Salivary Gland Tumors and Esophageal Disorders
48 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to Lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the most common benign salivary gland tumor?

  • Mucoepidermoid carcinoma
  • Pleomorphic adenoma (correct)
  • Adenoid cystic carcinoma
  • Warthin tumor

Which condition is associated with painful swallowing in immunocompromised patients until proven otherwise?

  • Candidal esophagitis (correct)
  • Reflux esophagitis
  • Esophageal carcinoma
  • Gastroesophageal reflux disease

What is a primary characteristic of systemic sclerosis?

  • Increased LES sphincter tone
  • High peristaltic activity
  • Acute inflammatory response
  • Esophageal dysmotility (correct)

What defines a sliding hiatal hernia?

<p>95% of all hiatal hernias (A), Abnormal relation of the cardia to the diaphragm (B)</p> Signup and view all the answers

What contrast agent is typically used in suspected esophageal perforation?

<p>Gastrografin (D)</p> Signup and view all the answers

What is the most common malignant salivary gland tumor?

<p>Mucoepidermoid carcinoma (A)</p> Signup and view all the answers

What is the characteristic feature of Warthin tumor?

<p>Resembles lymphatic tissue (B)</p> Signup and view all the answers

Which condition is least likely to cause high-volume hematemesis?

<p>Mallory-Weiss tear (D)</p> Signup and view all the answers

What can cause esophageal perforation?

<p>Recent endoscopy (D)</p> Signup and view all the answers

What is the best diagnostic tool for hiatal hernia?

<p>Upper endoscopy (A)</p> Signup and view all the answers

Which scenario describes a paraesophageal hiatal hernia?

<p>Fundus protrudes above the level of T10 (D)</p> Signup and view all the answers

Which of the following is primarily associated with systemic sclerosis?

<p>Multi-organ fibrosis (C)</p> Signup and view all the answers

What is a potential risk of using inhaled corticosteroids in asthma patients?

<p>Oral thrush (D)</p> Signup and view all the answers

What causes a Mallory-Weiss tear?

<p>Excessive alcohol consumption (C)</p> Signup and view all the answers

Which symptom is indicative of esophageal dysmotility in CREST syndrome?

<p>Difficulty swallowing (C)</p> Signup and view all the answers

In cases where a patient has aspiration risk, which contrast is preferred?

<p>Barium (A)</p> Signup and view all the answers

Which condition is characterized by dysphagia to both solids and liquids from the onset?

<p>Achalasia (D)</p> Signup and view all the answers

What is the typical presenting demographic for Zenker diverticulum?

<p>Overweight males aged 40-50 (B)</p> Signup and view all the answers

Which of the following mechanisms is NOT associated with Zenker diverticulum?

<p>Increased esophageal motility (A)</p> Signup and view all the answers

What is the first step in diagnosing achalasia?

<p>Barium swallow (B)</p> Signup and view all the answers

What type of diverticulum is Zenker diverticulum classified as?

<p>False diverticulum containing only mucosa and submucosa (D)</p> Signup and view all the answers

What type of gastritis is associated with pernicious anemia and affects the fundus/body of the stomach?

<p>Type A gastritis (D)</p> Signup and view all the answers

What effect do NSAIDs have on prostaglandin production and the gastric lining?

<p>Decrease prostaglandin production, leading to gastric lining disruption (A)</p> Signup and view all the answers

What is the confirmatory test for achalasia after a barium swallow?

<p>Esophageal manometry (B)</p> Signup and view all the answers

Which histological feature is characteristic of gastric cancer?

<p>Signet-ring cells containing mucin (B)</p> Signup and view all the answers

Which treatment method involves balloon dilation for achalasia?

<p>Pneumatic dilation (C)</p> Signup and view all the answers

In achalasia, what type of lesions can be a rare cause of the condition?

<p>Chagas disease (C)</p> Signup and view all the answers

What gross appearance is associated with advanced gastric cancer?

<p>Linitis plastica resembling a leather bottle (A)</p> Signup and view all the answers

Which condition is most commonly linked to the presence of signet-ring cells in bilateral ovarian lesions?

