GI-esophagus (1)

Question 1

what is the most common variant of a tracheoesophageal fistula?

Answer 1

proximal esophagus atresia (“blind pouch”)

distal esophagus comes off the trachea

Question 2

what are two major clinical findings in the TE fistula (proximal esophagus atresia variant)

Answer 2

baby will shoot its food back up

polyhydraminos- baby can’t consume amniot fluid

Question 3

TE fistulas can be assocaited with vater syndrome, what is this?

Answer 3

V-vertebral defects
A-anal atresia
TE- TE fistula
R-renal dysplasia

Question 4

what disorder is the following:

“thin protrusion of esophageal mucosa, most often in upper esophagus”

Answer 4

esophageal web

Question 5

what are the 4 key layers of teh GI track?

Answer 5

mucosa (lumen side)
submucosa
muscularis propria
serosa

Question 6

how does a person with esophageal web resent?

Answer 6

dysphagia for poorly chewed food

Question 7

what is the most important manifestation of esophageal web?

Answer 7

plummer vinson syndrome

Question 8

describe some features of plummer vinson syndrome

Answer 8

severe iron deficiency anemia

beefy red tongue with atrophic glossitis

Question 9

male or female predominance of plummer vinson syndrome?

Answer 9

90% of cases are female

Question 10

what disease:

“lower esophageal narrowing, usually seen at GE junction”

Answer 10

schatski ring

Question 11

tell me about the epithelium of the esophagus in schatski ring

Answer 11

upper surface of mucosal ring has stratified squamous epithelium and lower has columnar epithelium

Question 12

zenker diverticulum: true or false diverticulum

Answer 12

false

Question 13

what causes zenker diverticulum

Answer 13

abnormal pressure in the pharynx when swallowing (usually due to abnormal swallowing) and the pressure causes a protrusion through mucosa

Question 14

how does zenker diverticulum present

Answer 14

Can be asymptomatic or just feel like they have something in the back of their throat
or presents as dysphagia, obstruction and halitosis (food gets stuck and rots in the throat)

Question 15

what are epiphrenic diverticula?

Answer 15

true diverticula located immediately above the diaphragm. reflux esophagitis may play role in pathogenesis

Question 16

what disease:

“longitudinal laceration of mucosa at GE junction”

Answer 16

mallory weiss syndrome

Question 17

what causes mallory weiss syndrome

Answer 17

severe vomitting (alcoholism or bulimia)

Question 18

how does mallory weiss syndrome present

Answer 18

painful hematemesis

Question 19

what is boerhaave syndrome? when is it seen?

Answer 19

risk if the person has mallory weiss syndrome
rupture of the esophagus
air goes up the mediastinum and can get into the subcutaneous tissues (subcutaneous emphysema)

Question 20

what do you hear in boerhaave syndrome

Answer 20

you can hear crackling underneath the skin (the air under the skin)