Medical aspects Esophageal Dx

Question 1

Treatment Esophageal Varices

Answer 1

• Nonselective Beta - Blockers
  Endoscopy w/ band ligation
  + ScleroTx
• Balloon tamponade or SB tube for bleeding
• Transjugular intrahepatic portosystemic shunt (TIPS)

Question 2

Pill esophagitis

Answer 2

• Doxy/tetracyclines
• clindamycin
• anti-inflammatory meds
• Biphosphates
• KCl
• Fe

Question 3

A 43-year-old female underwent an upper endoscopy for the evaluation of longstanding heartburn and regurgitation. The patient has no medical history and denies any fever, vomiting, or changes in weight. An upper endoscopy with biopsies showed short linear erosions w/ erythema + small salmon-colored islets
No Goblet cells or signs of chronic inflammation of histology.

Answer 3

GERD with esophagitis

Question 4

A 43-year-old male with no significant past medical history was referred for the evaluation of worsening heartburn. He denies any dysphagia, odynophagia, weight loss or any other constitutional symptom. An upper endoscopy with biopsies was performed which revealed multiple extensive salmon-colored lesions above the EG Junction + Histology showing low grade dysplasia w/ goblet cells

Answer 4

Barrett’s Esophagus with Low Grade Dysplasia

Question 5

An 83-year-old male presented to his primary care physician with worsening dysphagia, initially to solids and now to liquids. His medical problems include hypertension treated with atenolol, chronic obstructive pulmonary disease treated with inhaled steroids and bronchodilators, and long history of heartburn self-treated with over the counter antacids. He has lost 16 lbs. over the past two months. He denies fevers, nausea, vomiting, abdominal pain, or odynophagia. An upper endoscopy with biopsies was performed. An endoscopic ultrasound showed obstructive fungating mass in distal esophagus

Answer 5

Esophageal Adenocarcinoma

Question 6

A 63-year-old female with a long history of tobacco use underwent an upper endoscopy for the evaluation of a positive fecal occult blood test, iron deficiency anemia, 15-pound weight loss over a three-month period and progressive dysphagia to solids. The patient has no other medical problems. She denies fevers, nausea, vomiting, or abdominal pain. Endoscopic evaluation with multiple biopsies revealed infiltrating + ulcerating circumferential lesions in distal esophagus.

Answer 6

Esophageal Squamous Cell Carcinoma

Question 7

A 62yo female awakened with severe odynophagia and dysphagia. Her only medical problem is osteoporosis treated with alendronate over the past eight months. Her weight has been stable, and she denies having fevers, nausea, vomiting, or abdominal pain. She denies a prior history of dysphagia

Answer 7

Medication-induced esophagitis (Pill Esophagitis)