Brainscape's Knowledge GenomeTM

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


See full index

SHU > Upper Gastrointestinal > Flashcards

Upper Gastrointestinal Flashcards

1
Q

GORD definition

A

Reflux of acidic stomach contents into the oesophagus due to inappropriate transient or permanent relaxation of the lower oesophageal sphincter

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

GORD can be classified into:

A

Erosive and non-erosive

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

__-__% of patients with GORD have the non-erosive subtype

A

50-70%

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

__-__% of patients with GORD have the erosive subtype

A

30-50%

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

Risk factors for GORD include:

A

Smoking, alcohol, stress, obesity, pregnancy, scleroderma

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

Clinical features of GORD include:

A

Retrosternal burning pain exacerbated with lying down, postprandially and triggered by certain foods/beverages. Regurgitation. Dysphagia. Bloating. Non-productive cough.

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

Diagnosis of GORD is made:

A

Clinically

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

Histopathological features of GORD include:

A

Superficial coagulative necrosis, basal cell thickening, elongation of papillae in lamina propria, inflammatory cell, squamous to columnar transformation

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

Lifestyle changes indicated in the management of GORD include:

A

Weight loss, exercise and avoidance of triggers

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

The first-line pharmacological treatment for GORD is:

A

Proton pump inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Surgical management of GORD includes:

A

Fundoplication

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

Fundoplication is only indicated in GORD which:

A

Is pharmacologically resistant to treatment

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

Squamous cell carcinoma is most commonly found in which portion of the oesophagus?

A

The upper 2/3

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

The most common subtype of oesophageal malignancy is:

A

Squamous cell carcinoma

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

Adenocarcinoma is most commonly found in which portion of the oesophagus?

A

The lower 1/3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Oesophageal malignancy can be classified by position according to:

A

The Siewert classification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Risk factors for development of oesophageal carcinoma include:

A

Male sex, age 60-70yo, smoking, alcohol, past medical history of GORD/Barrett’s oesophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

The overall five year survival rate of oesophageal malignancy is:

A

20%

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

Symptoms consistent with oesophageal carcinoma include:

A

Progressive dysphagia from solids to liquids, constitutional symptoms, dyspepsia, dyspnoea, retrosternal chest or back pain, persistent cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Signs of oesophageal carcinoma on physical examination include:

A

Vocal hoarseness, pallor, Horner’s syndrome, cervical lymphadenopathy

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

Histopathological findings consistent with oesophageal adenocarcinoma include:

A

Metaplasia of oesophageal epithelium to columnar epithelium with goblet cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Histopathological findings consistent with oesophageal squamous cell carcinoma include:

A

Lymphocytic infiltration between carcinoma clusters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Neoadjuvant chemoradiotherapy is indicated in oesophageal carcinoma in the following:

A

Locally invasive disease and Barrett syndrome high grade metaplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Chemotherapy is indicated for oesophageal carcinoma in:

A

Advanced disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Operative treatment of oesophageal carcinoma includes:

A

Endoscopic submucosal resection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Operative management of oesophageal carcinoma is indicated in:

A

Superficial epithelial lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Barrett’s oesophagus definition

A

Intestinal metaplasia of the oesophageal mucosa where squamous epithelium transforms to columnar epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Barrett’s oesophagus is induced by:

A

Chronic reflux of gastric contents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Risk factors for Barrett’s oesophagus include:

A

Male sex, age>50yo, obesity, GORD for >5years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Barrett’s oesophagus can be confirmed on:

A

Endoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Conservative management of Barrett’s oesophagus includes:

A

Regular endoscopic monitoring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Pharmacological management of Barrett’s oesophagus includes:

A

Proton pump inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Operative management of Barrett’s oesophagus includes:

A

Radiofrequency ablation

34
Q

Radiofrequency ablation of Barrett’s oesphagus is indicated in:

A

High-grade dysplasia

35
Q

Eosinophilic oesophagitis definition

A

Chronic inflammatory disorder of the oesophagus characterised by eosinophilia and resultant oesophageal dysfunction

36
Q

Eosinophilic oesophagitis affects _ in 100 adults

A

1

37
Q

Eosinophilic oesophagitis affects _ in 10,000 children

A

1

38
Q

Eosinophilic oesophagitis most commonly affects which patient group?

A

Men aged <40yo

39
Q

Eosinophilic oesophagitis pathophysiology

A

Exposure to allergens → chronic inflammation and eosinophilic infiltration of the oesophagus → subepithelial fibrosis, oesophageal remodelling and dysfunction

40
Q

Symptoms of eosinophilic oesophagitis include:

A

Dysphagia, dyspepsia refractory to acid suppression therapy, vomiting, food ‘sticking’ while swallowing, cough, melaena

41
Q

Histopathological findings in eosinophilic oesophagitis include:

A

Eosinophilia and subepithelial fibrosis

42
Q

Features of eosinophilic oesophagitis on endoscopy include:

A

Trachealisation of the oesophagus (circumferential mucosal lesions), longitudinal furrows, mucosal fragility

43
Q

Non-operative management of eosinophilic oesophagitis includes:

