Pathoma - Esophagus

Question 1

Tracheoesophageal fistula - cause

Answer 1

congenital defect

Question 2

common type of TE fistula

Answer 2

esophageal atresia

Question 3

clinical presentation of esophageal atresia

Answer 3

vomiting
polyhydramnios
distended abdomen (gas in stomach)
aspiration

Question 4

Esophageal web

Answer 4

protrusion of esophageal mucosa

Question 5

Esophageal web: most important manifestation

Answer 5

Plummer-vinson syndrome

Question 6

Plummer Vinson syndrome - clinical presenation

Answer 6

Iron deficiency anemia
esophageal web
beefy-red tongue (atrophic glossitis)

Question 7

Zenker’s diverticulum

Answer 7

outpouching of pharyngeal mucosa through acquired defect in muscular wall

Question 8

Zenker’s diverticulum - location

Answer 8

pharyngeal-esophageal junction

Question 9

Zenker’s diverticulum - clinical presentation

Answer 9

dysphagia, obstruction and halitosis

Question 10

Mallory-Weiss Syndrome

Answer 10

longitudinal laceration of mucosa

Question 11

MW syndrome - location

Answer 11

gastro-esophageal junction

Question 12

MW syndrome - cause

Answer 12

severe, repeated vomiting (alcoholism or bulimia)

Question 13

MW syndrome - clinical presentation

Answer 13

painful, bright red vomiting (hematemesis)

Question 14

most common cause of death in cirrhosis

Answer 14

esophageal varices rupture

Question 15

Esophageal varices - cause

Answer 15

portal hypertension

Question 16

Esophageal varices - clinical presentation

Answer 16

asymptomatic (until rupture)

Question 17

Variceal rupture - clinical presentation

Answer 17

PAINLESS hematemesis

Question 18

Achalasia

Answer 18

inability to relax lower esophageal sphincter (LES)

Question 19

Achalasia - cause

Answer 19

damage to myenteric (Auerbach’s) plexus (idiiopathic or Chagas’ dz)

Question 20

Achalasia - labs

Answer 20

“Bird beak sign” on barium swallow

Question 21

Achalasia - clinical presentation

Answer 21

dysphagia, halitosis, increased LES pressure, increased risk of squamous cell carcinoma

Question 22

GERD

Answer 22

loss of LES tone->reflux of stomach acid

Question 23

GERD - risk factors

Answer 23

alcohol, tobacco, obesity, fat-rich diet, caffeine, hiatal hernia

Question 24

GERD - complications

Answer 24

Barret’s Esophagus (metaplasia of squamous cells to columnar in epithelium of esophagus)
Ulceration w/ stricture

Question 25

GERD - clinical presentation

Answer 25

heartburn (chest pain)
adult-onset asthma
damage to enamel of teeth

Question 26

Barret’s esophagus - biopsy finding

Answer 26

non-ciliated columnar epithelium w/ goblet cells

Question 27

Esophageal carcinoma - types

Answer 27

Adenocarcinoma or squamous cell carcinoma

Question 28

Adenocarcnioma vs SCC - location

Answer 28

Adeno - lower 1/3

SCC- upper or middle third

Question 29

Adenocarcinoma vs SCC - cause

Answer 29

adeno - Barret’s esophagus

SCC - inflammation (alcohol, tobacco, achalasia, esophageal web/PV syndrome, esophageal injury (chemical ingestion))

Question 30

Adenocarcinoma vs SCC - epidemiology

Answer 30

Adenocarcinoma - #1 esophageal cancer in West

SCC - #1 worldwide

Question 31

Esophageal carcinoma- clinical presentation

Answer 31

PROGRESSIVE dysphagia, weight loss, pain, hematemesis

SCC- cough/hoarseness possible

Question 32

Regions of lymph node spread in esophageal cancer

Answer 32

upper 1/3: cervical nodes
middle 1/3: mediastinal/tracheobronchial nodes
lower 1/3: celiac/gastric nodes