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Alimentary system > Oesophageal disorders > Flashcards

Oesophageal disorders Flashcards

1
Q

what is the muscle make up of the oesophagus ?

A

upper 3-4cm is striated

rest is smooth

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2
Q

what sort of epithelium makes up the oesophagus ?

A

stratified squamous epithelium

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3
Q

what are symptoms of oesophageal disease ?

A

heartburn

dysphagia

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4
Q

what is heartburn, what can cause it and what are its complications ?

A

retrosternal discomfort or burning, associated with waterbrash or cough
certain drugs/foods can lower LOS pressure causing reflux
persistent reflux can result in GORD

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5
Q

what can cause dysphagia ?

A 
benign stricture
malignant stricture
motility disorders
eosinophilic oesophagitis
extrinsic compression
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6
Q

what investigations should be done for oesophageal disease ?

A

endoscopy
contrast radiology
oesophageal pH and manometry

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7
Q

what is an example of a hyper motility disorder ?

A

diffuse oesophageal spasm

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8
Q

what is the appearance of diffuse oesophageal spasm on a barium swallow ?

A

corkscrew appearance

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9
Q

what are clinical features of diffuse oesophageal spasm ?

A

chest pain
sometimes dysphagia
often confused with angina

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10
Q

what causes diffuse oesophageal spasm ?

A

idiopathic

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11
Q

what would a manometry show with diffuse oesophageal spasm ?

A

uncoordinated hypertonic contractions

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12
Q

how is diffuse oesophageal spasm treated ?

A

smooth muscle relaxants

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13
Q

what conditions are associated with hypomotility disorders ?

A

connective tissue diseases
diabetes
neuropathy

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14
Q

what is the pathology of hypomotility and what can it lead to ?

A

failure of LOS

leads to heartburn and reflux

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15
Q

what is achalasia and what is its pathology ?

A

failure of the LOS to relax leading to obstruction

functional loss of the myenteric plexus ganglion in distal oesophagus and LOS

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16
Q

what are symptoms of achalasia ?

A

progressive dysphagia
weight loss
chest pain
regurgitation and chest infection

17
Q

what is the treatment for achalasia ?

A

pharmacological - nitrates, calcium channel blockers
endoscopic - botox, ballon dilatation
surgical - myotomy

18
Q

what are complications of achalasia ?

A

aspiration pneumonia

risk of squamous cell oesophageal carcinoma

19
Q

what are risk factors for GORD ?

A 
pregnancy
obesity
drugs lowering LOS pressure
smoking
alcoholism
hypomotility
20
Q

what are symptoms of GORD ?

A

heartburn
cough
water brash
sleep disturbance

21
Q

what is GORD often associated with ?

A

hiatus hernia

22
Q

what complication is associated with GORD ?

A

Barrett’s oesophagus

23
Q

what are the treatment options for Barrett’s oesophagus ?

A

endoscopic mucosal resection
radio frequency ablation
oesophagectomy

24
Q

what is the treatment for GORD ?

A

lifestyle changes
drugs - alginates(gaviscon), H2RA (ranitidine), PPI (omeprazole)
anti-reflux surgery - fundoplication

25
Q

how does oesophageal cancer present ?

A 
progressive dysphagia
anorexia/weight loss
odynophagia
chest pain
cough
pneumonia
vocal cord paralysis
haematemesis
26
Q

where do squamous carcinomas commonly occur in the oesophagus ?

A

the upper 2/3rds

27
Q

where do adenocarcinomas commonly occur in the oesophagus ?

A

the bottom 1/3rd

28
Q

where does oesophageal cancer commonly metastasise ?

A

liver
brain
bone
lungs

29
Q

how do you investigate an oesophageal cancer ?

A

endoscopy and biopsy

staging - CT, USS, PET, bone scan

30
Q

how do you treat oesophageal cancer

A

surgical oesophagectomy

prognosis is poor

31
Q

what is eosinophilic oesophagitis ?

A

chronic immune/allergen mediated condition causing oesophageal dysfunction

32
Q

how does eosinophilic oesophagitis present ?

A

dysphagia

bolus obstruction

33
Q

how do you treat eosinophilic oesophagitis ?

A

topical corticosteroids
dietary elimination
endoscopic dilatation

34
Q

what are the ALARMS symptoms ?

A 
Anorexia
Loss of weight
Anaemia
Recent onset, >55 years old, persistent
Melaena/heamatemesis
Swallowing problems

Alimentary system (9 decks)

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