This is a barium enema x-ray of a patient with known colorectal cancer. What is the name of this classical appearance?
Apple core lesion
Salivary gland tumors are generally _____ (benign/malignant).
Where is the most common location for a salivary gland tumor?
A patient presents with a painless, movable mass in a salivary gland. The mass is removed and found to be benign. It later recurs. What type of tumor is it?
Name the benign tumor composed of heterotopic salivary gland tissue trapped in a lymph node, surrounded by lymphatic tissue.
What is the most common malignant salivary gland tumor?
Achalasia results from the failure of what process to occur?
Relaxation of the lower esophageal sphincter
In patients with achalasia, the lower esophageal sphincter cannot relax as a result of the loss of what source of innervation?
The myenteric (Auerbach's) plexus
What is the most common presenting symptom of achalasia?
In patients with achalasia, what test yields a classic diagnostic image?
Describe the findings of achalasia on barium swallow.
Bird's beak appearance: dilated proximal esophagus with tapering at the lower esophageal sphincter
Achalasia is associated with an increased risk of what malignancy?
Secondary achalasia can result from what parasitic disease endemic to South America?
What is the underlying pathophysiology of dysphagia associated with CREST?
There is esophageal dysmotility (poor peristalsis) and low esophageal pressure proximal to the lower esophageal sphincter
A patient with a history of asthma presents with a nonproductive cough and chest pain that is not associated with activity. It is worse with recumbency and is not relieved by inhalers or nitroglycerin. What is the likely diagnosis?
Gastroesophageal reflux disease
An alcoholic is brought into the emergency department vomiting copious amounts of blood. The condition this patient likely has causes painless bleeding from which vessels?
Submucosal veins in the lower one third of the esophagus, forming varices
A 45-year-old woman presents to the emergency department with a five-hour history of vomiting and retching. In the last hour, her vomitus was bloody and painful. What is the likely cause of her hematemesis?
A patient presents with chest pain after severe vomiting and is found to have substernal crepitus. What is the diagnosis?
Boerhaave syndrome (remember: "been-heaving syndrome")
Ingestion of what compound classically causes esophageal strictures?
Lye; strictures are also seen with gastroesophageal reflux disease
Esophagitis is commonly associated with what three etiologies?
Reflux, infection, or chemical ingestion
Which three infectious agents can cause esophagitis?
Herpes simplex virus type 1, cytomegalovirus, and Candida
Plummer-Vinson syndrome has a triad of what symptoms?
Dysphagia due to esophageal webs, glossitis, and iron deficiency anemia
A patient is having difficulty swallowing. He has a swollen, tender tongue that appears smooth. Laboratory tests reveal iron deficiency anemia. What is the most likely diagnosis?
Is Barrett's esophagus an example of glandular dysplasia, hyperplasia, neoplasia, or metaplasia?
In patients with Barrett's esophagus, there is a replacement of _____ _____ epithelium with _____ epithelium.
Nonkeratinized squamous; intestinal (columnar)
What causes Barrett's esophagus?
Chronic acid reflux resulting in epithelial metaplasia
What specific malignancy is associated with Barrett's esophagus?
Adenocarcinoma (remember: BARRett's = Becomes Adenocarcinoma, Results from Reflux)
What are two behavioral risk factors for esophageal cancer?
Alcohol use and cigarette use
List four pathologic states of the esophagus that are risk factors for esophageal cancer.
Barrett's esophagus, diverticuli, esophagitis, achalasia, and esophageal webs
In the United States, which type of esophageal cancer is most common?
Squamous cell carcinoma and adenocarcinoma of the esophagus have a roughly equal incidence