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PANCE Prep Pearls: 3rd Ed. (2019)
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Esophageal Disorders

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PANCE Prep Pearls: 3rd Ed. (2019) | Physician Assistant (PA) School Study Aid

Esophageal Disorders
16 Picmonics to Learn | 31 mins
Gastroesophageal Reflux Disease (GERD) Assessment
Pathophysiology
Relaxed Lower Esophageal Sphincter
Signs and Symptoms
Dyspepsia (Indigestion)
Belching
Nighttime Coughing
Dysphagia
Epigastric Pain
Regurgitation
Heartburn (Pyrosis)
Globus
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2 mins
Eosinophilic Esophagitis
Characteristics
History of Atopic Disease
Symptoms
Dysphagia
Diagnosis
Endoscopy with Biopsy
Eosinophilic Infiltrate
Unresponsive to GERD Therapy
Interventions
Elimination Diet
Proton Pump Inhibitors (PPIs)
Topical Glucocorticoids
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2 mins
Types of Hernias
Hiatal
Gastroesophageal Reflux Disease (GERD)
Inguinal
Men
Femoral
Women
Incisional
Umbilical
Consideration
Strangulation
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1 min
Hernia Interventions
Reduce Intra Abdominal Pressure
Avoid Straining and Lifting
Open Mouth Sneezing
Excision
Herniorrhaphy
Hernioplasty
Consideration
Scrotal Support
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1 min
Barrett's Esophagus
Histological findings
Metaplasia in Lower Esophagus
Columnar Epithelium
Associated Pathologies
Gastroesophageal Reflux Disease (GERD)
Esophagitis
Esophageal Ulcers
Increased Risk of Esophageal Adenocarcinoma
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1 min
Esophageal Squamous Cell Carcinoma Risk Factors and Presentation
Characteristics
Most Common Esophageal Cancer Worldwide
Upper 2/3 of Esophagus
RISK FACTORS
Plummer-Vinson Syndrome
Alcohol
Smoking
Poor Diet
Achalasia
Clinical Features
Progressive Dysphagia
Weight Loss
Anemia
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1 min
Esophageal Squamous Cell Carcinoma Diagnosis and Management
Diagnosis
Endoscopy with Biopsy
Barium Swallow
"Apple Core" Appearance
Ultrasound
CT Scan
Management
Chemotherapy and Radiation
Surgery
Considerations
Esophageal Stenosis
Tracheoesophageal Fistula (TEF)
Poor Prognosis
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2 mins
Esophageal Adenocarcinoma Characteristics and Presentation
Characteristics
Most Common Esophageal Cancer in USA
Lower 1/3 of Esophagus
Risk Factors
Gastroesophageal Reflux Disease (GERD)
Barrett's Esophagus
Achalasia
Obesity
Smoking
Presentation
Weight Loss
Progressive Dysphagia
Anemia
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2 mins
Achalasia
Pathophysiology
Failure to Relax Lower Esophageal Sphincter
Malignancies
Chagas Disease
Loss of Auerbach Plexus
Symptoms
Dysphagia to Solids & Liquids
Diagnosis
Barium Swallow
Bird's Beak Appearance
Manometry
Risk Factors
Increased Risk Squamous Cell Carcinoma
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2 mins
Zenker Diverticulum
Pathophysiology
False Diverticulum
Junction of Pharynx and Esophagus
Inferior Pharyngeal Constrictor
Symptoms
Dysphagia
Regurgitation of Undigested Food
Halitosis
Diagnosis
Barium Swallow
Treatment
Surgical Repair
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2 mins
Diffuse Esophageal Spasm
Characteristics
Spontaneous and Uncoordinated Muscle Spasms
Clinical Features
Dysphagia
Chest Pain
Diagnosis
Manometry
Corkscrew Appearance on Barium Swallow
Management
Avoid Triggers
Calcium Channel Blockers
Nitrates
Surgery
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3 mins
Boerhaave Syndrome
Pathophysiology
Esophageal Rupture
Increased Esophageal Pressure while Vomiting
Lower 1/3 of Esophagus
Signs and Symptoms
Chest Pain
Odynophagia
Subcutaneous Emphysema
Management
Shock
Surgical Emergency
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2 mins
Mallory-Weiss
Characteristics
Bleeding From Tears in Mucosa
Forceful Vomiting
Alcoholism
Eating Disorders (Bulimia)
Painful Hematemesis
Diagnosis
Endoscopy
Management
Observation
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2 mins
Plummer-Vinson Syndrome
Triad of Symptoms
Dysphagia
Esophageal Webs
Glossitis
Iron Deficiency Anemia
Association
Squamous Cell Cancer of Esophagus
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1 min
Esophageal Stricture
Risk Factors
Caustic Ingestion
Gastroesophageal Reflux Disease
Esophagitis
Schatzki Rings
Clinical Features
Dysphagia
Weight Loss
Diagnosis
Barium Swallow
Endoscopy
Management
Esophageal Dilation
Proton Pump Inhibitors
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3 mins
Esophageal Varices
Pathophysiology
Cirrhosis
Portal Hypertension
Left Gastric Vein and Esophageal Veins
Clinical Features
Hematemesis
Melena
Hypotension
Acute Management
IV Fluids
Antibiotics
Octreotide
Endoscopic Band Ligation or Sclerotherapy
Balloon Tamponade
Prophylaxis
Nonselective Beta Blockers
Transjugular Intrahepatic Portosystemic Shunt (TIPS)
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3 mins

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