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GI > non-cancer esophagus > Flashcards

non-cancer esophagus Flashcards

Describe the common presenting symptoms of esophageal motility disorders and what they mean pathologically. Describe the structural pathology of the esophagus and their common associations Describe the esophageal pathophysiology associated with alcoholism and cirrhosis Describe the common causes of esophagitis (infectious, eosinophilic, reflux) Describe the pathophysiology of reflux esophagitis, its outcomes and associations

1
Q

common sx of esophageal disorders

A 
dysphagia
odynophagia (painful swallowing)
heartburn
hematemesis
melena (blood in stools)
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2
Q

difficulty swallowing solids can indicate

A

stricture, obstruction, carcinoma

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3
Q

difficulty swallowing solids can indicate

A

motility problem

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4
Q

most common hernia

A

sliding

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5
Q

hourglass hernia where GE is displaced through diaphram

A

sliding

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6
Q

GE junction is below diaphram, cardia moves into the thorax

A

paraesophageal

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7
Q

newborn with aspiration, pnemonia, and feeding problems

A

espophageal fistula/atresia

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8
Q

most common espophageal fistula/atresia

A

atresia of the upper esophagus with a fistula between the trachea and lower esophagus (type “C”).

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9
Q

Protrusions of mucosa into the esophageal lumen

A

esophageal webs

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10
Q

squamous mucosa and a vascularized submucosal core

A

esophageal webs

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11
Q

causes of esophageal webs

A

congenital
long standing reflux
GVHD
blistering skin disease

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12
Q

Paterson-Brown-Kelly or Plummer-Vinson syndrome

A

upper esophageal web accompanied by iron deficiency anemia, glossitis, cheliosis

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13
Q

long term risk of Paterson-Brown-Kelly or Plummer-Vinson syndrome

A

postcricoid esophageal carcinoma

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14
Q

achalasia

A

Failure of the lower esophageal sphincter to relax following swallowing

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15
Q

causes of achalasia

A

Functional obstruction
Dilation of upper esophagus
Primary vs. secondary (i.e. Chagas’ disease, DM, infiltrative disorders)

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16
Q

sx of achalasia

A

Dysphagia, nocturnal regurgitation, aspiration

17
Q

long term risk of achalasia

A

Increased risk of squamous cell carcinoma

18
Q

Absent myenteric (Auerbach’s) ganglia from the esophageal body will cause

A

achalasia

19
Q

birds beak on barium swallow

A

achalasia

20
Q

painful tears in the LES from retching and vomiting

A

mallory-weiss tears

21
Q

risk factors of mallory-weiss tears

A

alchoholics and underlying hiatal hernia

22
Q

complications of mallory-weiss tears

A

infection and massive hemorrage

23
Q

Boerhaave syndrome

A

mallory-weiss syndrome with rupture

24
Q

causes esophageal varices

A

portal hypertension

25
Q

mortality of esophageal varices

A

50%

26
Q

esophageal varices found in pts with

A

cirrosis (2/3)

27
Q

types of esophagitis

A 
reflux
corrosives/irratants
radiation/chemo
infection
eosinophillic
28
Q

giant multinucleated cells with inclusions

A

herpes

29
Q

silver stains candida…

A

black

30
Q

PAS stains candida

A

pink

31
Q

GERD with no response to medications

A

eosinophillic esophagitis

32
Q

other sx seen with eosinophillic esophagitis

A

general allergies (asthma, exzema, chronic rhinitis)

33
Q

24 hour probe testing for eosinophillic esophagitis returns…

A

normal

34
Q

eosinophillic esophagitis appearance on endoscopy

A

felinization

35
Q

sequalae of eosinophillic esophagitis

A

stricture

36
Q

causes of reflux

A

incompetent LES, sliding hiatal hernia, delayed gastric emptying, increased gastric volume

37
Q

microscopic signs of reflux

A

Eosinophils +/- other inflammatory cells (neutrophils and lymphocytes)
Elongation of vascular papillae
Basal layer hyperplasia

38
Q

risk of barrett’s esophagus

A

esophageal adenocarcinoma

39
Q

barrett’s esophagus changes what to what

A

normal distal stratified squamous mucosal to intestinal-type glandular mucosa

GI (22 decks)

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