<p>Gastric cancer metastases (D)</p> Signup and view all the answers

What is the significance of the Virchow node in relation to gastric cancer?

<p>It can indicate visceral malignancy, especially gastric cancer (C)</p> Signup and view all the answers

What role do nitrosamines play in gastric cancer incidence in certain populations?

<p>They are associated with an increased incidence of gastric cancer (D)</p> Signup and view all the answers

What distinguishes MALT lymphoma from gastric cancer histologically?

<p>MALT lymphoma contains B cells and lacks signet-ring cells (B)</p> Signup and view all the answers

What is the first imaging study recommended for the diagnosis of choledocholithiasis?

<p>Ultrasound (D)</p> Signup and view all the answers

What complication arises when a gallstone obstructs the hepatopancreatic ampulla?

<p>Gallstone pancreatitis (C)</p> Signup and view all the answers

In a patient with obstructive jaundice, which of the following presentations would most likely indicate pancreatic cancer?

<p>Heavy smoking and negative CT scan (D)</p> Signup and view all the answers

Which lab values would you expect to see elevated in gallstone pancreatitis?

<p>High ALP, high direct bilirubin, and high lipase (D)</p> Signup and view all the answers

In the presence of obstructive jaundice, which option is the most definitive test to visualize the biliary tract?

<p>ERCP (B)</p> Signup and view all the answers

Why is it important to differentiate cholangiocarcinoma from pancreatic cancer?

<p>Each condition has a different prognosis (A)</p> Signup and view all the answers

What does intra-operative cholangiography assess during a cholecystectomy?

<p>Bile duct patency (A)</p> Signup and view all the answers

What is the primary diagnosis method for spontaneous bacterial peritonitis (SBP)?

<p>Abdominal paracentesis (A)</p> Signup and view all the answers

When faced with a case presenting obstructive jaundice and previous gallbladder removal, which is a critical consideration?

<p>Possible choledocholithiasis due to retained stones (C)</p> Signup and view all the answers

In the case of SBP, what laboratory test should be performed first after paracentesis?

<p>White cell count and differential (D)</p> Signup and view all the answers

Which symptom is NOT typically linked to spontaneous bacterial peritonitis?

<p>Jaundice (A)</p> Signup and view all the answers

What is the minimum white blood cell count indicating a diagnosis of SBP?

<blockquote> <p>250 WBCs/µL (C)</p> </blockquote> Signup and view all the answers

Which of the following is often confused with paracentesis?

<p>Pericardiocentesis (B)</p> Signup and view all the answers

A patient with cirrhosis presents with ascites but without fever or abdominal pain. Which of the following is the most relevant next step in evaluation?

<p>Immediate paracentesis (D)</p> Signup and view all the answers

What complication is primarily associated with the presence of major risk factors for ascites in cirrhosis patients?

<p>Spontaneous bacterial peritonitis (D)</p> Signup and view all the answers

What is the correct sequence of the next steps following abdominal paracentesis in SBP diagnosis?

<p>White cell count, then gram stain and culture (B)</p> Signup and view all the answers

Flashcards

Oral candidiasis (Thrush)

A fungal infection that can occur in patients using inhaled corticosteroids for asthma.

Odynophagia

Painful swallowing, often a sign of a Candida infection in the esophagus.

Pleomorphic Adenoma

The most common benign tumor of the salivary glands, characterized by cells with varying sizes and shapes.

Mucoepidermoid Carcinoma

The most common malignant tumor of the salivary glands.

Signup and view all the flashcards

Warthin Tumor

A salivary gland tumor that resembles lymphatic tissue.

Signup and view all the flashcards

Hiatal Hernia

A condition where the stomach protrudes upwards through the diaphragm.

Signup and view all the flashcards

Sliding Hiatal Hernia

A condition where the cardia of the stomach rises upwards through the esophageal hiatus, the most common type of hiatal hernia.

