Lec 03: Gross and Histopathologic Features of GIT Disorders: Esophagus

Question 1

(T/F) The esophagus can store and digest food.

Answer 1

F

Question 2

Term for vomiting of blood

Answer 2

hematemesis

Question 3

Which increases LES Tone?

a. gastrin
b. nitric oxide
c. vasoactive intestinal polypeptides
d. NOTA

Answer 3

a. gastrin

Question 4

(T/F) Achalasia = Obstruction

Answer 4

F. Obstruction is a consequence of Achalasia wherein the esophagus is constantly constricted.

Question 5

(T/F) Most GIT pathologies mainly involve dilatation.

Answer 5

F. Most GIT pathologies involve constriction.

Question 6

Which of the following results in Achalasia?

a. Failure of relaxation of the lower esophagus
b. Increased basal tone of the LES
c. Aperistalsis
d. AOTA

Answer 6

d. AOTA

Together, the three choices is called the Triad of Achalasia

Question 7

PRIMARY or SECONDARY Achalasia?

most common

Answer 7

PRIMARY

Question 8

PRIMARY or SECONDARY Achalasia?

inherent

Answer 8

PRIMARY

Question 9

PRIMARY or SECONDARY Achalasia?

Chagas’ disease

Answer 9

SECONDARY

Question 10

PRIMARY or SECONDARY Achalasia?

Caused by degenerative changes in neural innervation

Answer 10

PRIMARY

Question 11

The characteristic sign seen in imaging Achalasia.

Answer 11

bird-beak sign

Question 12

An organism that destroys the myenteric plexus leading to failure of peristalsis and esophageal dilatation

Answer 12

Trypanosoma cruzi

Question 13

All of the following are Achalasia-like diseases, except:

a. sarcoidosis
b. diabetic autonomic neuropathy
c. polio
d. NOTA

Answer 13

d. NOTA
Other Achalasia-like diseases include:
- Infiltrative disorders such as malignancy and amyloidosis
- Lesions of dorsal motor nuclei such as polio and surgical ablation

Question 14

All of the following are Achalasia-like diseases, except:

a. sarcoidosis
b. diabetic autonomic neuropathy
c. polio
d. NOTA

Answer 14

d. NOTA
Other Achalasia-like diseases include:
- Infiltrative disorders such as malignancy and amyloidosis
- Lesions of dorsal motor nuclei such as polio and surgical ablation

Question 15

Longitudinal tears of the mucosa in the lower esophagus.

Answer 15

Mallory-Weiss Tear

Question 16

Distal esophageal rupture and mediastinitis

Answer 16

Boerhave Syndrome

Question 17

(T/F) Ingested acid is more destructive than alkali

Answer 17

F. Alkali is more destructive since it liquefies protein

Question 18

Histologic appearance of Reflux Esophagitis, except:

a. Edema
b. PMNL infiltration
c. Prominent rete pegs
d. Basal zone hyperplasia
e. NOTA
f. AOTA

Answer 18

f. AOTA
There is reactive atypia in the cells. Cells in the basal area are active. Normally, the cells get smaller as you go up the layer. However with reflux, the upper cells remain prominent in
appearance. It is difficult to differentiate between this and neoplastic atypia.

Question 19

The presence of goblet cells in the esophageal mucosa is diagnostic of:

Answer 19

Barrett’s Esophagus
- intestinal metaplasia of a normally squamous esophageal mucosa due to GERD, Alcohol abuse, tobacco smoking, obesity, idiopathic, etc.

Question 20

Single most common risk factior for esophageal adenocarcinoma

Answer 20

Barrett’s esophagus

Question 21

(T/F) Barrett’s esophagus is irreversible.

Answer 21

T. Treatment therefore centers on prevention of progression to cancer.

Question 22

For every 10cm of Barrett’s esophagus, how many biopsy samples must be taken?

Answer 22

4 biopsy samples repeated every 6 months to 1 year.

Question 23

For every 10cm of Barrett’s esophagus, how many biopsy samples must be taken?

Answer 23

4 biopsy samples repeated every 6 months to 1 year.

Question 24

Segment of the esophagus most often affected by Barrett’s esophagus

Answer 24

distal third.

Question 25

A sequelae of inflammation: Fibrosis or artificial narrowing of lumen in esophagus that hinders the movement of food previously swallowed.

Answer 25

Strictures.

Question 26

The basal zone is usually how many percent of the wall thickness of the esophagus?

Answer 26

25-30%

Question 27

Which of the following is used for the treatment of Barrett's esophagus? a. surgery b. proton pump inhibitors c. H2 receptor antagonists. d. AOTA

Answer 27

d. AOTA

Question 28

(T/F) A bigger lesion means a higher staged cancer.

Answer 28

F. GI cancers are staged based on depth of invasion and not size.

Question 29

Congestion of subepithelial and submucosal venous plexus in the esophagus.

Answer 29

Esophageal varices

Question 30

Three common areas of portal/caval anastomoses:

Answer 30

HUE Hemorrhoidal, Umbilical, Esophageal

Question 31

Most common cause of hepatic failure in the Philippines:

Answer 31

Schistosomiasis

Question 32

(T/F) Esophageal varices can be related to Portal hypertension.

Answer 32

T. Esophageal varices are 100% related to portal hypertension.

Question 33

Most feared consequence of Esophageal varices:

Answer 33

Massive, sudden and fatal varix rupture

Question 34

Appearance of the esophageal surface in Esophageal varices.

Answer 34

cobblestone appearance

Question 35

Most common benign esophageal tumor.

Answer 35

Leiomyoma

Question 36

Most common presentation of esophageal benign tumors.

Answer 36

dysphagia

Question 37

Cure for esophageal benign tumors

Answer 37

Complete excision

Question 38

Most common malignant tumor of the esophagus.

Answer 38

Squamous cell CA (seen more proximally than adenocarcinoma which is seen more distally)

Question 39

Most common malignant tumor of the esophagus.

Answer 39

Squamous cell CA (seen more proximally than adenocarcinoma which is seen more distally)