II. Gastrointestinal Pathophysiology - AI Flashcards
What is dysphagia, and how does it differentiate between oropharyngeal and esophageal dysphagia?
Dysphagia is characterized by difficulty swallowing. Oropharyngeal dysphagia is associated with neurological conditions like stroke or Parkinson’s disease, while esophageal dysphagia may result from mechanical issues or dysmotility.
What clinical manifestation is indicative of a structural disorder in dysphagia?
Difficulty swallowing solids alone typically signals a structural disorder, which could be either benign or malignant, such as strictures.
What is the primary symptom of achalasia, and what complications may arise from this condition?
The primary symptom of achalasia is dysphagia, and complications may include pulmonary aspiration, pneumonia, and lung abscess.
How is esophageal achalasia diagnosed, and what role does diagnostic imaging play?
Esophageal achalasia is diagnosed through a combination of methods, including the patient’s medical history and diagnostic imaging. X-rays of the upper GI tract, as well as more detailed studies like MRI or CT scans, may be employed.
What is the purpose of endoscopic dilation and Heller myotomy in treating esophageal achalasia?
Endoscopic dilation widens the constricted esophagus, while Heller myotomy involves cutting the muscles of the lower esophageal sphincter to alleviate swallowing difficulties.
What are the palliative treatments for achalasia, and what potential complications may arise?
Palliative treatments include medications, botulinum injection, dilation, Heller Myotomy, and per oral endoscopic myotomy (POEM). Complications may include pneumothorax and pneumoperitoneum.
What challenges are associated with anesthetic considerations for individuals with achalasia?
Addressing the risk of aspiration is crucial, and precautions are necessary due to the dilated esophagus. Measures such as rapid sequence intubation (RSI) and evacuation procedures may be employed.
What type of diverticulum is Zenker’s diverticulum, and what is the preferred method for its repair?
Zenker’s diverticulum is a pharyngoesophageal diverticulum. The preferred method for repair is endoscopic.
What precautions are recommended during anesthesia induction for Zenker’s diverticulum repair?
Rapid sequence intubation (RSI) is recommended, and cricoid pressure should be avoided. Positioning the patient with the head elevated helps mitigate complications.
What are the two main types of hiatal hernia, and what distinguishes them?
Sliding hiatal hernia and paraesophageal hiatal hernia. Sliding involves the upward movement of the gastroesophageal junction and fundus, while paraesophageal maintains the normal junction location with a herniated pouch.
What are the treatment options for hiatal hernia, and when is surgery considered?
Treatment includes medication and surgery. Surgical intervention is considered when conservative measures are ineffective or when there is a risk of complications such as strangulation.
What are the predominant symptoms of gastroesophageal reflux disease (GERD), and what complications may arise?
Heartburn and regurgitation are common symptoms. Complications may include esophagitis, strictures, ulcers, and Barrett’s metaplasia with an increased risk of adenocarcinoma.
How does laryngopharyngeal reflux differ from GERD, and what respiratory complications may result?
Laryngopharyngeal reflux involves backflow into the pharynx, larynx, and trachea, leading to respiratory issues like chronic cough, bronchoconstriction, and pneumonia.
What lifestyle modifications are recommended for managing GERD, and what pharmacological interventions are effective?
Lifestyle modifications include avoiding trigger foods. Pharmacological interventions involve proton pump inhibitors (PPIs) and H2 receptor antagonists.
What are the surgical options for GERD, and how do they address the underlying issue?
Surgical options include laparoscopic and robotic Nissen Fundoplication, which reinforces the lower esophageal sphincter to reduce acid reflux.
