GIGU Week 1: Achalasia. GERD, Barrett's, Esophageal Tumors, Gastroenteritis sdog

What is the definition of Achalasia?

Failure of Lower esophageal sphincter to relax (hyperactive)

What is not a cause of Achalasia?

Acid Reflux

3 multiple choice options

What are some symptoms of Achalasia?

- Dysphagia

- Pressure in chest (angina)

- Nocturnal Regurgitation

What are the most notable exam findings for achalasia?

Weight change

What is the best diagnostic testing for Achalasia?

Esophageal manometry

2 multiple choice options

What is the definition of GERD?

Incompetent lower esophageal sphincter (hypoactive)

What are the risk factors for GERD?

- Smoking

- Pregnancy

- Medication

- Abnormal cardio-esophageal junction

- Obesity

Hiatal Hernias

What are the symptoms of GERD?

- Heartburn (pyrosis)

- Regurgitation

- Dysphagia

- Odynophagia (painful swallowing)

- Water brash (excessive saliva)

What are the Exam findings for GERD?

Acid in mouth

What are the diagnostic special tests for GERD?

Upper GI endoscopy

pH Monitor

What is Barrett's esophagus caused from?

Chronic GERD (~20 years)

What is Barrett's Esophagus?

Change in the lining of the lower part of esophagus from stratified to columnar

What percent of chronic GERD suffers will develop Barrett's Esophagus?

5-10%

What are the symptoms of Barrett's esophagus?

Same as GERD

What are some diagnostic tests for Barrett's esophagus?

Upper GI endoscopy and Biopsy

What is the only diagnostic test that can differentiate GERD from Barrett's esophagus?

Biopsy

3 multiple choice options

What are the two major types of esophageal tumors?

- Squamous cell carcinoma

- Adenocarcinoma

Where is Squamous cell carcinoma found in the esophagus?

Upper 2/3

3 multiple choice options

Where is Adenocarcinoma found in the esophagus?

Lower 1/3

3 multiple choice options

Is squamous cell carcinoma or adenocarcinoma strongly related to GERD and Barrett's esophagus?

Adenocarcinoma

1 multiple choice option

What symptom will be in both squamous cell carcinoma and adenocarcinoma?

Dysphagia

What change in vitals would be seen in squamous cell carcinoma and adenocarcinoma?

Weight loss

What are some diagnostic test to preform for tumors of the esophagus?

- Upper GI endoscope

- Biopsy

- Chest CT and X-ray

- Barium swallow

What does stage 1 cancer entail?

Tumor effects 1 layer of tissue

What does stage 2 cancer entail?

Tumor effects more than 1 layer or lymphatic spread

What does stage 3 cancer entail?

Proximal Metastasis

What does stage 4 cancer entail?

Distal Metastasis

What does Gastroenteritis mean?

Inflammation of the lining of the GI tract.

Are viral or bacterial infections more common?

Viral

1 multiple choice option

What is the most common viral infection in young children?

Rotavirus

What is the most common viral infection in adults?

Norovirus

3 multiple choice options

What are some common bacterial infections?

- Campylobactor jejuni, E coli, salmonella, shigella, staphylococcus

Are food endotoxins or exotoxins what produces symptoms for us?

Exotoxins

What type of bacterial are entero-invasive?

campylobacter jejuni, E coli, salmonella, shigella, and staphylococcus

What does enteroinvasive bacteria do?

Damage cells which cause bleeding

How can you differentiate a bacterial infection of the GI system from a viral infection of the GI system?

Bloody diarrhea

What are some examination finding for gastroenteritis?

Dehydration

What are some diagnostic tests for gastroentritis?

CBC (complete blood count)

Lower GI endoscopy