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Year 2- GIT > Oesophageal Disorders > Flashcards

Oesophageal Disorders Flashcards

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1
Q

What is the most common symptom of oesophageal disease?

A

Heartburn

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2
Q

Where is heartburn felt?

A

Retrosternal chest pain

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3
Q

What is dysphagia?

A

Difficulty swallowing food or fluids

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4
Q

What is odynophagia?

A

Painful swallowing

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5
Q

What is important to ask about if a patient presents with dysphagia?

A

-The type of food or fluid which causes difficulty as this could provide an indication to the severity of the obstruction.
-The pattern, if it’s infrequent or progressive
-Associated features like weight loss, cough, regurgitation

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6
Q

What is the commonest cause of oesophageal dysphagia?

A

Benign stricture

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7
Q

What are some other causes of oesophageal dysphagia?

A

Malignant stricture
Motility disorders
Oeosinophilic oesophagitis
Extrinsic compression, like lung cancer

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8
Q

Which investigations are common in those with oesophageal disease?

A

OGD- Oesophago-Gastro-Duodenoscopy
Upper GI Endoscopy

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9
Q

Which type of imagining might be used in those with oesophageal disease?

A

Contrast imaging using a barium swallow

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10
Q

How can the pH of the stomach be measured?

A

Using pH-mentry

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11
Q

What does manometry measure?

A

The pressure waves of the oesophagus

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12
Q

What are the two subdivions of motility disorders?

A

Hypermotility
Hypomotility

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13
Q

In those with hypermotility, if they did a barium swallow, what would the oesophagus look like?

A

Corkscrew appearance

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14
Q

What is the presentation of hypermotility oesophageal disorder?

A

Severe chest pain +/- dysphagia

Can often be mistaken for angina

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15
Q

What would manometry show in those with hypermotility oesophageal disorder?

A

Exaggerated, uncoordinated, hypertonic contractions

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16
Q

What is the treatment for hypermotility oesophageal disorders?

A

Smooth muscle relaxants like calcium channel blockers or nitrates

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17
Q

Name a common important hypomotility disorder.

A

Achalasia

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18
Q

What are the symptoms of achalasia?

A

Progressive dysphagia for solids and liquids
Chest pain
Weight loss
Regurgitation
Chest infections

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19
Q

What are some of the pharmalogical treatments for achalasia?

A

Nitrates
Calcium channel blockers

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20
Q

What are some of the endoscopic treatments for achalasia?

A

Botox
Pneumatic balloon dilation

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21
Q

What is one surgical treatment for achalasia?

A

Myotomy- affected muscle is cut to allow better passage of solids and liquids from the oesophagus to the stomach

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22
Q

What are some of the long term complications of untreated achalasia?

A

Aspiration pneumonia and lung disease
Increased risk of squamous cell oesophageal carcinoma

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23
Q

What is the most common oesophageal disease?

A

Gastro-Oesophageal Reflux Disease

24
Q

What causes GORD?

A

Acid and bile exposure to the lower oesophagus from the stomach

25
Q

What are some of the symptoms for GORD?

A

Heartburn
Waterbrash (too much saliva so combines w stomach acid and backs up into throat)
Cough
Sleep disturbance

26
Q

What are some of the risk factors for GORD?

A

Pregnancy
Obesity
Drugs lowering LOS pressure
Smoking
Alcoholism
Hypomotility

27
Q

Who are most likely to be affected by GORD>?

A

Men> women
Caucasian > Black > Asian

28
Q

Why is endoscopy a poor diagnostic test for GORD?

A

Patient often has no oesophageal abnormality

29
Q

When would an endoscopy be performed in someone with GORD?

A

When alarm symptoms are present e.g. weight loss, dysphagia, vomiting).

30
Q

Which other problem can cause GORD?

A

Hiatus hernia

31
Q

What are the two types of hiatus hernia?

A

Sliding
Para-oesophageal

32
Q

What happens in a hiatus hernia?

A

Fundus of stomach moves proximally through the diaphragmatic hiatus.

33
Q

What are some of the complications of GORD?

A

Ulceration
Stricture
Carcinoma
Barrett’s oesophagus- glandular metaplasia

34
Q

Describe what happens in Barrett’s oesophagus.

A

Squamous epithelium changes to mucus-secreting columnar epithelium in the lower oesophagus in response to acid exposure.

35
Q

What is Barrett’s oesophagus a precursor for?

A

Dysplasia/adenocarcinoma

36
Q

What are some possible treatments for Barrett’s oesophagus?

A

Endoscopic mucosal resection
Radio-Frequency Ablatic
Rarely but sometimes oesophagectomy

37
Q

Which drug is the main drug used to help treat GORD after dealing with any lifestyle changes?

A

Proton pump inhibitors.

38
Q

What are the two types of oesophageal cancer?

A

Squamous cell
Adenocarcinoma

39
Q

What is the presentation for oesophageal cancer?

A

Progressive dysphagia
Anorexia and weight loss
Odynophagia
Chest pain
Cough
Pneumonia
Vocal cord paralysis
Haematemesis

40
Q

Describe a squamous cell carcinoma.

A

Often large exophytic, occluding tumours

41
Q

Where in the oesophagus would a squamous cell carcinoma occur?

A

First 2/3 of oesophagus

42
Q

What are two significant risk factors for an oesophageal squamous cell carcinoma?

A

Smoking and alcohol

43
Q

Where in the oesophagus would an adenocarcinoma occur?

A

Distal end, last 1/3

44
Q

What are some predisposing factors for an oesophageal adenocarcinoma?

A

Male
Obesity
Middle aged
Caucasian

45
Q

Which condition is an oesophageal carcinoma associated with?

A

Barrett’s oesophagus

46
Q

Which investigation helps to diagnose oesophageal cancer?

A

Endoscopy

47
Q

Which investigations can be useful in the staging of oesophageal cancer?

A

CT scan
PET scan
Bone scan
Endoscopic ultrasound

48
Q

What is the only potential cure for oesophageal cancer?

A

Oesophagectomy +/- chemotherapy

49
Q

Which patients can get an oesophagectomy?

A

Those <70 with localised disease

50
Q

As most patients with oesophageal cancer present late, what treatment can be offered?

A

Palliative treatment

51
Q

In those with incurable oesophageal cancer, what is the main priority?

A

To get rid of the dysphagia

52
Q

How can patients w incurable oesophageal cancer be treated of their dysphagia?

A

Endoscopic insertion of stent

53
Q

Name the condition-

Chronic immune/allergy related condition
Affects children and young adults more
Incidence and prevelance are increasing
Symptoms of oesophageal dysfunction

A

Eosinophillic Oesophagitis

54
Q

What’s the presentation of Eosinophillic Oesophagitis?

A

Dysphagia and food bolus obstruction

55
Q

What is the treatment for Eosinophillic Oesophagitis?

A

Topical/swallowed costisteroids
Dietary elimination
Endoscopic dilatation

56
Q
A

Year 2- GIT (37 decks)

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