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year 1 > GI - oesophagus > Flashcards

GI - oesophagus Flashcards

1
Q

what are some causes of acute oesophagitis (rare)

A

corrosive following chemical ingestion

infective in immunocompromised

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2
Q

what are some causes of chronic oesophagitis (common)

A

reflux disease e.g. GORD
defective sphincter
hiatus hernia
pregnancy

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3
Q

what is the histology of oesophagitis

A

basal zone epithelial expansion (hyperplasia) - increased proliferation
intraepithelial neutrophils, lymphocytes and eosinophils

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4
Q

what are some complications of oesophagitis

A

ulceration
haemorrhage
stricture
barretts oesophagus

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5
Q

“acid abuse accompanied by eosinophils”

A

oesophagitis

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6
Q

what is barrett’s oesophagus

A

replacement of stratified squamous epithelium with metaplastic columnar epithelium with goblet cells (like intestine)

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7
Q

what cause barrett’s oesophagus

A

prolonged exposure of normal oesophagus to GORD —> mucosal inflammation and erosion

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8
Q

is barrett’s oesophagus spontaneous or patchy

A

either

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9
Q

what is seen in barrett’s oesophagus macroscopically

A

red velvety mucosa in lower oesophagus

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10
Q

what is seen in barrett’s oesophagus microscopically

A

columnar lined mucosa with interstitial metaplasia

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11
Q

what is the treatment of barrett’s oesophagus

A

annual endoscopy + biopsy

PPIs

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12
Q

why must barrett’s oesophagus be monitored

A

increased risk of dysplasia –> carcinoma

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13
Q

what is allergic oesophagitis

A

immune mediated oesophagitis caused by reaction to food

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14
Q

what kind of immune cell infiltrate is there in allergic oesophagitis

A

eosinophils

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15
Q

what does the oesophagus look like in allergic oesophagitis

A

corrugated feline or spotty oesophagus

looks like trachea

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16
Q

who is at risk of allergic oesophagitis

A

males > females
Hx Asthma / Fmhx asthma
young

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17
Q

what would a pH probe for allergic oesophagitis show

A

negative for reflux

18
Q

what does achalasia show on a barium swallow

A

birds beak appearance with proximal dilation

dilated tapering oesophagus

19
Q

what is achalasia

A

disordered oesophageal motility
with inability to relax the LOS
due to degeneration of myenteric plexus

20
Q

what are some s/s of achalasia

A

dysphagia for solids and liquids
regurgitation
substernal cramps
weight loss

21
Q

what does achalasia increase risk of

A

oesophageal squamous cell carcinoma

22
Q

what are some causes of achalasia

A

Chaga’s

reduced secretion of NO

23
Q

what is the treatment for achalasia

A

endoscopic balloon dilation
Heller’s cardiomyotomy + PPI
CCBs and nitrates to relax sphincter

24
Q

what is the most common cause of death due to cirrhosis

A

oesophageal varices

25
Q

how do oesophageal varices present

A

painless haematemesis

26
Q

what are oesophageal varices

A

abnormally dilated oesophageal veins arising secondary to portal hypertension

27
Q

when should oesophageal varices be suspected

A

alcohol abuse
cirrhosis
- looks for signs of cirrhotic liver disease e.g. encephalopathy, splenomegaly, ascites

28
Q

what is the prophylactic treatment of oesophageal varices

A

non-selective BB e.g. propranolol

repeat endoscopic banding ligation

29
Q

what is the treatment of oesophageal varices after 1st variceal bleed

A

TIPSS

30
Q

what does TIPSS stand for

A

transjugular intrahepatic portal systemic shunt

31
Q

what is the treatment of acute variceal bleeding

A

vitamin K
FFP (fresh frozen plasma)
platelet transfusion

32
Q

what is a trans-oesophageal fistula

A

congenital defect where there is a connection between oesophagus and trachea

33
Q

what are some s/s of a trans-oesophageal fistula

A

vomiting
polyhydramnios
abdominal distension
aspiration

34
Q

what is a mallory-weiss tear

A

painful haematemesis due to oesophageal mucosal tear

35
Q

what causes a mallory-weiss tear

A

persistent vomiting
alcoholism
bulimia

36
Q

what is corkscrew oesophagus

A

diffuse oesophageal spasm - primary oesophageal motility disorder

37
Q

what are some s/s of corkscrew oesophagus

A

dysphagia
chest pain
Ba swallow - abnormal contractions (cork screw oesophagus)

38
Q

what are some risk factors of a hiatus hernia

A

female
obese
over 50

39
Q

what is a sliding hiatus hernia

A

gastrooesophageal junction slides up into the chest

–> acid reflux

40
Q

what is a rolling hiatus hernia

A

gastrooesophageal junction remains in the abdomen but a bulge of stomach herniates into chest alongside oesophagus (paraoesophagheal)

41
Q

how is a hiatus hernia diagnosed

A

barium swallow

42
Q

how is a hiatus hernia treated

A

lose weight

treat reflux symptoms

year 1 (45 decks)

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