Oesophageal Disease

Question 1

What does ALARMS stand for?

Answer 1

Anaemia
Lost weight
Anorexia
Recent
Melena
Swallowing problem

Question 2

3 causes of acid reflux?

Answer 2

Weak LOS
Hiatus hernia
Pregnancy

Question 3

Causes of acute vs chronic oesophagitis + which one is more common?

Answer 3

Acute = chemical ingestion
Chronic = reflux/GORD or allergic (more common)

Question 4

Appearance of allergic oesophagitis and 2 options for treatment?

Answer 4

Spotty/corrugated

Steroid or dilation

Question 5

WBC associated with acid abuse?

Answer 5

Eosinophils

Question 6

Chronic reflux oesophagitis/GORD symptoms?

Answer 6

Excessive saliva
Heart burn
Cough
Dysphagia

Question 7

Chronic reflux oesophagitis/GORD tests (+ finding)?

Answer 7

Endoscope
pH study
Barium swallow (corkscrew contraction)

Question 8

Symptom relief + healing medication for GORD + when is surgery needed?

Answer 8

Antacid/H2 antagonist
PPI
PPIs not working and LOS very damaged

Question 9

3 complications of GORD?

Answer 9

Ulcers/bleeding
Strictures
Barret’s

Question 10

What is Barrett’s + appearance + location?

Answer 10

Stratified squamous metaplasia to columnar
Red velvet mucosa
Lower oesophagus

Question 11

Treatment for Barrett’s + monitoring and treatment for dysplasia?

Answer 11

PPI
Annual endoscope
EMR or ablation

Question 12

Barrett’s is a major risk factor for?

Answer 12

Oesophageal carcinoma

Question 13

2 types of oesophageal cancer?

Answer 13

Adenocarcinoma

Squamous cell carcinoma

Question 14

Where does oesophageal adenocarcinoma and squamous cell carcinoma present + associated factors?

Answer 14

Adenocarcinoma = lower 1/3rd and Barrett's
SSC = upper 2/3rd and smoking

Question 15

Oesophageal carcinoma is more common males or females?

Answer 15

Males

Question 16

3 test for oesophageal cancer + 50% are treated by?

Answer 16

Endoscopy
Barium meal
CT scan +
Sugery

Question 17

What is a Mallory Weiss tear and what causes it?

Answer 17

Tear in lower oesophagus and strong vomiting or coughing

Question 18

Describe a sliding hiatus hernia?

Answer 18

GO junction slides into chest

Question 19

Describe a rolling hiatus hernia?

Answer 19

Stomach slides into chest (normal GO junction)

Question 20

Test and treatment for a hiatus hernia?

Answer 20

Barium swallow

Weight loss and PPI

Question 21

Obese women > 50 are at risk of a hiatus hernia. True or false?

Answer 21

True

Question 22

What are oesophageal varices caused by?

Answer 22

Portal hypertension

Question 23

Drug + surgical treatment options for oesophageal varices?

Answer 23

Beta-blockers

Ligation or TIPS

Question 24

Cause of achalasia?

Answer 24

Damaged myenteric plexus means stiff LOS

Question 25

Test and result + 2 surgical options for achalasia?

Answer 25

Barium swallow with Bird beak sign | Balloon dilation or Heller's cardiomyotomy

Question 26

What percent of people with GORD will go on to get Barrett's?

Answer 26

3-5%