Signup and view all the flashcards

Paraesophageal Hiatal Hernia

A condition where the fundus of the stomach herniates upwards through a hole in the diaphragm adjacent to the esophagus, a less common type of hiatal hernia.

Signup and view all the flashcards

Zenker Diverticulum

A pouch-like protrusion in the wall of the esophagus, most commonly found in the upper esophagus near the cricopharyngeal muscle.

Signup and view all the flashcards

What is a Zenker Diverticulum?

A false diverticulum, formed by an outpouching of the esophageal mucosa and submucosa through a weak spot in the muscular wall, typically at the junction of the pharynx and esophagus.

Signup and view all the flashcards

What is Achalasia?

A disorder characterized by the inability of the lower esophageal sphincter (LES) to relax properly, leading to difficulty swallowing and food buildup in the esophagus.

Signup and view all the flashcards

What is the Mechanism of Achalasia?

Achalasia is a disorder of the LES caused by a loss of nerve cells in the Auerbach plexus (myenteric plexus) controlling LES relaxation. This leads to an inability of the LES to relax during swallowing, resulting in food buildup in the esophagus.

Signup and view all the flashcards

What is Dysphagia in Achalasia?

Difficulty swallowing, often a symptom of Achalasia, and typically presents as dysphagia to both solids and liquids from the onset.

Signup and view all the flashcards

What is the 'Bird's Beak' Appearance in Achalasia?

A hallmark finding on barium swallow examination in Achalasia, demonstrating a narrowing of the esophagus near the gastroesophageal junction, resembling a bird's beak.

Signup and view all the flashcards

What is Pneumatic (Balloon) Dilation?

A treatment modality for Achalasia, involving the forceful dilation of the LES with a balloon catheter, aimed at widening the LES to improve food passage.

Signup and view all the flashcards

What is Myotomy for Achalasia?

A surgical procedure to widen the LES by cutting muscle fibers, often used to treat Achalasia, particularly when pneumatic dilation is not effective.

Signup and view all the flashcards

Systemic Sclerosis (Scleroderma)

An autoimmune disease characterized by widespread fibrosis (hardening) of tissues, including the skin, internal organs, and blood vessels. This hardening can lead to various symptoms, including digestive issues, pulmonary problems, and skin changes.

Signup and view all the flashcards

CREST Syndrome

An idiopathic autoimmune disease that primarily affects the blood vessels and skin. Commonly characterized by the acronym CREST syndrome: Calcinosis, Raynaud's phenomenon, Esophageal dysmotility, Sclerodactyly, Telangiectasias.

Signup and view all the flashcards

Esophageal Dysmotility

A condition where the lower esophageal sphincter (LES) is weak and does not contract properly, leading to backflow of stomach acid into the esophagus. It can be a symptom of various conditions, including scleroderma, and often associated with heartburn and indigestion.

Signup and view all the flashcards

Mallory-Weiss Tear

A tear in the lining of the esophagus, often caused by forceful retching, vomiting, or straining. It can lead to blood in vomit, but usually not large amounts.

Signup and view all the flashcards

Esophageal Varices

Enlarged and twisted esophageal veins caused by portal hypertension, typically seen in individuals with liver cirrhosis or splenic vein thrombosis. These veins can rupture, leading to significant bleeding in the esophagus.

Signup and view all the flashcards

Esophageal Perforation

A tear in the esophagus that allows the contents of the esophagus to leak into the surrounding tissues, often causing inflammation and infection.

Signup and view all the flashcards

Gastrografin

A contrast medium used in X-rays to visualize the esophagus and detect potential perforations. Because it is water-soluble, it can safely leak into the mediastinum without causing harm.

Signup and view all the flashcards

Barium

A contrast medium used in X-rays to visualize the digestive tract. It is not water-soluble and can cause complications if it leaks into the mediastinum, so it is not typically used in patients with potential esophageal perforations.

Signup and view all the flashcards

Pernicious anemia

A condition where the body's immune system attacks the parietal cells in the stomach, leading to decreased production of intrinsic factor and vitamin B12 malabsorption.

