Oesophageal Disease Flashcards Preview

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Flashcards in Oesophageal Disease Deck (25)
1

Acute oesophagitis is more common than chronic oesophagitis. True/False?

False

2

What are some causes of acute oesophagitis?

Chemical abuse -> corrosion
Infection (herpes, candidiasis)

3

What is the main cause of chronic oesophagitis?

Reflux disease [reflux oesophagitis]

4

Define "reflux oesophagitis" (GORD)

Inflammation of the oesophagus due to reflux of acid from the stomach

5

What are the 3 main causes of GORD?

Incompetent LOS
Poor oesophageal motility/clearance
Impaired mucosal barrier

6

What is the dominant immune cell that accompanies acid abuse?

Eosinophils

7

Name 3 complications of reflux oesophagitis

Ulceration/bleeding
Stricture formation due to scarring
Barrett's Oesophagus

8

Define "Barrett's Oesophagus"

Replacement of stratified squamous epithelium -> columnar epithelium [metaplastic change]

9

How is Barrett's Oesophagus pre-malignant?

Mucosa becomes unstable, and persistent acid insult increases risk of developing dysplasia and carcinoma

10

What is allergic oesophagitis?

Immune-mediated oesophagitis caused by reaction to food
Eosinophilic infiltrates present

11

Benign oesophageal tumours are rarer than malignant tumours. True/False?

True

12

What is the most common benign oesophageal tumour?

Squamous papilloma

13

What are the two main types of malignant oesophageal tumour?

Squamous cell carcinoma
Adenocarcinoma

14

Squamous cell carcinoma of oesophagus is commoner in males. True/False?

True

15

Where is adenocarcinoma of the oesophagus most likely to develop? Why?

Lower 1/3 of oesophagus
Reflux insult is greatest here

16

What are the 3 main mechanisms of metastasis of oesophageal tumours?

Direct invasion
Lymphatic spread
Haematogenous spread

17

Give examples of symptoms of GORD

Heartburn
Waterbrash (hyper-salivation)
Dysphagia, odynophagia
Reflux
Chest pain

18

What are the main investigations for GORD?

Endoscopy
Barium swallow
Manometry (pressure) studies
Nuclear imaging

19

Name the ALARM Symptoms

Anaemia
Loss of weight
Anorexia
Recent progressive symptoms
Malaena or haematemesis
Swallowing difficulty

20

Antacids provide symptomatic relief and heal oesophagitis in GORD. True/False?

False
Provide symptom relief but no healing or preventative qualities

21

H2 receptor antagonists mainly provide symptomatic relief of GORD; give an example of one

Ranitidine

22

Proton pump inhibitors provide symptomatic relief and heal oesophagitis. True/False?

True

23

When is surgery indicated for GORD?

To repair LOS
When PPIs ineffective (cheaper doing surgery than being on PPI for 7+ years)

24

Which investigations are indicated for diagnosing oesophageal cancer?

Endoscopy
Barium meal
CT scan

25

Name some contraindications to surgery for treating oesophageal cancer

Invasion of adjacent structures
Widespread metastasis
Poor health/lack of fitness