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Path III Quizzes > Path III Quiz 3 Esophagus > Flashcards

Path III Quiz 3 Esophagus Flashcards

1
Q

What is most common type of esophageal atresia?

A

distal fistula

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2
Q
  • Where are congenital esophageal webs located?

- Where are acquired esophageal webs?

A

congenital: distal (middle and inferior 1/3)
aquired: proximal 2/3 (top/cervical area)

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3
Q

What does achalasia look like on an x-ray?

A

bird beak

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4
Q

What is achalasia?

A
  • Increased pressure and tone at lower esophageal sphincter
  • Diminished or absent peristalsis
  • Lack of coordinated LES in response to swallowing (can’t relax)
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5
Q

Histology of achalasia?

A
  • lymph infiltrate of auerbachs plexus
  • fibrosis
  • loss of auerbachs plexus = no peristalsis in lower esophagus
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6
Q

What is etiology of iopathic achalasia according to study findings?

A

autoimmune and highly related to emotional problems

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7
Q

Where is auerbachs plexus located?

A

between longitudinal and circular layers of muscularis externs in GI tract
- parasympathetic and sympathetic fibers

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8
Q

Diffues Esophageal Spasm (DES)

A
  • corkscrew esophagus
  • contractions are uncoordinated
  • several segments contract at same time
  • dysphagia
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9
Q

Nutcracker esophagus

A
  • contractions are coordinated

- amplitude is excessive

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10
Q

Mallory Weiss Syndrome

A

Bleeding from tears in mucosa at gastro esophageal junction

  • involves mucosa and submucosa, but not muscular layer
  • caused by coughing, vomitting
  • associated with alcoholism and NSAID abuse
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11
Q

Boerhaave’s Syndrome

A
  • full thickness tear or rupture in esophageal wall

- from severe vomitting or coughing, perforation of ulcer, lye poisoning

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12
Q

Most common cause of esophagitis

A

GERD

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13
Q

Most common infection to cause esophagitis

A

candida in immunocompromised

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14
Q

Histology of candida infection

A

budding hyphae

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15
Q

Sliding hiatal hernia

A

gastroesophageal junction moves above diaphragm with some of the stomach

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16
Q

What is esophagtits called if it is caused by GERD?

A

reflux esophagitis

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17
Q

GERD

A

mucosal damage to esophageal lining due to stomach acid reaching the esophagus

  • caused by changes in barrier between stomach and esophagus:
    • abnormal relaxation of LES
    • hiatal hernia
18
Q

Paraesophageal hernia

A

part of stomach herniates through diaphragm and lies next to esophagus without movement of GE junction

19
Q

Shatski Ring

A

form of web near gastro-esophageal junction that marks proximal margin of hiatal hernia

  • A ring above esophagus/stomach junction
  • B ring lower esophagus at squamocolumnar junction.
  • B is more common
20
Q

Barrett’s Esophagus

A

transformation of cells at lower esophagus from squamous to columnar epithelium

21
Q

What type of cancer is Barrett’s esophagus more likely to acquire?

A

Adenocarcinoma due to metaplastic changes

22
Q

In Barretts’ esophagus, what type of metaplasia is associated with increased risk of malignancy in genetically susceptible individuals?

A

Colonic type

23
Q

What type of cancer are pt with Barrett’s esophagus at higher risk for?

A

Adenocarcinoma

24
Q

What are the cellular changes associated with malignancy?

A

1) increased nucleus to cytoplasm ratio due to cells undergoing division
2) abnormal nucleus: dark stain, increased mitotic figures
3) Abnormal cell shape

25
Q

Esophageal Varices

A

dilated veins in lower 1/3 of esophagus

26
Q

What is #1 etiology of esophageal varices?

A

Cirrhosis due to portal HTN backing up

27
Q

What is #1 cause of cirrhosis in US?

A

alcoholism

28
Q

What is risk of esophageal varicose?

A

hemorrhage

29
Q

What is most common cause of cirrhosis worldwide?

A

hep B or C

30
Q

What pressure is considered portal HTN?

A

> 5mmHg

31
Q

Granular Tumor

A

benign
from schwann cells
can be anywhere in body
smooth, pink, normal

32
Q

Henangioma

A

benign

from blood vessels

33
Q

Leiomyoma

A

from smooth muscle
benign
smooth

34
Q

What is most common benign esophageal tumor?

A

leiomyoma = 2/3 of all benign esophageal tumors

35
Q

leiomyosarcoma

A

malignant

36
Q

Where is adenocarinoma found?

A

lower 1/3 esophagus

associated with Barrett’s and GERD

37
Q

Where is SCC found?

A

upper 2/3

38
Q

What is most common esophageal cancer worldwide?

A

SCC

39
Q

What is most common esophageal cancer in US?

A

adenocarcinoma

40
Q

Hist of adenocarcinoma?

A
  • normal squamous epithelium becomes glandular
  • crypt cells
  • columnar
  • goblet cells
  • darker staining nuclei
41
Q

Hist of SCC

A
  • in situ: basement membrane is intact

- full thickness replacement with dysplastic cells

Path III Quizzes (10 decks)

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