Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key


Play button


Play button




Click to flip

23 Cards in this Set

  • Front
  • Back
What is Achalasia?
- a neuromuscular disorder of the esophagus
- involves impairment of peristalsis and lower esophageal sphincter relaxation
- rarely, patients presenting with this disorder have a malignancy of the gastroesophageal junction
Between what ages does Achalasia normally present?
- between is usually a gradual onset
What are the major signs and symptoms of Ahalasia?
- gradual onset dysphagia of both solids and liquids, also involves regurgitation, at night, causes cough and aspiration
How do you diagnose Achalasia?
- barium swallow studies show classic beak-like lower portion, peristalsis is absent
- endoscopy with biopsy is used to rule out stricture and carcinoma
How do you treat Achalasia?
- pneumatic dilation or botulinum toxin injection often relieves the obstruction, and both can be repeated if neessary
- laparoscopic myotomy (surgical division of the involved muscle) is useful, although this may result in gastroesophageal relux...simultaneous fundoplication is often performed
What is Barrett's esophagus?
- an change in the esophagus from normal stratus epithelium to columnar epithelium which sometimes leads to adenocarcinoma...usually after uncontrolled GERD
What are some symptoms of infants with GERD?
- vomiting, failure to thrive, anemia, or pulmonary symptoms
What are some atypical symptoms associated with GERD?
- sore throat, cough, asthma, and non-cardiac chest pain
How do you diagnose GERD?
- history is suggestive
- endosopy, motility studies, or pH probe can all be used to confirm diagnosis
How do you treat GERD?
- elevate the head of bed, change diet to decrease intake of fat, alcohol, hocolate, caffeine, and late-night snacks
- medical treatment includes antacids, H2-receptor antagonists, or a short-term trial of metoclopramide (Reglan) or a proton pump blocker (omeprazole, lansoprazole)
- surgical procedure, such as Nissen fundoplication, which wraps stomach tissue around the lower esophageal sphincter to tighten it, may help with severe disease
What is the two most common forms of Esophageal cancer, and what are they normally derived from?
- squamous cell carcinoma is the most common and is related to alcohol and tobacco use
- adenocarcinoma is a close second and is related to Barrett's esophagus and chronic GERD
- most patients have metastases to the lymph nodes at the time of presentation, and local extension with invasion of nearby structures is also common
What are some signs and symptoms suggestive of esophageal cancer?
- initial symptom is dysphagia leading to weight loss
- weakness, anemia, pain, regurgitation, and aspiration
- coughing or hoarseness may be present if the laryngeal nerves are involved
How do you diagnose esophageal cancer?
- barium swallow shows a lumen narrowed by an irregular mass...constricting bands are seen with annular lesions
- esophagoscopy with biopsy is necessary for tissue Dx.
- CT may show extension and metastases
How do you Tx. Esophageal Cancer?
- prognosis is poor...and treatment is not very effective
- some combination of surgery, radiation, and chemotherapy
What is a sliding hiatal hernia?
- involves upward displacement of both the gastroesophageal junction and the stomach throught the diaphragm
What is a paraesophageal hiatal hernia?
- results when part of the stomach is pushed through the diaphragm next to a normally located esophagus and gastroesophageal junction
What are some signs and symptoms of a hiatal hernia?
- if the lower esophageal sphincter is displaced upward, it is exposed to lower pressures in the thoracic cavity and may not be able to remain lased...leading to GERD
- many cases are asymptomatic, though
How do you diagnose a hiatal hernia?
- X-rays and barium studies show a portion of the stomach above the diaphragm
How do you treat a hiatal hernia?
- sliding H. H. only treated by controlling refux, if present
- paraesophageal H. H. can incarcerated and strangulate...this can be prevented by surgical reduction
- surgery also indicated for recurrent or intractable symptoms and often involves a Nissen fundoplication
What is erosive gastritis?
- A.K.A."stress gastritis" - involves rapidly developing superfiial lesions which can be caused by NSAID use, alcohol, severe illness, or trauma
What is non-erosive gastritis?
- caused by H. pylori - present in 30-50% of the population and may cause gland atrophy or metaplasia - complete atrophy of the fundal mucosa with loss of parietal cells results in pernicious anemia
What are some signs and symptoms of gastritis?
- mild dyspepsia is the presenting symptom
- stress gastritis in hospitalized patients, blood in the nasogastric aspirate or hematemisis ("coffee grounds" emesis) is often the first sign
- nonerosive gastritis is usually asymp
How do you diagnose gastritis?
- endosopy should be done promptly to rule out bleeding from more serious lesions such as ulcers or esophageal varices
- in erosive gastritis, petechiae and erosions may be seen
- in nonerosive gastritis, the stomach appears normal but biopsy shows inflam. with neutrophils and lymphocytes