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Gastrointestinal
Esophageal
40
Medical
Graduate
02/05/2010

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Cards

Term
Sensation of food being hindered (“sticking”) in its normal passage from the mouth to the stomach.
Definition
Dysphagia
Term
What are the 2 types of dysphagia?
Definition
Oropharyngeal and esophageal dysphagia
Term
What metabolic d/o cause oropharyngeal dysphagia? Infectious dz?
Definition
Cushings, Wilson'd dz. Polio, diptheria, botulism, lyme dz.
Term
Do motility d/o affect swallowing of liquids or solids? Mechanical obstruction?
Definition
Motility - liquids and solids. Obstruction - solids only.
Term
Painful swallowing.
Definition
Odynophagia
Term
Name 5 causes of odynophagia.
Definition
Caustic ingestion, pill-induced esophagitis, infectious esophagitis, severe reflux, and obstructing tumors
Term
Unexpected and effortless appearance of GI contents in mouth.
Definition
Regurgitation
Term
What causes regurgitation to have a sour taste? Bitter?
Definition
Gastric acid. Duodenal contents.
Term
Outpouring of salivary secretions in response to gastroesophageal reflux.
Definition
Water brash
Term
What is the most common of all esophageal sx?
Definition
Pyrosis (heartburn)
Term
What foods aggravate heartburn?
Definition
High fat foods, chocolate, spicy foods, etoh, and caffeine.
Term
Name 3 alleviating factors for heartburn.
Definition
Antacids, baking soda, and milk.
Term
What is the most common cause of esophageal induced chest pain?
Definition
Reflux
Term
Name 3 distinguishing factors of reflux related CP from cardiac CP.
Definition
Pain during sleep, lasts hours to days, hot and cold liquids/meals aggravate
Term
Name 3 drugs that commonly cause pill induced esophagitis.
Definition
Doxycycline, Vit C, and NSAIDs
Term
Engorged and tortuous esophageal veins d/t portal HTN.
Definition
esophageal varices
Term
What are the leading causes of esophageal varices? Where in the esophagus do they occur?
Definition
Alcoholic and viral cirrhosis. Lower 1/3.
Term
Name 2 tx for esophageal varices.
Definition
Beta blockers and endoscopic variceal ligation (EVL)
Term
Mucosal laceration of gastroesophageal junction.
Definition
Mallory-Weiss Syndrome
Term
Mallory-Weiss is strongly associated w/ a h/o what?
Definition
Portal HTN (alcoholism)
Term
What c/o do pts typically present w/ in Mallory-Weiss syndrome?
Definition
Hematemesis, 50% w/ h/o vomiting and retching
Term
What is the tx for Mallory-Weiss syndrome?
Definition
Usually self-limiting, endoscopic hemostatic therapy in severe cases
Term
Protrusion of pharyngeal mucosa at the pharyngoesophageal junction between inferior pharyngeal constrictor and cricopharyngeus.
Definition
Zenker Diverticulum
Term
What is the etiology of Zenker Diverticulum?
Definition
Loss of elasticity of the UES
Term
Symtpoms of Zenker diverticulum in the elderly tend to have an insidious onset and include what?
Definition
Dysphagia, regurgitation, and halitosis
Term
What diagnostic test is used for Zenker diverticulum? What is the tx?
Definition
Barium esophagram. Surgical diverticulectomy.
Term
What are the 3 most common esophageal motility d/o?
Definition
Achalasia, diffuse esophageal spasm, and scleroderma
Term
A condition in which the loss of ganglion cells in Auerbach’s plexus leads to increased tone and impaired relaxation of the LES and absent peristalsis.
Definition
Achalasia
Term
What is the mean age of onset of achalasia? More common in men or women?
Definition
30-60s (peak in 40s). Men 2:1.
Term
What is seen on CXR of a pt w/ achalasia? Barium swallow?
Definition
Dilated, fluid-filled esophagus. Distal "bird-beak" tapering.
Term
What are sx of achalasia?
Definition
Dysphagia and regurgitation
Term
Name 3 findings on manometry in a pt w/ achalasia.
Definition
1)High resting LES pressure 2)Absence of peristalsis 3)Incomplete/abn relaxation w/ swallowing
Term
Name 4 tx of achalasia.
Definition
1)Meds (CCB or nitrates - ineffective) 2)Mechanical Dilation (good short term, repeat /p 5yrs) 3)Myotomy (less risk, higher efficacy, high cost, dev. GERD) 4)Botulinum toxin injection
Term
A rare esophageal dysmotility d/o that is associated w/ degeneration of nerve's in Auerbach's plexus.
Definition
Esophageal spasms
Term
What are common sx reported by pts w/ diffuse esophageal spasms?
Definition
Substernal CP (similar to angina) w/ intermittent dysphagia
Term
What is the appearance of esophageal spasms on barium x-ray?
Definition
"Corkscrew" esophagus
Term
What is the finding on manometry in a pt w/ esophageal spasms?
Definition
Normal pressure
Term
What meds can be used to tx esophageal spasms?
Definition
Smooth muscle relaxants (Isosorbide, nifedipine) or antidepressants (Amitriptyline or trazodone)
Term
What tx is used in a pt w/ severe dysphagia and wt loss d/t esophageal spasms?
Definition
Pneumatic dilation or a long esophageal myotomy
Term
What diagnostic test is used to evaluate for abnormal peristalsis & poor LES tone?
Definition
Esophageal manometry
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