Quiz #2 b Flashcards
_____ can be found in 10% of people with GERD
Barret esophagus
alteration of stem cell differentiation via addition of intestinal mucus secreting goblet cells
Barret esophagus
how does barret esophagus affect reflux episodes?
they last longer
significance with local ulceration with bleeding and stricture
Barret esophagus
Barret esophagus can come from ____
GERD
Esophageal varices location
mostly in submucosa of distal esophagus and proximal stomach
increase pressure on esophageal plexus veins can cause
esophageal varices
esophageal varices develop in _____% of cirrhosis patients
90% (mostly alcohol)
______ has no symptoms until rupture leading to ______
esophageal varices, hematemesis
venous thrombosis and inflammation may occur after varices _____
rupture
blood goes into the lumen as well as suffusion of the esophageal wall with blood
hemorrhage of the esophageal varices
esophageal varices 1/2 of deaths are from _____ the other from ______
cirrhosis, hepatic coma
______ may be the only complication of uncomplicated GHERD
hyperemia
Characteristic of GHERD
basal cell hyperplasia (20%)presence of inflammatory cells (WBCs) in squamous epithelial layerelongation of lamina propr. papillae with constriction
GERD: Symptoms do not always ____ with the level of histological esophagitis
match
severe chest pain that maybe mistaken for a heart attack is not uncommon for
GERD
children: melena, hematemesis, sourbrash
GERD
Causes of GERD
Nasogastric Tubealcohol, tobaccosclerosis disorderspregnancyCNS depressantshypothyroidism
contritubute to GERD
Inadaquate/esophageal clearance of reflux materialsliding haital herniareduction of reparative capacity of esophageal mucosaprolonged exposure to gastric juices
Alchalasia associated with esophageal squamos cell carcinoma __%
5%
Alchalasia may come from _____ disease via destruction of myenteric plexus
chagas
Progressive dilation of the esophagus above the level of LES
Alchasia
degenerative changes in innervation of the _____ nerve may also occur in Alchalasia
vagus (intrinsic or extraesophageal)
complication of alchalasia
progressive dysphagiacandida esophagitislower esophageal diverticula
aspiration/pneumonia/airway obstruction in Alchasia can be from
aperistalsispartial or incomplete relaxation of LES when swallowingincreased resting tone of LES
Alchalasia is associated with dysfunction of ___Containing neurons
NO
_____ happens often in alcoholics due to severe stretching from vomiting
Mallory Weiss syndrome
Mallory Weiss syndrom is longitudinal tears in the esophagus at the ________ junction or _______
esophagogastric, proximal gastric mucosa
_____% of cases with mallory weis syndrom there is bleeding in the upper GI Tract
5-10%
inflammatory ulcer, media stinitidis w/ infection
Boerhave syndrome can be a result of Mallory Weis syndrome
Separation of diaphragmatic cura and widening of the space between the muscular cura and esophageal wall.
Hatial Hernia
_____ hernia is 95% of cases of Hatial hernia
sliding
nonaxial/paraesophageal hernia is ___ of Hatial hernia occurences
5%
protrusion of stomach above diaphragm with bell shaped dilation with diaphragmatic narrowing
sliding hernia
stomach along the greater curvature enters the thorax through a widen foramen
nonaxial/paraesophageal hernia
gastrinomas that hypersecret gastrin in the pancreas, duodenum, and peripancreatic soft tissue
Zollinger-Ellison Syndrome
Zollinger-Ellison Syndrome associated with pancreatic islet cell lesions in ____% of cases
90-95%
over half the tissues discovered are _____ invasive or _____ at time of diagnosis (Zollinger-Ellison Syndrome)
locally, metastasized
Zollinger-Ellison Syndrome + other endocrine tumors found in ___% of patients
MEN-1, 25%
extreme gastric acid secretion leads to
ulcers
Zollinger-Ellison Syndrome ___% have diarrhea and is the presenting symptom
50
