GI & Liver Week 1

eem8u's version from 2017-01-10 03:39


Question Answer
distance form incisors to LES40 cm
2 phases of swallowingoral and pharyngeal (see 1.6)
basal pressure (tonic P) of UES vs LES vs esophageal body 70 mmHg >> 30 mmHg (body is 0 or negative)
gold test for GERD diagnosis24 hr pH monitor
2 tests that demonstrate potential for reflexLES pressure, barium swallow
study dysphagia algorithm1.34
achalasia - pathogenesisloss of myenteric plexus >> 1) LES tonic contraction 2) No peristalsis
achalasia - common sx (3)dyspahgia, regurgitaiton of esoph. contents, weight loss (**NO HEARTBURN**)
achalasia - treatmetn (3)botulinum (relaxation), pneumatic dilation of LES, heller myotomy (relax by cutting muslce)
chagas can causeachalasia (trypanosoma cruzii)
sclerodoma - pathogenesisCT disroder > smooth muscle replaced w/ fibrosis > 1) loss of LES / 2) poor peristalsis
LESp in scerlodomaLOW > causes reflux of gastric contents
diffuse Eso spasm - 2 primary sxchest pain (mimics angina petori) and odynophagia
diffuse Eso spasm - pathogenesissimultaneous contraction
LESp in diffuse Eso spasmnormal
diffuse Eso spasm - Tx (3)muscle relax, Ca+ chanel block, nitrates
nutcracker Eso - pathogenesisnormal paristalsis, but Very high amplitude contractions (>180 mmHg)

Esophagus - Pathology

Question Answer
pathogenesis - alkali esophagitiscell necrosis > saponification (fats break down) > esophagus rutpure > chemcial in mediastinum > quick death
CHEMICAL ESOPHAGITIS - assc w/ what cancersquamous c
candida esophagitis - primary sxodynophagia
CMV infects what cellmesenchymal (not squamous) >> will only be Id'ed on biopsy w/ ulcer
herpes infects what cellsquamous (such as lips)
2 primary sx of eosinophilic esoph.dysphagia, food impaction
pathophys of eosinophilic esoph.unknown, antigen derived?
GERD - primary sx"heartburn"
EoE - tx (3)diet change, PPI, steroid
GERD - (2)PPI, h2 agonists
barrett e. is risk factor for ___ canceradenocarcinoma (metaplasia to columnar) > dysplasia
squamous c carcinoma - 3 risk factorsM > F sex, drinking & smoking, age >50
sqamous vs adenocarcinoma - geogrpahic prevalencesquamous more in "developing countries"
which cancer can cause hoarsenesssquamous c > hits recurrent laryngeal