Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GI Exam 1 > Pathology of Esophagus > Flashcards

Pathology of Esophagus Flashcards

1
Q

dysphagia definition

A

difficulty swallowing due to mechanical and functional disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

odynophasia definition

A

painful swallowing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

heartburn definition

A

retrosternal burning pain , usually due to regurgitation of gastric contents into lower esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

hematemesis definition

A

vomiting of blood due to inflammation, or ulceration or rupture of blood vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Problem swallowing both solids and liquids then the issue is usually?

A

nerve related - peristalsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Problem swallowing solids then the issue is usually?

A

an obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Achalasia: symptoms:

A

progressive dysphagia, nocturnal regurgitation, young adults, functional obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Achalasia - abnormalities:

A
  • aperistalsis
  • incomplete relaxation of LES (NO and VIP chemical issue)
  • increased resting tone of LES

–> lower esophagus is constricted and above LES is dilation due to crap getting stuck == muscle hypertrophy and thinned wall (distention)
birds beak appearance with CT contrast or MRI whatever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Achalasia - causes:

A

1) usually primary (idiopathic) uncertain etiology
2) Secondary causes:
- failure of distal inhibitory neurons containing NO and VIP
- degenerative changes in innervation
- decreased myenteric ganglia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Danger of achalasia?

Other complications?

A

-SCC*

  • candida esophagitis
  • diverticula
  • aspiration pneumonia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Secondary achalasia occurs with?

A

1) Chagas disease (Trypanosoma cruzi destroys ganglion cells)
* 2) Disorders of the vagal dorsal motor nuclei (polio surgical ablation)
* 3) Diabetic autonomic neuropathy
* 4) Infiltrative disorders (malignancy, amyloidosis, sarcoidosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hiatal hernia - how does it happen? What 2 types?

A

1) cause unknown but there is a separation of diaphragmati crura with widening
2) types:
a) sliding hernia - MOST COMMON - proximal part of the stomach slides up through hole in diaphragm
b) paraesophageal - some portion of cardia goes through like a finger projection = possible acute strangulation!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

True diverticula definition:

A

all of the layers of the whatever part of GI tract pouch out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

false diverticula definition

A

only mucosa or submucosa pouch out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Zenker diverticula:
where is it?
what kind is it?

A

PROXIMAL

  • right above UES/cricopharyngeus muscle
  • FALSE DIVERTICULUM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Traction diverticula
where is it?
what kind is it?

A

midportion of esophagus

  • TRUE DIVERTICULUM
  • probably congenital or due to scarring from surgery or something
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Epiphrenic diverticula
where is it?
what kind is it?

A
  • distal esophagus right above LES
  • TRUE DIVERTICULUM
  • probably due to peristaltic dyscoordination and LES relaxation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Patient presentation of diverticula?

A

usually bad breath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Mallory Weiss Tears

  • where do these happens?
  • who gets these often?
A
  • longitudinal lacerations/tears at GE junction
  • severe vomiting ex) ALCOHOLICS or pregnancy
  • hiatal hernia predisposes
  • people with Ulcers!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Mallory Weiss Tears

-what happens?

A

-Failure of reflex relaxation of LES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Mallory Weis Tears - patient symptoms:

A
  • coughing up blood
  • if not coughing up look for blood stools - melena
  • usually no symptoms prior to massive rupture = fatal
22
Q

Main cause of Esophageal varices?

A

Liver disease - alcohol cirrhosis!

2nd most common cause=schistosomiasis

23
Q

Esophageal varicies-

-what happens?

A
  • collateral bypass channels bc of portal hypertension (liver damage - blood cant get through liver so finds another way back to heart)
  • dilated submucosal and subepithelial veins
  • rupture == massive bleed, frequently fatal
24
Q

Esophagitis - definition:

A

inflammation of esophageal mucosa

25
Q

esophagitis - prevelance:

A

northern iran and some of china - might be diet related

26
Q

esophagitis - symptoms

A 
dysphagia, 
heartburn, 
regurgitation, 
hematemiesis, 
melena
27
Q

esophagitis - etiology:

-most common cause?

