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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
Plummer vinson syndrome triad:
esophageal web, dysphagia, iron def anemia (inc cancer risk)
26
Food bolus impaction | cause
Meat | Peptic stricture or esophageal ring
27
Food bolus impaction | sx
Food stuck | Cant swallow food or water
28
Food bolus impaction | dx and trmt
Endoscopy- remove food or dilate ring/stricture during removal
29
Zenker diverticulum?
Sac at pharyngeal esophageal junction | Usually in elderly
30
Zenker diverticulum cause
Loss of elasticity of UES
31
Zenker diverticulum sx
Dysphagia, regurg of undigested food, halitosis (bad breath)
32
Zenker diverticulum dx
Barium swallow | Video esophagography
33
Zenker diverticulum trmt
Surgery
34
Odynophagia ?
Sharp substernal pain when swallowing that causes someone to limit oral intake In immunocompromised
35
Odynophagia causes
Erosive or infectious | Pill induced ulcers
36
Esophagitis types
``` Infectious- immunocompromised Candida Cmv Herpetic Pill induced Hx Bed bound pts Eosinophilic esophagitis ```
37
Infectious Esophagitis | is commonly in this pop
Immunocompromised- HIV, chemo
38
Infectious Esophagitis | cause
Candida- diffuse linear yellow white plaques CMV- few large superficial ulcers Herpes- many small deep ulcers
39
Infectious Esophagitis | sx
Odynophagia, dysphagia, chest pain
40
Infectious Esophagitis | dx
Endoscopy | Biopsy
41
Pill induced esophagitis | risks
Hospitalized/bed bound patients
42
Pill induced esophagitis | cause
Pill in contact with mucus too long | NSAIDS, vit c, iron, KCl, bisphosphonates, doxycycline, tetracycline
43
Pill induced esophagitis | sx
Severe retrosternal pain shortly after taking pill
44
Pill induced esophagitis | trmt
Remove pill with endoscopy
45
Pill induced esophagitis | prevention
Sit up straight and take pills with 4 oz water
46
Eosinophilic esophagitis | is assoc with
Assoc with allergic conditions
47
Eosinophilic esophagitis | dx
Biopsy- Eosinophils in squamous epithelium
48
Eosinophilic esophagitis | trmt
Allergist | Modify diet
49
Not responsive to PPI
Eosinophilic esophagitis
50
Barrett esophagus?
Squamous epithelium replaced by metaplastic columnar epithelium Dark red color on esophagus High risk for cancer
51
Barrett esophagus | cause
Complication of GERD
52
Barrett esophagus | dx
Confirmed by biopsy on endoscopy
53
Barrett esophagus | trmt
Treat aggressively | Long term PPI dec CA risk
54
Barrett esophagus | sxreening
In high risk pts: men with 2+ adenocarcinomas, over age 50, obese, tobacco, FH
55
Esophageal neoplasm pop
In older pts | More men
56
Esophageal neoplasm sx
Progressive solid food dysphagia Weight loss May have odynophagia Sx based on spread
57
Esophageal neoplasm dx
Barium swallow | Confirm with endoscopy and biopsy
58
Esophageal neoplasm trmt
Depends on cancer stage | Die soon after dx
59
Adenocarcinoma population? location?
White, obese men Complication from Barrett Distal third of esophagus
60
SCC
Black men, china, SE Asia From ETOH and tobacco Assoc with other head and neck CA
61
UGI bleed | ?
Bleeding above ligament of Treitz
62
UGI bleed | cause
PUD MC Portal HTN/esophageal varices Mallory weiss tear
63
UGI bleed | sx
Hematemesis- red or coffee ground Melana Can have hematochezia
64
UGI bleed | trmt
Treat cause May need blood Admit
65
Mallory weiss tear ?
Nonpenetrating (superficial) mucosal tear at gastroesophageal junction
66
Mallory weiss tear risks
Alcohol use
67
Mallory weiss tear cause
Forceful vomiting | Usually pt comes in and said they vomited blood once then got scared so came in
68
Mallory weiss tear sx
Hematemesis
69
Mallory weiss tear dx
Endoscopy- see tear
70
Mallory weiss tear trmt
Usually resolves on its own | Cautery, clip, epi injection

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