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

65 Cards in this Set

  • Front
  • Back
  • 3rd side (hint)
The esophagus conveys food from the mouth to the stomach by a 3 stage mechanical process. What are those 3 stages?
• Oral stage
• Pharyngeal stage
• Esophageal stage
Describe the muscles of the esophagus, from proximal to distal
• the upper third consists of striated muscle
• the lower two-thirds consists of smooth muscle
What is the purpose of manometric studies?
• can measure muscle pressure within the esophagus
• can measure pH within the esophagus
What muscle makes up the upper esophageal sphincter?
cricopharyngeal muscle
What is a Z line?
the esophageal-gastric junction, which shows the transition from squamous cells to columnar cells
What is Globus Hystericus?
the feeling of a lump in the throat
Dysphagia caused by phase 1 (oral stage) of swallowing is usually caused by what?
neuromuscular disorder
Dysphagia caused by stage 2 (pharyngeal stage) is usually caused by what?
spasm or carcinoma
Dysphagia caused by stage 3 (esophageal stage) usually is caused by what?
narrowing by esophagitis or diverticulum
List causes of dysphagia
• Achalasia (Phase 3 type)
• ALS (Lou Gerig's Disease)
• Esophageal cancer (Phase 2 or 3)
• Esophageal Diverticulum (Phase 3)
• Esophagitis (Phase 3)
• Esophageal spasm (Phase 2)
• Foreign Body (Phase 2 or 3)
• Gastric Ca (Phase 3)
• Myasthenia Gravis (Phase 1)
• Plummer-vinson syndrome (Phase 3)
What are different diagnostic studies that can be done to evaluate dysphagia?
• Chest Xray (could show widening of the mediastinum w/ an air fluid level)
• Barium swallow (1st specific diagnostic study)
• Endoscopy
• Manometry
What is a Zenker's Diverticulum?
• an esophageal diverticulum
• causees obstruction of the lumen
• above the upper esophageal sphincter
What is the most common type of esophageal cancer?
• Squamous cell carcinoma (95%)
• Adenocarcinoma (5%)
What are symptoms of esophageal cancer?
• Asymptomatic or esophagitis symptoms
• Back pain (means mediastinal spread)
• GI bleeding
• Iron-deficiency anemia
• Odynophagia
• progressive solid food dysphagia (can swallow fluids, but not solid foods)
• Upper lesions cause hoarseness (by affecting the recurrent laryngeal nerve)
• Weight loss
What are predisposing factors for squamous cell carcinoma of the esophagus?
• smoking & alcohol consumption
• achalsia
• Plummer-Vinson syndrome
What is Barret's Esophagus?
• columnar metaplasia of the esophagus
What are characteristics of Barret's Esophagus?
• a common occurrence of chronic esophageal reflux
• Z line has an abnormal contour
• up to 15% of Barrett's converts to adenocarcinoma
What is the TNM classifcation?
• T: Primary Tumor
• N: Nodes
• M: Metastatic
Describe the sub-classification of T (tumor) in the TNM classification
• T1: mucosa
• T2: invasion of submucosa
• T3: adventitia
• T4: adjacent tissue
Describe the sub-classification of N (nodes) of the TNM classification
• N0: no nodes
• N1: regional lymph nodes
Describe the sub-classification of M (metastasis) of the TNM classification
• M0: no metastasis
• M1: distant spread
What are the different stages of cancer based on TNM classification?
• Stage I: T1, N0, M0
• Stage II: T2, N1, M0
• Stage III: T3, N1, M0
• Stage IV: any T or N, M1
What are causes of achalasia?
• loss of ganglion cells » lack of peristalsis in distal 2/3 of the esophagus with absent relaxation of LES
What are symptoms of achalsia?
dysphagia to solids & liquids
What is the treatment for achalsia?
• balloon dilation
• botox
• myotomy (surgical removal of muscle)
What are characteristics of esophageal spasms?
• a disorder of motility characterized by episodic chest pain & dysphagia
• occurs w/out warning; provoked by swallowing of cold or hot liquids
• associated with reflux in 50% of cases
What is a nutcracker esophagus?
a severe muscle spasm with marked amplitude and normal LES tone
What is the treatment of esophageal spasm?
• Nitrates
• Calcium channel blockers
What is Plummer-Vinson Syndrome?
• an esophageal web + iron-deficiency anemia + in women
• also can have glossitis (beefy red tongue), angular chelitis (inflamed lips), & koilonychia (spoon-shaped nails
What is a Schatzki ring?
a symmetrical, submucosal fibrous thickening occuring at the LES junction
What is the most common of all esophageal symptoms?
heartburn (pyrosis)
What is water brash?
an increase in clear, non-regurgitated oral salivary secretions in the mouth from the vagal reflex
What is the definition of GERD?
any symptomatic clinical condition or histologic alteration of esophageal mucosa that results from acid gastroesophageal reflux
What are causes of GERD?
• incompetant LES sphincter (most common)
• hiatal hernias
• delays in gastric emptying time (diabetes, duodenal ulcers, gastritis, hypothyroidism)
What are aggravating factors for GERD?