A
  • can be physical, chemical, or biologic
  • USUALLY A COMBO OF THINGS - decreased efficacy of antireflux mechanisms (LES tone)
  • REFLUX ESOPHAGITIS MOST COMMON!
  • barretts
  • infectious & chemical
  • eosinopilic
28
Q

Some causes of esophagitis:

A
  • sliding hiatal hernia
  • slow clearance of refluxed material & acid exposure - inflammation
  • delayed gastric emptying = inc gastric volume
29
Q

What causes the damage in reflux esophagitis?

A

acid peptic juices!

30
Q

Early marker of reflux esophagitis?

A

Eosinophils!

31
Q

Tissue changes of reflux esophagitis:

A
  • eosinophils, lymphocytes, and PMNs
  • basal zone hyperplasia 9-thickens!
  • elongation of lamina propria papillae
  • superficial necrosis
  • ulceration
32
Q

Prolonged Reflux esophagitis = tendency to develop:

A

Barrett esophagus = metaplasia = risk for esopageal carcinoma!!

33
Q

Key feature to see for Barrett esophagus?

A

-metaplasia from squamous to columnar WITH GOBLET CELLS!*

34
Q

Salmon red epithelium in esophagus think:

A

Barrett esophagus - metaplasia has happened!

35
Q

Radiation esophagitis usually heals how and which layer?

A

Severe fibrosis of submucosa

36
Q

Major cause of esophagus strictures?

A

inflammation*

  • peptic
  • caustic
  • ischemic
  • post op
  • radiation
  • congenital
  • infectious
  • trauma
  • scleroderma*
37
Q

Scleroderma predisposes/causes what issue? How? What issues do these patients have?

A
  • esophageal stricture
  • vascular obliteration and fibrosis in smooth muscle = weak LES, poor esophageal contraction, delayed gastric emptying
  • swallowing liquids and solids in addition to a whole bunch of other stuff
38
Q

Prevalence of benign esophageal tumors? Which is most common

A
  • RARE
  • most common is leiomyoma
  • usually mesenchmal within wall of esophagus
39
Q

Malignant tumors of esophagus:

  • discovery?
  • origin of tumor?
  • most common?
A
  • discovered LATE
  • epithelial origin
  • Squamous cell carcinoma and **adenocarcinomas **
40
Q

most common cancer of esophagitis worldwide??

A

SCC

41
Q

most common regions for SCC/esophagitis?

A

Highest in Iran
N China
S Africa
S Brazil

42
Q

Population stats regarding SCC/esophagitis?

A

M to F varies but blacks more likely than whites

43
Q

Causes of SCC/esphagitis:

A
  • dietary enivornmental factors a promoters/potentiators of carcinogens
  • nitroso compounds knock out p53 via mutations - stepwise accumulation
  • Chronic esophagitis and associated chronic inflammation = dysplasia
44
Q

First place esophageal SCC metastasizes?

A

LN!

then they like the liver and lungs

45
Q

Patient presentation of esophageal SCC?

A
  • Extreme weight loss
  • progressive gradual dysphagia - not noticed until lumen 30-50% blocked (low survival)
  • substernal or back pain
  • hoarseness and cough
46
Q

3 types of esophageal SCC?

Which is most common

A
  • protruded- polypoid, fungating
  • flat - diffuse, infiltrative
  • excavated - necrotic, ulcerates deeply
47
Q

Adenocarcioma of esophagus:

  • think what tissue type affected?
  • most common area to get?
  • associated with what disease?
  • some risk factors?
A
  • think GLANDS
  • distal 1/3
  • most from Barrett
  • tobacco , obesity, H pylori? ETOH
48
Q

Cause of adenocarcina?

population stats?

A
  • cause = mutlistep process - overexpression of p53

WHITE MORE COMMON THAN BLACK
MORE MALES

49
Q

Which esophageal is more common in whites and which in blacks?

A

– Whites = adenocarcinoma

–Blacks = SCC

50
Q

Adenocarcinoma micro - what is associated with more aggressive cancer?

A

lots of mucin-producing cells

-signet ring

51
Q

prognosis for SCC and adenocarcinoma?

A

both really poor

if superficial adenocarcinoma 5yr is 80%

52
Q

Lymphatics and esophagus

A

Lymphatics all over the place and run from top to bottom = easy spread for the tumor if it wants to metastasize

GI Exam 1 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions