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Alimentary System > Oesophageal Diseases > Flashcards

Oesophageal Diseases Flashcards

1
Q

Which type of cancer is typically present in the lower 1/3 of the oesophagus?

A

Adenocarcinoma

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2
Q

What does adenocarconima in the oesophagus typically arise from?

A

Barrett’s Oesophagus

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3
Q

What are the 2 types of cancer that can arise in the oesophagus?

A

Squamous carcinoma

Adenocarcinoma

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4
Q

Why is prognosis for oesophageal cancer so poor?

A

Because it is relatively asymptomatic until late presentation

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5
Q

What are the main alarm symptoms of presenting oesophageal cancer?

A 
DYSPHAGIA 
Weight loss
Anorexia 
Chest pain 
Hoarse voice
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6
Q

What investigations need to be carried out in oesophageal cancer?

A

Upper GI endoscopy
Barium swallowing
CT - staging
Endosocopic Ultrasound

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7
Q

What is Barrett’s oesophagus?

A

Consequence of GORD
Acid causes a change from squamous epithelium to glandular epithelium in the oesophagus
Dysplasia which can lea to metaplasia
Predisposition for cancer

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8
Q

What is a palliative treatment for oesophageal cancer?

A

Endoscopic stenting

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9
Q

What are the requirements for the surgical resection of oesophageal cancer?

A

Need to be fit for surgery (consider age)
No metastases
Pre-op chemotherapy

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10
Q

Is heartburn common?

A

Yes

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11
Q

What is GORD disease?

A

Recurrent reflux of gastric acid into the oesophagus

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12
Q

What are the symptoms of GORD?

A

Heartburn - recurrent
Dysphagia
Nocturnal cough
Chest pain

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13
Q

What are the investigations for GORD?

A

Endoscopy

24 hour ABPM pH monitoring

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14
Q

What is the Pathology of GORD?

A

Oesphagus is not designed to cope with an acidic environment
Oesophagitis
Endoscopic change
Scarring and ulceration

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15
Q

What is a potential consequence of GORD that can be a predisposition to cancer?

A

Barrett’s oesophagus

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16
Q

What is the patient required to do during 24 hours ABPM pH monitoring?

A

Record a symptom diary

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17
Q

What is the treatment for GORD?

A

Anti-acids
PPI
H2 antagnosits
Endoscopic surveillance for dysplasia

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18
Q

Why does GORD require endoscopic surveillance?

A

To monitor for barrett’s oesophagus

And dysplasia

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19
Q

What is a hiatus hernia?

A

When part of the stomach protrudes into the oesophagus

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20
Q

What are the symptoms of a hiatus hernia similar to that of?

A

GORD

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21
Q

What is the treatment for hiatus hernia?

A

Essentially the same as treatment for GORD

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22
Q

How long is the oesophagus?

A

Approximately 25cm long

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23
Q

Where does the oesophagus begin anatomically?

A

Cricoid cartilage C6

24
Q

Where does the oesophagus terminated anatomically?

25
Q

What epithelium lines the oesophagus?

A

Stratified squamous keratinised epithelium

26
Q

What is water brash?

A

Acid taste in the mouth

27
Q

What is dysphagia?

A

Symptom - difficulty with swallowing

28
Q

What are differential diagnoses for dysphagia?

A 
Benign stricture 
Malignant stricture 
Motility disorders 
Oesophagitis 
Extrinsic compression (i.e from a tumour in the lung ect..)
29
Q

What investigations are common for suspected oesophageal disorders?

A 
OGD - oesophago-gastro-duodenoscopy 
Upper GI endoscopy 
Endoscopy 
Contrast radiology e.g barium swallowing 
Oesophageal pH and manometry
30
Q

What is hypermotility often confused with?

31
Q

What is the treatment for hypermotility?

A

Smooth muscle relaxants

32
Q

What are the symptoms of oesophageal hypermotility?

A

Chest pain

Dysphagia

33
Q

Is GORD more common in men or women

34
Q

What are the risk factors for GORD?

A

Anything that increases pressure on the abdomen e.g obesity or pregnancy

35
Q

Is Endoscopy useful for diagnosis of GORD?

A

No - usually no clinical findings

36
Q

Describe type I hiatus hernia?

A

When the proximal stomach moves up and down in the oesophagus

37
Q

Describe type II hiatus hernia?

A

When the stomach moves up alongside the oesophagus

The fundus of the stomach moves proximally though the diaphragmatic hiatus alongside the oesphagus

38
Q

What are potential complications of reflux disease?

A

Ulceration
Stricture
Glandular metaplasia (Barrett’s oesophagus)
Carcinoma

39
Q

What is Barrett’s oesophagus?

A

Intestinal metaplasia related to prolonged acid exposure in distal oesophagus
Changes from squamous to glandular epithelium
Metaplasia can change into dysplasia
Which is a precursor for carcinoma

40
Q

Are benign tumours of the oesophagus common or rare?

41
Q

What are the 2 types of carcinoma of the oesophagus?

A

Squamous cell

Adenocarcinoma

42
Q

What are the main symptoms of oesophageal cancer?

A 
Progressive dysphagia 
Anorexia and weight loss 
Odynophagia 
Chest pain 
Cough 
Pneumonia 
Vocal cord paralysis
43
Q

Where does squamous cell carcinoma commonly occur?

A

Proximal and middle 1/3 of oesophagus

44
Q

What are risk factors for squamous cell carcinoma?

A

Smoking and alcohol

Potentially diet

45
Q

Where does adenocarcinoma commonly occur anatomically?

A

Distal oesophagus

46
Q

Which carcinoma is associated with barrett’s oesophagus?

A

Adenocarcinoma

47
Q

Does oesophageal cancer usually present early or late?

48
Q

Where are common metastases for oesophageal cancer?

A

Liver
Brain
Lungs
bone

49
Q

By what investigation is oesophageal cancer diagnosed?

A

Endoscopy and biopsy

50
Q

By what investigations is oesophageal cancer stages?

A

CT
Endoscopic US
PET
Bone scan

51
Q

What classification system is used to stage oesophageal cancer?

52
Q

What is the cure for oesophageal cancer?

53
Q

What can be done to relieve the symptoms of dysphagia?

A

Inserting a stent

54
Q

Who is oesophageal surgery for cancer limited to?

A

Those with primary disease without co-morbidity

55
Q

How long is the oesophagus?

56
Q

Which nerve mediates peristalsis?

57
Q

What is waterbrash?

A

Acid taste in the mouth

Alimentary System (29 decks)

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