Signup and view all the flashcards

NSAIDs and Gastritis

Nonsteroidal anti-inflammatory drugs (NSAIDs) can decrease prostaglandin production, which is essential for protecting the gastric lining. This can lead to gastritis and ulcers.

Signup and view all the flashcards

Gastric Cancer

A type of gastric cancer characterized by signet ring cells, which are tumor cells containing mucin.

Signup and view all the flashcards

Linitis plastica

A leather bottle appearance of the stomach caused by gastric cancer.

Signup and view all the flashcards

Gastric Metastasis to Ovaries

Gastric cancer can metastasize to the ovaries, often as bilateral lesions containing signet ring cells.

Signup and view all the flashcards

Virchow Node

The presence of a palpable supraclavicular lymph node, often indicating visceral malignancy, especially gastric cancer.

Signup and view all the flashcards

Nitrosamines and Gastric Cancer

Nitrosamines, often found in smoked foods, are a risk factor for gastric cancer.

Signup and view all the flashcards

MALT Lymphoma

A B cell lymphoma that can be associated with H. pylori infection, but does not display signet ring cells.

Signup and view all the flashcards

What is Choledocholithiasis?

Choledocholithiasis is a condition where a gallstone blocks the common bile duct, preventing bile flow from the gallbladder into the small intestine.

Signup and view all the flashcards

How is Choledocholithiasis Diagnosed?

The USMLE often asks for an abdominal ultrasound followed by an ERCP (Endoscopic Retrograde Cholangiopancreatography) as the initial diagnostic steps for choledocholithiasis.

Signup and view all the flashcards

What is Gallstone Pancreatitis?

Gallstone pancreatitis occurs when a gallstone lodges at the hepatopancreatic ampulla (where the common bile duct and pancreatic duct meet), blocking the flow of pancreatic enzymes and causing inflammation.

Signup and view all the flashcards

What are the Clinical Manifestations of Gallstone Pancreatitis?

Obstructive jaundice, elevated liver enzymes (ALP, direct bilirubin), and high pancreatic enzymes (amylase and lipase) are classic clinical manifestations of gallstone pancreatitis.

Signup and view all the flashcards

Where does obstruction occur in Gallstone Pancreatitis?

The hepatopancreatic ampulla is the preferred location for obstruction in gallstone pancreatitis, despite the stone being in the common bile duct.

Signup and view all the flashcards

How to Differentiate Choledocholithiasis from Pancreatic Cancer?

Pancreatic cancer can mimic choledocholithiasis, presenting with obstructive jaundice. Key distinctions include the patient's history (e.g., smoker, weight loss, no gallbladder) and negative CT findings.

Signup and view all the flashcards

What if CT is Negative for Pancreatic Cancer?

If a patient has obstructive jaundice and a negative CT scan, suspect cholangiocarcinoma, a cancer arising from the bile duct.

Signup and view all the flashcards

What is ERCP?

ERCP (Endoscopic Retrograde Cholangiopancreatography) is a commonly used diagnostic and therapeutic procedure for both diagnosing and treating choledocholithiasis.

Signup and view all the flashcards

Spontaneous Bacterial Peritonitis (SBP)

A serious bacterial infection of the peritoneal cavity, often occurring in patients with cirrhosis and ascites.

Signup and view all the flashcards

Abdominal Paracentesis

A procedure involving aspiration of fluid from the peritoneal cavity.

Signup and view all the flashcards

White Cell Count and Differential

The initial diagnostic step for SBP, performed after paracentesis, involves counting and classifying white blood cells in the fluid.

Signup and view all the flashcards

Gram Stain and Culture of the Fluid

A diagnostic test performed after paracentesis, involving examining the fluid for the presence of bacteria.

Signup and view all the flashcards

SBP Diagnostic Criteria

SBP is diagnosed when abdominal paracentesis reveals greater than 250 white blood cells per microliter (WBCs/µL) of ascitic fluid.

Signup and view all the flashcards

Minimal Change Disease and SBP

Minimal change disease is a form of nephrotic syndrome that can cause abdominal pain and fever in children, potentially mimicking spontaneous bacterial peritonitis.

