Gi Tract-Usera Flashcards by Danielle Hayes

Congenital abnormalities are normally discorvered shortly after birth. It will result in (Blank) during feeding. This must be corrected promptly since they are incompatible with life. What are all the types of congenital GI abnormalities?

regurgitation

agenesis
Atresia
Stenosis
Duplication

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What is esophageal agenesis?

Is it common?

esophagus is absent

no it is rare

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Duplication cysts are (blank) and (Blank) cystic masses that contain redundant smooth muscle layers. May be present in what parts of the body?

saccular
elongated

esophagus, small intestine, colon

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What is this:

thin noncanalized cord replaces a segment of esophagus causing mechanical obstruction

Esophageal atresia

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In esophageal atresia, what will the proximal and distal blind pouches of the esophagus connect to?

pharynx and stomach

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Esophageal atresia most commonly occurs at the (blank) of the trachea

bifurcation (carina)

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Esophageal atresia is associated with what defects and diseases?

congenital heart defects
genitourinary malformations
neurologic disease

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In esophageal atresia, a (blank) may connect to the bronchus or trachea and may lead to what thing?

fistula

aspiration
suffocation
pneumonia
severe fluid and electrolyte disturbances

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What is this:
incomplete form of atresia
lumen is reduced due to fibrous thickening of the wall
complete or partial obstruction

Stenosis

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Where does esophageal stenosis occur?

any part of GI tract

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What is the most common form of congenital intestinal atresia?
What is it due to?

imperforate anus

- failure of cloacal diaphragm to involute

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What is this:
incomplete formation of the diaphragm and abdominal viscera herniates into thoracic cavity

What may this cause?

Diaphragmatic hernia

pulmonary hypoplasia

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What is this:
closure of the abdominal musculature is incomplete and abdominal viscera herniates into the ventral membranous sac.

Is it associated with other congenital abnormalities?

how do you treat it?

Omphalocele

yes

surgically repaired

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What is this:
Ventral wall defect similar to omphalocele

What layers of the abdominl wall does it affect?

gastroschisis

all layers (from peritoneum to the skin)

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Is ectopia common in the GI tract?
Where do you most frequently get it?
What may it result in?

yes

inlet patch, occurs in the upper 1/3 of the esophagus.
dysphagia, esophagitis, Barrett esophagus or adenocarcinoma

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Where do you find ectopic pancreatic tissue? Is it usually symptomatic?

in esophagus and stomach

- asymptomatic but can cause damage and local inflammation that causes obstruction

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What is this:
ectopic gastric tissue in the small bowel or colon

It may present with occult (blank) due to (blank) of the adjacent mucosa

Gastric heterotopia

blood loss
peptic ulceration

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What is the mucosa like of the esophagus?

nonkeratininzing stratified squamous epithelium
Lamina propria
Muscularis mucosa

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What is the submucosa of the esophagus made up of?

-loose CT with submucosal glands

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What is the muscularis propria of the esophagus made up of?

-inner and outer longitudinal SM

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What are some lesions that can cause esophageal obstruction?

nutrcracker esophagus
esophageal spasm
webs
rings
stenosis
achalasia

What is this:
ledgelike protrusions of the mucosa into the upper esophagus lumen

What is it associated with?

What is the main symptom?

Webs

GER
GVHD
Blistering Skin Diseases

Dysphagia

What is Plummer Vinson syndrome (Paterson-Brown Kelly)?

Esophageal webs w/ Fe deficiency
Anemia
Glossitis
Cheilosis

What are Schatzki rings?

Circumferential, thick protrusion into the lower esophagus lumen

What do Schatzki rings consist of?

mucosa, submucosa and LP

What type of rings are these: | Occur in the distal esophagus above the GE junction

A rings

What type of rings are these: | Occur at the GE junction

B rings

What is this: outpouchings of the alimentary tract that contains all visceral layers What is this: an outpouching of mucosa and submucosa

True diverticulum False diverticulum

What are the three types of diverticulum based on location?

Zenker-above upper esophagus sphincter Traction- middle esophagus Epiphrenic- above lower esophagus sphincter

What is this: | narrowing of the lumen due to fibrous thickening of the submucosa and atrophy of the muscularis propria

Stenosis

What is stenosis caused by

inflammation and scarring from GER Irradiation Caustic injury

In stenosis, (blank) is progressive, first for solids then liquids

dysphagia

What is this: | increased tone of the LES as a result of impaired SM relaxation

Achalasia

Alchalasia is characterized by...?

incomplete LES relaxation increased LES tone aperistalsis of the esophagus

What is primary achalasia due to?

failure of distal esophagus inhibitory neurons

In secondary achalasia, you often see it in (Blank) disease

Chagas disease (trypanosoma cruzi)

Why does secondary achalasia occur?

infection causes destruction of the myenteric plexus, failure of peristalsis and esophageal dilation

How do you treat achalasia?

- laparoscopic myotomy - pneumatic balloon dilation - botulinum toxin injection

What is this: - associated with retching due to acute alcohol toxication - longitudinal tears that range in length from mm to cm

Mallory-Weiss tears

Mallory Weiss tears usually cross the (blank) junction but can occur at the proximal gastric mucosa. Does it require surgical intervention?

EG | no

What is this: distal rupture of the esophagus with mediastinitis Is it common?

Boerhaave syndrome rare and catastrophic event

What is this: inflammation of the esophageal mucosa What may it be secondary to?

Esophagitis - gastric reflux - infections - drug use - irradiation - trauma - corrosive agents

What is the most common outpatient GI diagnosis and the most common cause of esophagitis? What is the clinical condition called?

Reflux esophagitis | GERD

What is reflux esophagitis due to? | Which can be caused by?

decreased tone in LES ``` Alcohol Tobacco Obesity CNS depressants Pregnancy Hiatal hernia Delayed gastric empyting Increased gastric volume ```

What are the clinical featuers of reflux esophagitis? | What is the tx?

dysphagic and heartburn PPI, H2 histamine receptor antagonists

Esophagitis infections can occur in any patient but occurs most often in (blank) patients. What are some agents that cause this?

immunocompromised Herpes simple Cytomegalovirus Fungus (candida, mucormycosis, aspergillus)

Esophagitis has a (blank) infiltrate. What are the clinical features? How do you treat it?

eosinophilic food impaction dysphagia failure of PPI therapy absence of reflux steroids or dietary restriction

What is this: | separation of the diaphragmatic crura and protrusion of the stomach into the thorax

Hiatal hernia

What is this: | intestinal metaplasia w/in the esophageal squamos mucosa

Barrett's esophagus

Barrett's esophagus is a complication of (blank). You will be at increased risk of (blank). Presence of (Blank) determines tx

chronic GERD esophageal adenocarcinoma high grade dysplasia

(blank) arises in the background of Barrett esophagus and long standing GERD

Adenocarcinoma

What are the risk factors for squamos cell carcinoma?

- alcohol - tobacco use - poverty - caustic esophageal injury - achalasia - Plummer Vinson syndrome - Frequent consumption of hot beverages - nutritional deficiencies - polycyclic hydrocarbons - nitrosamines