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36 Cards in this Set
- Front
- Back
Where is the upper esophageal spincter?
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circopharyngeus muscle
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Where is the lower esophageal sphincter?
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level of the diaphragm
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What maintains LES tone?
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gastrin, serotonin, histamine
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What is esophageal agensesis?
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failure of esophagus to form
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What is esophageal atresia?
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segment of the esophagus fails to form
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What is esophageal stenosis?
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incomplete atresia with reduced dimaeter due to fibrosis
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What is esophageal fistula?
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communication of the lumen to the bronchus or trachea
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What is the most common cause of esophagitis?
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acid reflux into the lower esophagus
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What causes acid reflux?
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malfunction of LES
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What are the symptoms of acid reflux?
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dysphagia, pain, dyspepsia
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What do you see with prolonged acid reflux?
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inflammatory cell infiltrate with a lot of eosinophils
can get erosion or ulceration |
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What are the complications of chronic reflux?
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bleeding stricture, Barrett metaplasia
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What is eosinophilic esophagitis?
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vomiting, epigastric pain, solid food dysphagia with food impaction
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Who commonly gets eosinophilic esophagitis?
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young males
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What does the mucosa look like with eosinophilic esophagitis?
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furrowed/webbed mucosa grossly
hyperplasia of squamous epithelium, infiltration of proximal and distal esophagus by eosinophils and micro abscesses |
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Who gets esophageal infections?
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people with cancer/immuno-compromise
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What is the most common cause of fungal esophageal infection?
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candida albicans
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What are the common viral esophageal infection causes?
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Herpes or CMV
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Who gets fungal esophagus infections?
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debilitated patients
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Who gets viral esophageal infections?
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people with leukemia and lymphoma
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Who gets a bacterial infection of the esophagus?
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infection elsewhere, secondary involvement of the esophagus
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What is intestinal metaplasia?
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squamous mucosa in distal esophagus is replaced with metaplastic intestinal epithelium
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What do you do with Barrett Esophagus?
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regular endoscopic screening and biopsy to monitor for dysplastic changes
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Where do benign esophageal tumors come from?
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mesenchyme, arise in the wall
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What do benign esophageal tumors present with?
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symptoms of mass lesion
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How do you cure benign esophageal tumors?
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local resection
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What are the two kinds of esophageal carcinoma?
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squamous cell, adenocarcinoma
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Who usually gets squamous cell carcinoma of the esophagus?
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black men
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What causes squamous cell carcinoma of the esophagus?
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alcohol, smoking, nitrosamines
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What do squamous carcinomas of the esophagus look like?
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grow outwards, flat diffuse wall invading, ulcerated excavated mass that grows deeply and invades adjacent structures
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What do squamous cell esophageal cancers look like?
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poorly differentiated, keratin, intercellular bridges
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What is the prognosis for squamous cell esophageal cancer?
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poor usually late stage and too late for resection
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Who gets adenocarcinoma of the esophagus?
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long-standing Barrett esophagus
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Where do most esophageal adenocarcinomas arise?
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lower 1/3 of the esophagus
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What do most adenocarcinomas look like?
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intestinal type look like adenocarcinoma of the large bowel
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What is the survival for adenocarcinoma of the esophagus?
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poor, less than 30%
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