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Block 10 Week 4 > Usera: GI Tract > Flashcards

Usera: GI Tract Flashcards

1
Q

What is esophageal agenesis?

A

absent esophagus - extremely rare

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2
Q

Saccular and elongated cystic masses that contain redundant smooth muscle layers
May be present in the esophagus, small intestine or colon

A

duplication cysts

**most common in the ascending colon, but can occur anywhere along the luminal GI tract

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3
Q

Thin, noncanalized cord replaces a segment of esophagus causing mechanical obstruction
Proximal and distal blind pouches connect to the pharynx and stomach
Occur most commonly at the bifurcation of the trachea (carina)
Associated with congenital heart defects, genitourinary malformations and neurologic disease

A

Atresia

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4
Q

Where does GI atresia most commonly occur?

A

at the bifurcation of the trachea

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5
Q

What is the most common variant of of proximal esophageal atresia?

A

tracheoesophageal fistula - the esophagus ends in a blind pouch allowing the distal esophagus to communicate openly with the trachea –> can cause food to aspirate into the trachea, can cause suffocation, pneumonia, etc

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6
Q

Incomplete form of atresia
Lumen is reduced due to fibrous thickening of the wall
Complete or partial obstruction
May occur in any part of the GI tract

A

Stenosis

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7
Q

Most common form of congenital intestinal atresia

Failure of the cloacal diaphragm to involute

A

imperforate anus

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8
Q

Incomplete formation of the diaphragm
Abdominal viscera herniates into the thoracic cavity
May cause pulmonary hypoplasia

A

diaphragmatic hernia

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9
Q

Closure of the abdominal musculature is incomplete
Abdominal viscera herniates into the ventral membranous sac
Associated with other congenital abnormalities
Can be surgically repaired

A

omphalocele

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10
Q

Ventral wall defect similar to omphalocele

Involves all layers of the abdominal wall from peritoneum to the skin

A

gastroschisis

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11
Q

Ectopic gastric mucosa
Occurs in the upper 1/3 of the esophagus
May result in dysphagia, esophagitis, Barrett esophagus or adenocarcinoma

A

inlet patch - ectopic tissue in GI tract

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12
Q

Occurs in the esophagus and stomach

Usually asymptomatic but can cause damage and local inflammation that causes obstruction

A

ectopic pancreatic tissue

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13
Q

Ectopic gastric tissue in the small bowel or colon

May present with occult blood loss due to peptic ulceration of the adjacent mucosa

A

gastric heterotopia

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14
Q

What is unique about the histology of the esophagus?

A

no serosa!

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15
Q

What are the layers of the esophagus?

A

mucosa: nonkeratinizing stratified squamous epithelium w a lamina propria & muscularis mucosa
submucosa: loose CT with submucosal glands
muscularis propria: inner & outer longitudinal smooth muscle

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16
Q

These lesions can cause esophageal obstruction

A 
Nutcracker esophagus
Esophageal spasm
Diverticula
Webs
Rings
Stenosis
Achalasia (loss of nerve tone)
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17
Q

Ledgelike protrusions of the mucosa into the upper esophagus lumen

A

esophageal webs

18
Q

What are esophageal webs associated with?

A

GER
Graft vs host disease
blistering skin diseases

19
Q

**board favorite: Esophageal webs with Fe deficiency anemia, glossitis and cheilosis

A

Paterson-Brown-Kelly (Plummer Vinson syndrome)

20
Q

Main symptom of esophageal web?

A

dysphagia

21
Q

Circumferential, thick protrusions into the lower esophagus lumen
Consists of mucosa, submucosa and muscularis propria (all the mural components)

A

Rings (Schatzki rings)

22
Q

Outpouching of the alimentary tract that contains all visceral layers

A

true diverticulum

23
Q

An outpouching of mucosa and submucosa. Lamina propria remains intact.

A

false diverticulum

24
Q

3 types of diverticula?

A

Zenker - above upper esophageal sphincter
Traction - middle esophagus
Epiphrenic - above lower esophageal sphincter

25
Q

Narrowing of the lumen due to fibrous thickening of the submucosa and atrophy of the muscularis propria
Caused by inflammation and scarring from
GER
Irradiation
Caustic injury
Dysphagia is progressive; first for solids then liquids

A

esophageal stenosis

26
Q

Increased tone of the lower esophageal sphincter as a result of impaired smooth muscle relaxation
Bird-beak radiographic appearance on barium swallow

A

achalasia

27
Q

What happens to the LES relaxation in achalasia? What happens to LES tone?

A

incomplete LES relaxation; increased LES tone

**can lead to dilation of the esophagus

28
Q

What causes primary achalasia? Secondary?

A

primary: Due to failure of the distal esophagus inhibitory neurons
secondary: Chagas disease (Trypanosoma cruzi), Infection causes destruction of the myenteric plexus

29
Q

Treatments for achalasia?

A

laparoscopic myotomy
pneumatic balloon dilatation
botulinum toxin injection

30
Q

Longitudinal laceration of mucosa at the gastroesophageal junction
Caused by severe vomiting, usu due to alcoholism or bulimia
Presents with painful hematemesis
Do not require surgical intervention
Risk of Boerhaave syndrome

A

Mallory Weiss tears

31
Q

Distal rupture of the esophagus leading to air in the mediastinum & subcutaneous emphysema
Rare and catastrophic event

A

Boerhaave syndrome

32
Q

Things that can cause inflammation of the esophageal mucosa?

A 
Gastric reflux
Infections
Drug use (pill induced)
Irradiation
Trauma
Corrosive agents
33
Q

What causes reflux esophagitis?

A 
decrease in LES tone
Alcohol
Tobacco
Obesity
CNS depressants
Pregnancy
Hiatal hernia
Delayed gastric empyting
Increased gastric volume
34
Q

How does reflux esophagitis present?

A

dysphagia

heartburn

35
Q

How to treat reflux esophagitis?

A

proton pump inhibitor

H2- histamine receptor antagonists

36
Q

What agents can cause esophageal infections?

A

Herpes simplex
CMV
Fungus (candida, mucormycosis, aspergillus)

37
Q

What are some clues that you have eosinophilic esophagitis? How can you treat it?

A

food gets stuck & can become allergenic
occurs in kids
dysphagia
failed proton inhibitor therapy

**usu goes away by removing whatever food caused the inflammation! can use steroids, too

38
Q

Separation of the diaphragmatic crura and protrusion of the stomach into the thorax

A

hiatal hernia

39
Q

Intestinal metaplasia within the esophageal squamous mucosa
Complication of chronic GERD (only in about 5%)
Increased risk of esophageal adenocarcinoma!!
Presence of high grade dysplasia determines treatment

A

Barrett esophagus

40
Q

Neoplasm of the esophagus
Arises in the background of Barrett esophagus and long standing GERD
Has increased in prevalence in the West

A

adenocarcinoma

41
Q

Risk factors for squamous cell carcinoma of the esophagus?

**Really rare in the West!

A 
Alcohol
Tobacco
Poverty
Caustic esophageal injury
Achalasia
Plummer-Vinson syndrome
Frequent consumption of hot beverages
Nutritional deficiencies
Polycyclic hydrocarbons
Nitrosamines

Block 10 Week 4 (8 decks)

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