• bending over or lying down
• caffeine & chocolate
• emotions
• ETOH intake
• high fat & spicy food
• nocturnal eating
• obesity medications
• smoking
What increases the tone of the LES?
• cholinergics
• gastrin
What decreases the tone of the LES (dilates the LES)?
• alcohol
• caffeine
• cholecystokinin
• diazepam
• morphine
• secretin
• smoking
What are typical and atypical symptoms of GERD?
• Typical: heartburn, regurgitation, water brash
• Atypical: chest pain, cough, laryngitis
What are compliations of GERD?
• Barrett's esophagus
• Esophageal strictures
• Esophageal peptic ulcers
• Hiatal hernia
• Pulmonary aspiration pneumonia
• UGI bleed/Esophageal Perforation/Mallory-Weiss tear
What is a Mallory-Weiss tear?
• tear in the mucosa of the esophagus due to repeated strenuous retching or vomiting
• may occur as a result of excessive alcohol ingestion
What is Boerhaave's Syndrome?
• a complete, transmural (rupture) of the lower part of the esophagus
• exit of gastric contents and air into the mediastinum
• most severe form of Mallory-Weiss Syndrome
What are causes of esophagitis?
• ingestion of acid or alkali (alkali ingestion is usually worse)
• infection (found mostly in diabetics, HIV, immunocompromised, malignancies)
• post radiation
• swallowing medications
What is the treatment of a fungal esophagitis?
• Nystatin
• Clotrimazole, Ketoconazole, Micronazole, Imidazole
• Amphotericin B
What is the treatment of an infectious esophagitis caused by herpes simplex virus (HSV)?
• Gangcyclovir or Acyclovir
• Oral viscous lidocaine (for pain)
What is Iatrogenic Esophagitis?
• aka pill esophagitis
• caused by improper ingestion of pills (causes odynophagia & dysphagia)
What are causes of constipation?
• Atonic (from excessive laxative use)
• Dietary
• Dyskinesia
• Dyshygenic
• Iatrogenic
• Obstruction
• Post-diarrheal
• Post smoking
What are causes of constipation caused by the rectum or colon?
• Left colon obstruction (1. Neoplasm, 2. Volvulus, 3. Diverticular Disease)
• slow colonic motility (esp. in patients w/ excessive laxative abuse)
• Hirschprung's disease
• Chagas disease
• Outlet obstruction
What are causes of constipation that originate outside of the colon?
• poor dietary habit (most common)
• medications
• systemic endocrine (MC = hypothyroidism) & neurologic disease
• psychologic factors
• diet (inadequate water or fiber intake, overuse of alcohol, coffee, or tea)
What are some medications that may contribute to constipation?
• Anticholinergic drugs
• Calcium channel blockers
• Excessive laxative use
• Inadequate thyroid supplementation
• Iron supplements
• Many psychotropic drugs
• Narcotics (Tylenol w/ codeine)
• Nonmagnesium antacids
What are neurologic causes of constipation?
• diabetic autonomic neuropathy
• head injury
• multiple sclerosis
• Parkinson's disease
• spinal cord injury
When should you use Gastrografin over a barium study?
use Gastrografin (a type radiocontrast agent) with an acute abdomen because this prevents the risk of extravasation of barium into the periotoneal cavity
What is obstipation?
• severe constipation resulting from an obstruction in the intestines
• so severe that the patient does not pass gas
What are the top 3 most common neoplasms of the GI tract?
1. Colon
2. Pancreas
3. Stomach
What are characteristics of oral cancer?
• currently the most rapidly increasing cancer
• 95% squamous cell; 3% adenocarcinoma, 1% melanoma
• 50% associated with HPV infection
What type of cancer is overwhemingly dominant in stomach cancer?
• adenocarcinoma (90%)
• squamous cell is very rare
What is a Virchow node?
• solitary enlarged left-sided supraclavicular lymph node
• seen in gastric carcinoma
What is the most common hepatic malignancy?
Hepatocellular carcinoma
What are significant lab in patients with hepatocellular carcinoma?
• increase LFT
• depressed coagulation (elevated PT)
• increased alpha-fetoprotein (AFP)
What are characteristics of carcinoma of the gallbladder?
• adenocarcinoma most common (70%)
• female > male 4:1
• symptoms may resemble cholecystitis or duct obstruction
• unremitting RUQ pain with massive weight loss
What are characteristics of Choangiocarcinoma?
• adenocarcinoma (most common)
• increased incidence w/ primary sclerosing cholangitis
• unremitting painless jaundince
• diagnosed by ERCP
What is the most common type of pancreatic carcinoma?
• ductal carcinoma (most common ~ 90%)
• most are adenocarcinoma of ampulla area
How does pancreatic carcinoma presention differ if it is located in the head or in the tail?
• head: painless, non-pruritic, & jaundice
• tail: painful
What are classic findings of pancreatic carcinoma?
• none in early stages
• jaundice & icterus if common duct is obstructed
• Courvoisier's sign (palpable gallbladder)
• ascites & peripheral edema
• Trousseau's sign (superficial thrombophlebitis)
What is the most common type of carcinoma of the ampulla of Vater?
papillary adenocarcinoma
What can be a complication of ERCP?