Lecture 13 - Diseases of the Esophagus

Question 1

_____-_____ fistula is the most common congenital anomaly of the Esophagus. It is usually associated (90% of cases) with Esophageal _____ in the mid third of the esophagus. This disease is present in the _____ period (right after birth) –> look for excessive ______ or _____ sounds in the abdomen.

Can lead to death via _____ _____.

Answer 1

Tracheo-esophageal fistula

Esophageal Atresia

Neonatal

Drooling

Breath sounds

Aspiration Pneumonia

Question 2

_______ is more common as an acquired disease than as a congenital disease. It arises from denervation of the LES, leading to spasms.

Answer 2

Achalasia

Question 3

_____ Hernia is a relatively common and is characterized as either _____ or Paraesophageal.

Answer 3

Hiatal Hernia

Sliding

Question 4

There are 2 types of Diverticula:

Zenker’s –> results from congenital weakness of the ________ muscle. Passing food causes an outpouching of ONLY the ______ layer, so this is really a pseudo-diverticulum that takes years to develop. Patients will present with extreme ______ bc food accumulates in that outpouching, and this will eventually impede the esophagus.

Traction –> Typically a triangular outpouching around the ____-esophagus caused by fibrotic ______ of the tissue, pulling all the tissue layers outward (true diverticulum). Look for patients with chronic ________ diseases of the mediastinum, particularly ____.

Answer 4

Cricopharyngeal muscle

Submucosal layer

Halitosis

Mid-esophagus

Contracture

Inflammatory

TB

Question 5

Normal esophageal lining appears _____-____ in color, while Barret’s esophagus will appear ____ and velvety.

Answer 5

Pale-pink

Red

Question 6

For HSV esophageal infections, look for Ulcers and cells with _______-appearing nuclei and marginalized ______. Also look for syncitial cells.

Answer 6

Glassy-appearing

Chromatin

Question 7

For CMV infections, look for endothelial cells with _____ (light or dark?) nuclear inclusions.

Answer 7

Dark

Question 8

Keep in mind Candida infection occurs at the surface, HSV involves the ______, and CMV is at the base of the ulcer and involves _______ cells.

Answer 8

Epithelium

Endothelial

Question 9

Mallory-Weiss Syndrome results from longitudinal tears in the _____ (upper, mid, or lower?) esophagus, typically from violent _____. Patients will likely present with _______.

Answer 9

Lower

Vomiting

Hematemesis

Question 10

Lye is NaOH found in many household cleaners. One of the big issues from ingestion, aside from the obvious caustic trauma, is stricture formation and resultant predisposition to ______ years later.

Answer 10

Cancer

Question 11

Esophageal varices are most commonly caused by _______ HTN, resulting most commonly from excess _____ consumption and second most commonly from _______ (look for patients from Puerto Rico and parts of Africa). Rupture of the varices will cause MASSIVE ________ (think about how this compares to presentation of Mallory-Weiss Syndrome).

Answer 11

Portal HTN

Alcohol

Schistosomiasis

Hematemesis

Question 12

Esophageal Carcinoma accounts for 6% of all GI malignancy. In the US, it is most commonly ________ that results from reflux esophagitis, though ____ _____ carcinoma was previously most common and occurs most frequently in alcoholics and smokers. Mutations in ____ is a predisposing factor for both of these types.

Answer 12

Adenocarcinoma

Squamous Cell carcinoma

p53