Gi 1124 Esophageal Disorders

Front 1

Where is the upper esophageal spincter?

Back 1

circopharyngeus muscle

Front 2

Where is the lower esophageal sphincter?

Back 2

level of the diaphragm

Front 3

What maintains LES tone?

Back 3

gastrin, serotonin, histamine

Front 4

What is esophageal agensesis?

Back 4

failure of esophagus to form

Front 5

What is esophageal atresia?

Back 5

segment of the esophagus fails to form

Front 6

What is esophageal stenosis?

Back 6

incomplete atresia with reduced dimaeter due to fibrosis

Front 7

What is esophageal fistula?

Back 7

communication of the lumen to the bronchus or trachea

Front 8

What is the most common cause of esophagitis?

Back 8

acid reflux into the lower esophagus

Front 9

What causes acid reflux?

Back 9

malfunction of LES

Front 10

What are the symptoms of acid reflux?

Back 10

dysphagia, pain, dyspepsia

Front 11

What do you see with prolonged acid reflux?

Back 11

inflammatory cell infiltrate with a lot of eosinophils
can get erosion or ulceration

Front 12

What are the complications of chronic reflux?

Back 12

bleeding stricture, Barrett metaplasia

Front 13

What is eosinophilic esophagitis?

Back 13

vomiting, epigastric pain, solid food dysphagia with food impaction

Front 14

Who commonly gets eosinophilic esophagitis?

Back 14

young males

Front 15

What does the mucosa look like with eosinophilic esophagitis?

Back 15

furrowed/webbed mucosa grossly
hyperplasia of squamous epithelium, infiltration of proximal and distal esophagus by eosinophils and micro abscesses

Front 16

Who gets esophageal infections?

Back 16

people with cancer/immuno-compromise

Front 17

What is the most common cause of fungal esophageal infection?

Back 17

candida albicans

Front 18

What are the common viral esophageal infection causes?

Back 18

Herpes or CMV

Front 19

Who gets fungal esophagus infections?

Back 19

debilitated patients

Front 20

Who gets viral esophageal infections?

Back 20

people with leukemia and lymphoma

Front 21

Who gets a bacterial infection of the esophagus?

Back 21

infection elsewhere, secondary involvement of the esophagus

Front 22

What is intestinal metaplasia?

Back 22

squamous mucosa in distal esophagus is replaced with metaplastic intestinal epithelium

Front 23

What do you do with Barrett Esophagus?

Back 23

regular endoscopic screening and biopsy to monitor for dysplastic changes

Front 24

Where do benign esophageal tumors come from?

Back 24

mesenchyme, arise in the wall

Front 25

What do benign esophageal tumors present with?

Back 25

symptoms of mass lesion

Front 26

How do you cure benign esophageal tumors?

Back 26

local resection

Front 27

What are the two kinds of esophageal carcinoma?

Back 27

squamous cell, adenocarcinoma

Front 28

Who usually gets squamous cell carcinoma of the esophagus?

Back 28

black men

Front 29

What causes squamous cell carcinoma of the esophagus?

Back 29

alcohol, smoking, nitrosamines

Front 30

What do squamous carcinomas of the esophagus look like?

Back 30

grow outwards, flat diffuse wall invading, ulcerated excavated mass that grows deeply and invades adjacent structures

Front 31

What do squamous cell esophageal cancers look like?

Back 31

poorly differentiated, keratin, intercellular bridges

Front 32

What is the prognosis for squamous cell esophageal cancer?

Back 32

poor usually late stage and too late for resection

Front 33

Who gets adenocarcinoma of the esophagus?

Back 33

long-standing Barrett esophagus

Front 34

Where do most esophageal adenocarcinomas arise?

Back 34

lower 1/3 of the esophagus

Front 35

What do most adenocarcinomas look like?

Back 35

intestinal type look like adenocarcinoma of the large bowel

Front 36

What is the survival for adenocarcinoma of the esophagus?

Back 36

poor, less than 30%