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GI - Pathology > Oesophageal Disorders > Flashcards

Oesophageal Disorders Flashcards

1
Q

vertebral extent of the oesophagus

A

C6 to T11/12

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2
Q

true/false the LOS is a true sphincter

A

false - while there is some muscle thickening it is largely functional from the muscle of the diaphragm around it

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3
Q

how do certain drugs cause heartburn

A

by reducing LOS pressuring and increasing reflux

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4
Q

what does GORD stand for

A

gastro-oesophageal reflux disease

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5
Q

what problem with eating do people with oesophageal disease encounter

A

dysphagia

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6
Q

causes of oesophageal dysphagia

A

stricture
motility disorder
eosinophilic oesophagitis
external compression (such as from lung cancer)

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7
Q

investigations that can be used to view the oesophagus

A

endoscopy

contrast radiology with barium swallow

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8
Q

what would be the preferred test to investigate dysphagia or reflux symptoms

A

endoscopy

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9
Q

what is a manometry

A

investigation to measure pressure through the oesophagus and sphincters

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10
Q

when would you use manometry

A

when investigating dysphagia or a motility disorder

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11
Q

what are the motility disorders

A

hypermotility, hypomotility and achalasia

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12
Q

what does hypermotility look like on barium swallow

A

corkscrew appearance

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13
Q

presentation of hypermotility

A

severe episodic chest pain with/out dysphagia

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14
Q

how do you treat hypermotility

A

smooth muscle relaxants

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15
Q

how does hypomotility present

A

heartburn and reflux symptoms

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16
Q

what is achalasia

A

loss of inhibitory neurons in myenteric plexus of oesophagus. Function is lost in distal and LOS

essentially the LOS won’t relax and the oesophagus is obstructed

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17
Q

presentation of achalasia

A

dysphagia
weight loss
chest pain
regurgitation

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18
Q

medical treatment for achalasia

A

nitrates and CCBs

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19
Q

endoscopic treatment for achalasia

A

endoscopic balloon dilatation

20
Q

what is motility disorder is aspiration a common complication of

A

achalasia

21
Q

how is reflux diagnosed

A

on the basis of symptoms

22
Q

when would you do an endoscopy in someone with reflux

A

if there are accompanying alarm symptoms

23
Q

what are the alarms symptoms

A 
Anorexia
Loss of weight
Anaemia
Recent Onset
Malaena/Mass
Swallowing Problems
24
Q

what causes barrett’s oesophagus

A

prolonged exposure to acid

25
Q

what is the epithelium change in barrett’s

A

stratified squamous –> mucus secreting simple columnar

26
Q

Treatment of barrett’s oesophagus to prevent cancer

A

endoscopy mucosal resection

radio-frequency ablation

27
Q

treatment for GORD

A

alginates (gaviscon)
PPI (reduce stomach acid)
H2 receptor antagonists

28
Q

how do H2 receptor antagonists work

A

they block histamine from binding and stimulating acid production

29
Q

what is a surgery than can be done in GORD

A

fundoplication - wrapping the fundus around the LOS region

30
Q

two types of oesophageal cancer

A

squamous and adeno

31
Q

which type of oesophageal cancer is most common in the western world

A

adenocarcinoma

32
Q

presentation of oesophageal cancer

A 
dysphagia
anorexia
weight loss
odynophagia
chest pain
cough
haematemesis
pneumonia from a fistula
hoarseness
33
Q

given the different causes of the two oesophageal cancers where do they occur in the oesophagus

A

adenocarcinoma in the distal part because it is caused by metaplasia from acid reflux

34
Q

which oesophageal cancer has smoking and drinking as risk factors

A

squamous

35
Q

what feature of the oesophagus makes tumour invasion easier

A

it’s lack of a serosal later

36
Q

invasions of oesophageal cancer

A

heart, trachea, aorta

37
Q

lymph node spread in oesophageal cancer is common/uncommon

A

common - richly lymphatic in lamina propria of oesophagus

38
Q

staging scans of oesophageal cancer

A

CT, PET, endoscopic US, bone scan

39
Q

treatment for oesophageal cancer

A

oesophagectomy with/out neo/adjuvant chemo

40
Q

how can you surgically eleviate symptoms in the cancer

A

by putting in a stent to help with the dysphagia

41
Q

what is eosinophilic oesophagitis

A

an autoimmune condition of eosinophil infiltration of oesophagus epithelium

42
Q

treatment of eosinophilic oesophagitis

A

topical or swallowed corticosteroids
dietary changes
endoscopic dilatation

43
Q

presentation of eosinophilic oesophagitis

A

dysphagia

44
Q

treatment in non resectable oesophageal cancer

A

stenting and palliative radio/chemo

45
Q

treatment in resectable oesophageal cancer

A

oesophagectomy and chemo, or just chemo/radio if unfit for surgery

46
Q

morbidity rate of an oesophagectomy

A

20%

47
Q

mortality rate of an oesophagectomy

A

5%

GI - Pathology (23 decks)

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