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NMF: General Surgery > Upper GI > Flashcards

Upper GI Flashcards

1
Q

What is achalasia?

A

ganglion cells destroyed causing failure of the lower oesophageal sphincter which presents with progressive dysphagia

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2
Q

How should achalasia be investigated?

A

urgent OGD (often normal)

manometry

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3
Q

How can achalasia be managed?

A

lots of fluids, eating slowly, ccb and botox

surgery: endoscopic balloon dilatation or myotomy

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4
Q

What is barrett’s oesophagus?

A

metaplasia of the oesophageal epithelium

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5
Q

What change occurs in barrett’s ?

A

stratified squamous replaced with columnar, glandular

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6
Q

How does barrett’s present?

A

GORD
retrosternal pain
belching, odynophagia, cough, hoarseness

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7
Q

How should barrett’s be investigated?

A

OGD + biopsy

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8
Q

How should barrett’s be managed?

A

PPI
monitor with repeat endoscopy in low-grade
endoscopic mucosal resection in high-grade

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9
Q

Which type of oesophageal cancer is most common in the UK?

A

adenocarcinoma

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10
Q

What are the risk factors for oesophageal adenocarcinoma?

A

GORD
barrett’s
obesity

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11
Q

Which part of the oesophagus is affected by adenocarcinoma?

A

lower third

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12
Q

What type of oesophageal cancer is more common in the developing world?

A

squamous cell

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13
Q

What is squamous cell cancer in the oesophagus associated with?

A

smoking
alcohol
vitamin A deficiency

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14
Q

Which part of the oesophagus is affected by squamous cell carcinoma?

A

middle and upper thirds

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15
Q

How does oesophageal cancer present?

A

progressive dysphagia
weight loss
odynophagia
hoarseness

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16
Q

What is the prognosis for oesophageal cancer?

A

very poor

70% are palliated

17
Q

What are the 2 presentations of upper GI bleeding?

A

haematemesis

melena

18
Q

What is melena?

A

black tarry smelly stool

19
Q

Why is melena black

A

oxidation of iron in the blood as it passes through the ileum and colon

20
Q

How should ? upper GI bleed be investigated?

A

urgent OGD

21
Q

What is Boerhave’s syndrome?

A

oesophageal rupture causing stomach contents to leak into the mediastinum + pleural space

22
Q

What causes Boerhave’s?

A

vomiting

23
Q

How does Boerhave’s present?

A

severe sudden retrosternal chest pain
respiratory distress
vomiting

24
Q

Which blood test is raised in upper GI bleed?

A

urea

NMF: General Surgery (8 decks)

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