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Clin Med II - GI > The Esophagus > Flashcards

Flashcards in The Esophagus Deck (22)
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1
Q

odynophagia

A

painful swallowing ranges from dull ache to stabbing pain

(usually represents a severe inflammatory process)

2
Q

zenker’s diverticula

A

approx. 85% occur in individuals >50

symptoms and sx:

fullness or gurgling in neck

coughing or aspiration

regurgitation of retained food

*dysphagia*

3
Q

achalasia

A

dilated esophagus with narrowed distal esophagus

“birds beak”

4
Q

what is the cause of achalasia?

A

unknown - believed to me defect in intramural innervation

5
Q

what are the symptoms of achalasia?

A

dysphagia to solids and liquids

chest pain

regurgitation

insidious onset

6
Q

how do we treat achalasia?

A

mainstay is surgery - endoscopic pneumatic dilatation of LES

can use smooth muscle relaxant - nitrates or Ca channel blockers

Botox injections

7
Q

what is the triad of findings in achalasia?

A
  1. increased LES resting pressure
  2. inability of the LES to relax
  3. Absence of peristalsis in the body of the esophagus
8
Q

What is Schatzki’s ring?

A

Ring of mucosal tissue in the distal esophagus that can cause narrowing and dysphagia

9
Q

What is eosinophilic esophagitis?

A

allergic inflammatory condition that causes dysphagia and food impaction

10
Q

what is the epi of eosinophilic esophagitis?

A

children > adults

males > females

11
Q

what are three causative organisms of esophageal infections?

A
  1. candida
  2. herpes
  3. CMV
12
Q

what are the most common agents in medication-induced esophagitis?

A

doxyccyline, iron, potassium, Vitamin C, aspirin, NSAIDs, alendronate

13
Q

what is a patient experiencing during esophageal spasm?

A

chest pain and dysphagia

due to abnormal contractions and ineffective peristalsis

(imposter of cardiac disease)

14
Q

what is the epi of GERD?

A

>25% of U.S. adults

7-10% have daily symptoms

20% have weekly symptoms

30-40% have monthly symptoms

male = female

60% of adults > 65% have monthly symptoms

15
Q

what are the possible complications of GERD?

A

bleeding

stricture

ulceration

Barrett’s epithelium

adenocarcinoma

16
Q

what do you do for the patient with typical symptoms of GERD and no coronary disease?

A

Nothing - they will take OTC medications

17
Q

what is esophageal mannometry useful for?

A

checking symptom etiology

monitoring medication effects

pre-operative evaluation (to tell how tight you need to wrap)

18
Q

How frequently do you see Barrett’s in GERD patients?

A

About 10%

19
Q

what is the epi of Barrett’s

A

males > females

history of GERD

20
Q

the risk of adenocarcinoma is ____ greater than in the general population in Barrett’s

A

40X

21
Q

what are the two types of esophageal cancer?

A
  1. squamous cell (tobacco and alcohol)
  2. adenocarcinoma (Barrett’s)
22
Q
A