Esophagus

Front 1

a. What is a tracheoesophageal fistula?

Back 1

i. Congenital defect resulting in a connection between the esophagus and trachea

Front 2

b. What is the most common variant of a TE fistula?

Back 2

i. Proximal esophageal atresia with distal esophagus arising from the trachea

Front 3

c. What are the symptoms of a TE fistula?

Back 3

i. Vomiting
ii. Polyhydramnios
iii. Abdominal distension
iv. Aspiration

Front 4

a. What is an esophageal web?

Back 4

i. Thin protrusion of esophageal mucosa
ii. Most often in upper esophagus

Front 5

b. What does having an esophageal web increase?

Back 5

i. Risk of esophageal squamous cell carcinoma

Front 6

c. What is Plummer-Vinson syndrome?

Back 6

i. Esophageal web characterized by →
ii. Severe iron deficiency anemia
iii. Esophageal web
iv. Beefy-red tongue due to atrophic glossitis

Front 7

a. What is a Zenker diverticulum?

Back 7

i. Outpouching of pharyngeal mucosa through an acquired defect in the muscular wall

Front 8

b. Where do you usually see a Zenker diverticulum?

Back 8

i. Above UES at junction of esophagus and pharynx

Front 9

c. What are the symptoms of a Zenker diverticulum?

Back 9

i. Dysphagia
ii. Obstruction
iii. Halitosis

Front 10

a. What is Mallory-Weiss syndrome?

Back 10

i. Longitudinal laceration of mucosa at GE junction
ii. Caused by severe vomiting

Front 11

b. What is the presentation of Mallory-Weiss syndrome?

Back 11

i. PAINFUL hematemesis

Front 12

c. What condition can lead to a risk for Boerhaave syndrome?

Back 12

i. Mallory-Weiss syndrome

Front 13

d. What is Boerhaave syndrome?

Back 13

i. Rupture of esophagus leading to air in the mediastinum and subcutaneous emphysema

Front 14

a. What causes esophageal varices?

Back 14

i. Portal hypertension

Front 15

b. What are the vessels involved in portal hypertension?

Back 15

i. Left gastric vein backs up into esophageal vein

Front 16

c. What is the presentation of ruptured esophageal varices?

Back 16

i. PAINLESS hematemesis

Front 17

d. What is the #1 cause of death in cirrhotic patients?

Back 17

i. Ruptured esophageal varices

Front 18

a. What is achalasia? What causes it?

Back 18

i. Inability to relax LES
ii. Due to damaged ganglion cells in Auerbach’s plexus

Front 19

b. What causes damage to ganglion cells in Auerbach’s plexus?

Back 19

i. Can be idiopathic
ii. Secondary to Chagas disease

Front 20

c. What is the presentation of achalasia?

Back 20

i. Dysphagia for solids and liquids
ii. Putrid breath
iii. High LES pressure
iv. Bird-beak sign on barium swallow

Front 21

d. What does achalasia put you at risk for?

Back 21

i. Esophageal squamous cell carcinoma

Front 22

a. What is GERD? What causes it?

Back 22

i. Reflux of acid from stomach into esophagus
ii. Due to low LES tone

Front 23

b. What are the clinical features of GERD?

Back 23

i. Heartburn
ii. Adult-onset asthma
iii. Damage to teeth enamel
iv. Ulceration with stricture
v. Barrett esophagus

Front 24

a. What is Barrett esophagus?

Back 24

i. Metaplasia of LES from stratified squamous epithelium to nonciliated columnar epithelium with goblet cells

Front 25

b. What causes Barrett esophagus?

Back 25

i. GERD

Front 26

c. What can Barrett esophagus progress to?

Back 26

i. Dysplasia
ii. Adenocarcinoma

Front 27

a. What precedes esophageal carcinoma?

Back 27

i. Barrett esophagus in lower 1/3 of esophagus

Front 28

b. Where does squamous cell carcinoma usually occur?

Back 28

i. Upper or middle 1/3 of esophagus

Front 29

c. What are the risk factors for squamous cell carcinoma?

Back 29

i. Alcohol and tobacco use
ii. Very hot tea
iii. Achalasia
iv. Esophageal web
v. Esophageal injury

Front 30

d. What are the symptoms of late esophageal carcinoma?

Back 30

i. Progressive dysphagia
ii. Weight loss
iii. Pain
iv. Hematemesis

Front 31

e. Where will cancer in the upper 1/3 of the esophagus spread?

Back 31

i. Cervical nodes

Front 32

f. Where will cancer in the middle 1/3 of the esophagus spread?

Back 32

i. Mediastinal or tracheobronchial nodes

Front 33

g. Where will cancer in the lower 1/3 of the esophagus spread?

Back 33

i. Celiac and gastric nodes