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Year 2 Gastrointestinal > Pathology of the esophagus > Flashcards

Pathology of the esophagus Flashcards

1
Q

definition: odynophasia

A

painful swallowing

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2
Q

definition: achalasia

A

failure of relaxation of LES - functional obstruction

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3
Q

what are the symptoms of achalasia?

A

progressive dysphagia

nocturnal regurgitation

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4
Q

what is the primary cause of achalasia? secondary?

A

idiopathic

failure of distal inhibitory neurons containing NO and VIP

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5
Q

what is the morphology associated with achalasia?

A

dilation above LES

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6
Q

what is the danger associated with achalasia?

A

squamous cell carcinoma

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7
Q

what are the causes of secondary achalasia?

A

chagas
vagal dorsal motor nuclei
diabetic autonomic neuropathy
infiltrative disorders - malignancy, amyloidosis, sarcoidosis

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8
Q

what is the main subtype of hiatal hernia?

A

sliding hernia (95%)

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9
Q

definition: true diverticula

A

outpouching of GI tract containing all visceral layers

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10
Q

definition: false diverticula

A

outpouching of GI tract containing mucosa and submucosa

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11
Q

where does a zenker diverticulum present? is it false or true?

A

immediately above UES

false

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12
Q

where does a traction diverticulum present? is it false or true?

A

mid esophagus

true

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13
Q

where does an epiphrenic diverticulum present? is it false or true?

A

immediately above LES

true

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14
Q

what is a mallory weiss tear?

A

longitudinal tear at GE junction

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15
Q

what is a mallory weiss tear associated with?

A

alcoholism
severe retching
pregnancy

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16
Q

what is the pathogenesis of mallory weiss tear?

A

failure of reflex relaxation of LES

17
Q

what is the main cause of esophageal varices?

A

portal hypertension secondary to alcoholic cirrhosis

18
Q

what is the general cause of reflux esophagitis? specific agents?

A

decreased efficacy of antireflux mechanisms (LES tone)

CNS depressants 
pregnancy, obesity 
irrtants - EtOH, smoking 
scleroderma 
hypothyroidism 
delayed gastric emptying
19
Q

what is an early marker of reflux esophagitis?

A

eosinophils

20
Q

what indicates increased severity of reflux esophagitis?

A

neutrophils

21
Q

what is the main sequelae of prolonged reflux esophagitis?

A

Barrett esophagus

22
Q

definition: barrett esophagus

A

replacement of normal distal squamous mucosa by metaplastic columnar epithelium, goblet cells (response to prolonged injury)

23
Q

patients with barrett esophagus are 30x-40x more likely to develop what major condition?

A

carcinoma

24
Q

once dysplastic cells break through the basement membrane of the esophagus what condition results?

A

adenocarcinoma

25
Q

how does scleroderma lead to stenosis?

A

vascular obliteration and fibrosis in smooth muscle leads to

weak LES
poor esophageal contractility
delayed gastric emptying

26
Q

what is the most common benign tumor of the esophagus?

A

leiomyoma

27
Q

malignant tumors of the esophagus are usually of what origin?

A

epithelial

28
Q

what is the most common esophagus cancer worldwide?

A

squamous cell carcinoma

29
Q

what are the primary factors influencing development of squamous cell carcinoma?

A

dietary and environmental

30
Q

what is the pathogenesis of dietary factors on development of squamous cell carcinoma?

A

methylating nitroso compounds in diet may lead to p53 point mutations

31
Q

progressive gradual dysphagia is not normally noticed until the lumen is closed to what degree?

A

30-50%

32
Q

what are the three morphologies of squamous cell carcinoma?

A

protruded
flat
excavated

33
Q

what is the most common squamous cell carcinoma morphology?

A

protruded

34
Q

what is the typical site of origin for adenocarcinoma of esophagus?

A

GE junction

Year 2 Gastrointestinal (38 decks)

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