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clin med > gi 4.1 > Flashcards

gi 4.1 Flashcards

1
Q

Dysmotility is dt

A

d/t spasm, hypercontractile esophagus, esophagogastric outflow obstruction, weak esophageal peristalsis, achalasia

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2
Q

Esophageal motility problems

common sx

A

Dysphasia (difficulty swallowing)

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3
Q

Esophageal motility problems

dx

A 
Barium esophagography (barium swallow)
Upper endoscopy/EGD (esophagogastroduodenoscopy)
Esophageal manometry
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4
Q

Achalasia cause

A

Denervation of esophagus

Peristalsis lost in distal esophagus and LES cant relax

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5
Q

Achalasia sx

A

Gradual dysphagia of solids and liquids

Regurgitation of undigested foods

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6
Q

Achalasia dx

A

Barium enema- Birds beak on distal esophagus
Confirm with manometry
EGD to look for strictures

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7
Q

Achalasia trmt

A

Botox
Pneumatic dilation
Surgery

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8
Q

Esophagus stricture

?

A

Narrowing of esophagus

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9
Q

Esophagus stricture

caus

A

MC GERD

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10
Q

Esophagus stricture

sx

A

Progressive solid food dysphagia

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11
Q

Esophagus stricture

dx

A

Barium swallow, endoscopy with biopsy

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12
Q

Esophagus stricture

trmt

A

Dilation with EGD then long term PPI

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13
Q

Esophagus ring

?

A

Smooth circumferential (go all way around esophagus) thin mucosal strictures in distal esophagus

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14
Q

Esophagus ring

mc ring

A

Schatzki ring MC

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15
Q

what is the Esophagus ring

made of and where is it located

A

hypertrophic mucosal ring proximal to squamocolumnar junction

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16
Q

Esophagus ring

cause

A

Chronic damage from GERD

congenital

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17
Q

Esophagus ring

sx

A

Solid food dysphagia, food impaction

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18
Q

Esophagus ring

dx

A

Barium swallow

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19
Q

Esophagus ring

trmt

A

Esophageal dilation

Treat GERD

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20
Q

Esophageal webs?

A 
Thin membranes of squamous epithelium in proximal upper half of esophagus
Non circumferential (don't go all way around esophagus)
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21
Q

Esophageal webs cause

A

Congenital

Immunological, derm, iron def anemia

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22
Q

Esophageal webs sx

A

Asymptomatic

Solid food dysphagia

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23
Q

Esophageal webs dx

A

Barium swallow

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24
Q

Esophageal webs trmt

A

Treat cause

Esophageal dilation

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25
Q

Plummer vinson syndrome triad:

A

esophageal web, dysphagia, iron def anemia (inc cancer risk)

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26
Q

Food bolus impaction

cause

A

Meat

Peptic stricture or esophageal ring

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27
Q

Food bolus impaction

sx

A

Food stuck

Cant swallow food or water

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28
Q

Food bolus impaction

dx and trmt

A

Endoscopy- remove food or dilate ring/stricture during removal

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29
Q

Zenker diverticulum?

A

Sac at pharyngeal esophageal junction

Usually in elderly

30
Q

Zenker diverticulum cause

A

Loss of elasticity of UES

31
Q

Zenker diverticulum sx

A

Dysphagia, regurg of undigested food, halitosis (bad breath)

32
Q

Zenker diverticulum dx

A

Barium swallow

Video esophagography

33
Q

Zenker diverticulum trmt

A

Surgery

34
Q

Odynophagia ?

A

Sharp substernal pain when swallowing that causes someone to limit oral intake
In immunocompromised

35
Q

Odynophagia causes

A

Erosive or infectious

Pill induced ulcers

36
Q

Esophagitis types

A 
Infectious- immunocompromised
Candida
Cmv
Herpetic
Pill induced
Hx
Bed bound pts
Eosinophilic esophagitis
37
Q

Infectious Esophagitis

is commonly in this pop

A

Immunocompromised- HIV, chemo

38
Q

Infectious Esophagitis

cause

A

Candida- diffuse linear yellow white plaques
CMV- few large superficial ulcers
Herpes- many small deep ulcers

39
Q

Infectious Esophagitis

sx

A

Odynophagia, dysphagia, chest pain

40
Q

Infectious Esophagitis

dx

A

Endoscopy

Biopsy

41
Q

Pill induced esophagitis

risks

A

Hospitalized/bed bound patients

42
Q

Pill induced esophagitis

cause

A

Pill in contact with mucus too long

NSAIDS, vit c, iron, KCl, bisphosphonates, doxycycline, tetracycline

43
Q

Pill induced esophagitis

sx

A

Severe retrosternal pain shortly after taking pill

44
Q

Pill induced esophagitis

trmt

A

Remove pill with endoscopy

45
Q

Pill induced esophagitis

prevention

A

Sit up straight and take pills with 4 oz water

46
Q

Eosinophilic esophagitis

is assoc with

A

Assoc with allergic conditions

47
Q

Eosinophilic esophagitis

dx

A

Biopsy- Eosinophils in squamous epithelium

48
Q

Eosinophilic esophagitis

trmt

A

Allergist

Modify diet

49
Q

Not responsive to PPI

A

Eosinophilic esophagitis

50
Q

Barrett esophagus?

A

Squamous epithelium replaced by metaplastic columnar epithelium
Dark red color on esophagus
High risk for cancer

51
Q

Barrett esophagus

cause

A

Complication of GERD

52
Q

Barrett esophagus

dx

A

Confirmed by biopsy on endoscopy

53
Q

Barrett esophagus

trmt

A

Treat aggressively

Long term PPI dec CA risk

54
Q

Barrett esophagus

sxreening

A

In high risk pts: men with 2+ adenocarcinomas, over age 50, obese, tobacco, FH

55
Q

Esophageal neoplasm pop

A

In older pts

More men

56
Q

Esophageal neoplasm sx

A

Progressive solid food dysphagia
Weight loss
May have odynophagia
Sx based on spread

57
Q

Esophageal neoplasm dx

A

Barium swallow

Confirm with endoscopy and biopsy

58
Q

Esophageal neoplasm trmt

A

Depends on cancer stage

Die soon after dx

59
Q

Adenocarcinoma population? location?

A

White, obese men
Complication from Barrett
Distal third of esophagus

60
Q

SCC

A

Black men, china, SE Asia
From ETOH and tobacco
Assoc with other head and neck CA

61
Q

UGI bleed

?

A

Bleeding above ligament of Treitz

62
Q

UGI bleed

cause

A

PUD MC
Portal HTN/esophageal varices
Mallory weiss tear

63
Q

UGI bleed

sx

A

Hematemesis- red or coffee ground
Melana
Can have hematochezia

64
Q

UGI bleed

trmt

A

Treat cause
May need blood
Admit

65
Q

Mallory weiss tear ?

A

Nonpenetrating (superficial) mucosal tear at gastroesophageal junction

66
Q

Mallory weiss tear risks

A

Alcohol use

67
Q

Mallory weiss tear cause

A

Forceful vomiting

Usually pt comes in and said they vomited blood once then got scared so came in

68
Q

Mallory weiss tear sx

A

Hematemesis

69
Q

Mallory weiss tear dx

A

Endoscopy- see tear

70
Q

Mallory weiss tear trmt

A

Usually resolves on its own

Cautery, clip, epi injection

clin med (35 decks)

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