Pathoma: Esophagus

Question 1

In the most common form of tracheo-esophageal fistula, the ___________________.

Answer 1

proximal esophagus just stops and the distal esophagus connects to the trachea

Question 2

What effect of TE fistula is most often detected during pregnancy?

Answer 2

Polyhydramnios

Question 3

What symptoms will babies with the most common form of TE fistula display?

Answer 3

Abdominal distention with breathing (because they breathe air into the stomach)

Aspiration pneumonia

Inability to feed

Question 4

Esophageal web increases risk of ________.

Answer 4

squamous cell carcinoma

Question 5

What is esophageal web?

Answer 5

Protrusion of only the mucosa into the esophagus –presenting with dysphagia; this usually occurs in the upper esophagus

Question 6

What three things characterize Plummer-Vinson syndrome?

Answer 6

Beefy red glossitis (because of mucosal atrophy)
Esophageal web
Iron-deficiency anemia

Think of a fat Spider-Man (because of esophageal webbing) licking (glossitis) a pipe beneath a sink (Plummer; iron deficiency).

Question 7

True or false: Zenker diverticulum is congenital.

Answer 7

False. It is an acquired defect in the pharyngeal muscles due to high-pressure swallowing.

Question 8

True or false: Zenker diverticuli are false diverticuli.

Answer 8

True.

Question 9

What is Mallory-Weiss syndrome?

Answer 9

It is linear lacerations of the distal esophagus due to extreme vomiting (such as in bulimia or alcoholism); presents with painful hematemesis.

Question 10

Crackling beneath the neck skin might be a product of ___________.

Answer 10

Boerhaave syndrome, in which extreme vomiting leads to a hole in the esophagus; this allows air into the mediastinum which subsequently rises.

(It BORes Air.)

Question 11

How can you distinguish rupture of esophageal varices and Mallory-Weiss syndrome?

Answer 11

MW is painful, while EV is painless.

Question 12

Disordered esophageal motility and lack of LES relaxation can result from _____________.

Answer 12

inflammatory destruction of esophageal ganglia (this being achalasia), because the ganglia control peristalsis and LES relaxation

Question 13

What infection can cause achalasia?

Answer 13

Chagas (Trypanosomiasis)

Question 14

The “hourglass sign” presents in what disorder that can cause GERD?

Answer 14

Hiatal hernia –the LES pinches the middle of the stomach that is sticking into the distal esophagus

Question 15

What type of NON-LIFE-THREATENING hernia will present with bowel sounds in the lower left lung?

Answer 15

Para-esophageal

Question 16

Adult-onset asthma can be a sign of __________.

Answer 16

GERD; the acid can trigger bronchoconstriction

Question 17

What type of tissue –be very specific –does esophageal metaplasia often change to in GERD?

Answer 17

Non-ciliated columnar epithelium with goblet cells

Question 18

Why do esophageal webs and achalasia lead to increased risk of SCC?

Answer 18

The web will be under much shear stress and achalasia leads to rotting food which leads to chemical stress –both leading to stress-induced metaplasia.