A

Avoidance of trigger allergens

44
Q

Pharmacological management of eosinophilic oesophagitis includes:

A

Proton pump inhibitors and topical glucocorticoids (e.g. fluticasone)

45
Q

Operative management of eosinophilic oesophagitis includes:

A

Oesophageal dilation

46
Q

In the setting of eosinophilic oesophagitis, oesophageal dilation is indicated:

A

In oesophageal strictures or disease refractory to conservative therapy

47
Q

Oesophageal varices definition

A

Dilation of the submucosal veins of the distal oesophagus as a complication of portal hypertension

48
Q

__% of cirrhotic patients have concurrent oesophageal varices

A

30%

49
Q

__% of patients with oesophageal varices will experience bleeding

A

50%

50
Q

__% of variceal bleeds are fatal

A

30%

51
Q

Risk factors for the development of oesophageal varices include:

A

Alcohol consumption, increased variceal size, advanced Child-Pugh classification

52
Q

Oesophageal varices pathophysiology

A

Liver cirrhosis → cannot accommodate blood flow → resultant retrograde portal hypertension → collateral enlargement → congestion of submucosal veins in the oesophagus → potential rupture +/- haemorrhage

53
Q

Symptoms of ruptured oesophageal varices

A

Sudden onset haematemesis, melaena, haematochezia (if rapid-transit bleed), abdominal discomfort

54
Q

Physical examination signs of oesophageal varices

A

Caput medusae, gynaecomastia, palmar erythema, testicular atrophy, splenomegaly, shifting dullness

55
Q

CBE in the setting of liver cirrhosis may show:

A

Normocytic normochromic anaemia and thrombocytopaenia

56
Q

LFTs in the setting of liver cirrhosis may show:

A

Increased AST/ALT and hypoalbuminaemia

57
Q

Endoscopy in the setting of oesophageal varices is useful to:

A

Identify active bleeding sites and provide treatment

58
Q

Non-operative management of bleeding oesophageal varices includes:

A

Resuscitation and stabilisation

59
Q

Pharmacological management of bleeding oesophageal varices includes:

A

Octreotide and erythromycin

60
Q

Octreotide is indicated for what time period in the setting of bleeding oesophageal varices?

A

3-5 days.

61
Q

Operative management of bleeding oesophageal varices includes:

A

Endoscopic band ligation, injection sclerotherapy and balloon tamponade

62
Q

Mallory Weiss syndrome definition

A

Longitudinal lacerations of the mucous membrane in the oesophagus

63
Q

Risk factors associated with Mallory Weiss syndrome include:

A

Prolonged severe vomiting, alcoholism, blunt abdominal trauma and GORD

64
Q

Mallory Weiss syndrome pathophysiology

A

Acute excessive rise in oesophageal intraluminal pressure, resulting in tearing of the oesophageal mucous membrane and submucosal arteries/veins leading to bleeding

65
Q

Endoscopic findings consistent with Mallory Weiss tear include:

A

Longitudinal tear limited to the mucosa and submucosa around the GOJ

66
Q

Operative management of Mallory Weiss syndrome includes:

A

Endoscopic adrenaline and endoscopic electrocoagulation

67
Q

Hiatus hernia definition

A

Abnormal protrusion of any abdominal structure, usually the stomach, into the thoracic cavity through a laxity in the diaphragmatic oesophageal junction

68
Q

Risk factors for the development of hiatus hernia include:

A

Obesity, increasing age, smoking and increased abdominal pressure

69
Q

Type I hiatus hernia may be associated with which symptom?

A

Retrosternal burning pain

70
Q

The following symptoms may be associated with type II or III hiatus hernia

A

Epigastric or substernal pain and early satiety

71
Q

Non-operative management of hiatus hernia includes:

A

Avoidance of triggers, smaller meals, weight loss and PPIs

72
Q

Operative management of hiatus hernias includes:

A

fundoplication

73
Q

Achalasia definition

A

Oesophageal motility disorder characterised by inadequate relaxation of the lower oesophageal sphincter and non-peristaltic contractions in the distal 2/3 of the oesophagus due to the degeneration of inhibitory neurons

74
Q

Achalasia commonly affects which age group?

A

25-60yo

75
Q

Clinical features of achalasia include:

A

Dysphagia progressing from solids to liquids, regurgitation, retrosternal pain and weight loss

76
Q

Pathophysiology of achalasia

A

Atrophy of inhibitory neurons → deficiency in inhibitory neurotransmitters → imbalance in excitatory vs inhibitory neurotransmitters → lack of relaxation and increased LOS resting pressure with dilation proximal to LOS

77
Q

Manometric findings in achalasia include:

A

Absence peristalsis in the lower 2/3 of the oesophagus, absent LOS relaxation and increased LOS resting pressure

78
Q

Signs of achalasia on barium swallow include:

A

Rats tail sign and widened proximal oesophagus

79
Q

Operative management of achalasia includes:

A

pneumatic dilatation

80
Q

Pharmacological management of achalasia includes:

A

Botox injection (indicated in poor surgical candidates)

SHU (7 decks)

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