Lecture 2 - Esophagus

Question 1

____ GI disorders include irritable bowel syndrome and non-ulcer dyspepsia. they are due to altered ____. there (is or is not) structural or histologic abnormality

Answer 1

functional;
physiology;
is not

e.g. abnormal motility

Question 2

esophagus:
upper part = ____ muscle.
lower part = ____ muscle.
what kind of epithelium

Answer 2

skeletal
smooth;
nonkeratinized stratified squamous

Question 3

in _____ dysphagia, the bolus “hangs up” in the throat and is associated with cough or regurg.

Answer 3

oropharyngeal

Question 4

esophageal dysphasia:
bolus hangs up _____;
with or without cough?
usually involves ____ muscle

Answer 4

substernally;
without;
smooth

Question 5

dysphagia to…
solids indicates presence of _____ lesions;
solids and liquids suggests ____ problem

most common lab test?

Answer 5

obstructive;
motor;

endoscopy

Question 6

intermittent dysphagia for solids or complete obstruction in a healthy patient suggests ____ _____ aka _____

Answer 6

esophageal ring, schatzki’s

Question 7

_____ is severe substernal pain implying ____ or inflammation

Answer 7

odynophagia;

ulceration

Question 8

3 things that can cause esophagitis in immunocomprimised patients

Answer 8

CMV, herpes, candida

Question 9

progression of solid dysphagia to solids and liquid dysphagia suggests _____

Answer 9

cancer

Question 10

the ____ test looks at acid perfusion of the esophagus. specific for ____

Answer 10

berstein;

reflux

Question 11

mallory weiss tear:
usually occurs where?
seen in ___ and ____;
presents as _____ _____

Answer 11

gastroesophageal junction;
alcoholics, bulimics;
PAINFUL hematemesis

Question 12

esophageal webs: due to protrusion of the ____;

most common benign esophageal tumor?

Answer 12

Mucosa;

leiomyoma

Question 13

achlasia:
loss of ___Ganglionic ____ neurons;
high or low LES resting pressure?
increased or decreased peristalsis?

Answer 13

post, inhibitory;
HIGH;
decreased

Question 14

achlasia:
dysphagia to _____;
“____” on barium swallow

Answer 14

solids AND liquids;

bird’s beak

Question 15

_____ is characterized by a corkscrew appearance on barium swallow

Answer 15

diffuse esophageal spasm

Question 16

sclerodermal esophagus:
high or low LES pressure?
esophageal smooth muscle ____

Answer 16

LOW;

atrophy –> decreased peristalsis

Question 17

treatment of motility disorders:
_____ injection, but high relapse rrate.;
laproscopic ____ _____ is first line

Answer 17

botulism toxin;

heller myotomy

Question 18

eosinophillic esophagitis:
associated with ____ disorders.
patients are usually young or old?
____ and linear ____ seen on endoscopy

Answer 18

atopic/allergic;
young;
rings, furrows

Question 19

GERD:

3 risk factors

Answer 19

alcohol, obesity, tobacco

and caffeine

Question 20

GERD:
associated with ____ if hits trachea;
______ if reaches teeth;
____ if reaches larynx

Answer 20

asthma;
damaged enamel;
hoarseness

Question 21

Barrets:

metaplasia to what kind of epithelium?
assocaited with what kind of cancer

Answer 21

nonciliated columnar with goblet cells;

ADENOCARCINOMA

Question 22

GERD:

most effective medication?

Answer 22

PPI ie omeprazole;

watch for rebound reflux if stop

Question 23

esophageal cancer (squamous v adeno):
affects upper 2/3 esophagus?
affects lower 1/3?
more common world wide?
more common in the US/west?

Answer 23

squamous;
adenocarcinoma;
squamous;
adenocarcinoma

Question 24

Chronic GERD, Barret’s and obesity all increase the risk for which kind of cancer?

Answer 24

esophageal adenocarcinoma

Question 25

alcohol, hot liquids, and strictures increase the risk of which kind of cancer?

Answer 25

squamous cell (esophagus)

Question 26

____ is hyperkeratosis of the palms and soles and is associated with which esophageal cancer?

Answer 26

tylosis;

squamous cell