Oesophageal Flashcards
Plummer Vinson syndrome
Oesophageal webs.
Angular stomatitis
Glossitis
Fe Defiecency
What type of oesophageal cancer do western people get?
Usually adenocarcinoma (A for Americans)
Developss a result of Barrett’s.
Smoking and alcohol
Progressive dysphagia, solids then liquids.
What prompts an urgent referral?
New onset dysphagia and > 55.
Age > 55 with upper abdo pain, reflux or dyspepsia.
How do you diagnose oesophageal cancer?
OGD and biopsy,
Staging = CT CAP
Lymph nodes - PET CT.
How does achalasia present?
Birds beak appearance on barium swallow
Incomplete relaxation of LOS on manometry.
1st line investigation of dysphagia?
OGD.
Management of achalasia?
Muscle relaxants (CCB or nitrates)
Definitive = Heller’s cardiomyotomy (need lifelong PPI after procedure)
How does diffuse oesophageal spasm present?
Intermittent dysphagia +/- retrosternal pain.
How does diffuse oesophageal spasm present on Barium swallow?
Corkscrew appearance.
What would make you suspect eosinophilia oesophagitis?
Young male patient with personal or family history of atopy and GORD like symptoms.
Appearance of eosinophillic oesophagitis on OGD?
Schatsi’s rings, mucosa has a corrugated appearance.
When would you refer for GORD?
If >55years >4weeks duration, weight loss, dysphagia or persistent symptoms despite Rx.
What is a starting dose of a PPI?
20mg OD
What are PPIs contraindicated in?
Osteoporosis.
Side effect of PPI?
Hyponatraemia.
What is an example of a H2 antagonist?
Ranitidine.
How does ondansteron work?
5-HT3 receptor antagonists (serotonin)
How does cylizine work?
H1 receptor antagonists (anti-histamine)
How does domperidone/prochlorepazine work?
Domperidone is a peripheral D2 and D3 dopamine receptor antagonist.
What is the change in barrels oesophagus?
Stratified squamous epithelium to glandular columnar.
