CMV cells possess what type of nucleus?

A

Owl eye

25
Q

What is Mallory-Weiss syndrome?

A

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

26
Q

What does MW syndrome lead to and who gets it?

A

Leads to hematemesis or vomiting blood, seen in alcoholics

27
Q

Are the tears perforating or superficial?

A

Superficial

28
Q

A syndrome that has transmural tears is?

A

Boerhaave syndrome

29
Q

Esophageal varices are a complication of?

A

Portal hypertension

30
Q

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

A

Caused by alcohol and leads to hematemesis and death

31
Q

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

A

The left gastric vein or the cardiac vein

32
Q

What are the two types of esophageal carcinoma?

A

Squamous cell and adenocarcinoma

33
Q

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

A

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

34
Q

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

A

Smoking and alcohol, men get it 4x as often

35
Q

Almost all esophageal adenocarcinomas occur in the presence of?

A

Barret’s esophagus

36
Q

Describes types A-E of atresia and fistulas

A
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
37
Q

Esophageal varices result from?

A

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