Signup and view all the flashcards

SBP in Ascites

Although ascites is a risk factor for SBP, fever, and abdominal pain are often absent.

Signup and view all the flashcards

Minimal Change Disease (MCD)

A type of nephrotic syndrome characterized by changes in the glomeruli, typically affecting children.

Signup and view all the flashcards

Study Notes

Medical Organization

  • Mehlman Medical Hy Gastro
  • Website: mehlmanmedical.com

Social Media

  • YouTube: @mehlmanmedical
  • Instagram: @mehlman_medical

Medical Conditions

  • Peutz-Jeghers syndrome: Combination of perioral melanosis (hyperpigmentation around the lips) and hamartomatous colonic polyps. USMLE frequently shows lip images. Key to identifying the polyps is hamartomatous.
  • Osler-Weber-Rendu syndrome: Hereditary hemorrhagic telangiectasia (autosomal dominant). NBME questions often include images of the mouth or fingernail showing telangiectasias. Patients may experience nosebleeds and GI bleeding, potentially leading to anemia.
  • Plummer-Vinson syndrome: Triad of iron deficiency anemia, esophageal webs (dysphagia), and angular cheilitis (cracked corners of the mouth). Patients might also exhibit pica (eating non-nutritive substances) or koilonychia (spoon-shaped nails).
  • Lip psoriasis: Possible USMLE mention on the upper lip or forehead; often misidentified.
  • Aphthous ulcer: Painful, self-resolving sores on the inner lining of the mouth (labial mucosa).
  • Kawasaki disease: Vasculitis characterized by fever, injected eyes, and/or lips/tongue, cervical lymphadenopathy, and edema of the hands/feet, along with desquamation of palms/soles. USMLE questions usually don't include coronary artery aneurysms.
  • Perioral impetigo: Superficial skin infection around the mouth, frequently appearing as pustules (often confused with herpes).
  • Herpes labialis: Oral herpes; commonly indicated by fever and regional lymphadenopathy. Recurring infections are less severe. Key is "DNA, enveloped, linear."
  • Scarlet fever: Characterized by a strawberry tongue and a fine maculopapular body rash.
  • Hand-foot-mouth: Benign infection presenting with sores in the mouth, as well as the hands and feet. Caused by Coxsackie A virus.
  • Herpangina: Caused by Coxsackievirus; causes oral ulcers.
  • Koplik spots (measles): White-to-blue spots in the oral mucosa.
  • Sialolithiasisis: Stones in the salivary glands (most often parotid).
  • Leukoplakia: White and painless lesions on the oral mucosa.
  • Oral hairy leukoplakia: Benign condition appearing as white plaques that may cause bleeding. Directly related to infection by the Epstein-Barr virus.
  • Oropharyngeal candidiasis: Seen in immunocompromised patients. Common cause of odynophagia (difficult swallowing).
  • Pleomorphic adenoma: Most common benign salivary gland tumor; presence of variable cell types.
  • Mucoepidermoid carcinoma: A common type of malignant salivary gland tumor.
  • Warthin tumor: Benign salivary gland tumor in which lymphoid stroma is prominent.
  • Hiatal hernia: Herniation of the upper stomach through the diaphragm.
  • Gastroesophageal reflux disease (GERD): Irritation of esophageal mucosa from gastric acid.
  • Barrett esophagus: Metaplasia of the esophageal mucosa, characterized by the presence of intestinal columnar epithelium. It is a risk factor for esophageal cancer.
  • Adenocarcinoma: Malignant tumor of the glands.
  • Squamous cell carcinoma: Malignant tumor of squamous cells.
  • Zenker diverticulum: An outpouching of the esophagus above the esophageal sphincter.
  • Achalasia: Inability of the lower esophageal sphincter (LES) to relax correctly.
  • Systemic sclerosis (scleroderma): Autoimmune disease characterized by fibrosis of many organs .
  • Esophageal perforation: Hole in the esophagus that is usually caused by trauma, endoscopic procedures, or straining.
  • Mallory-Weiss tear: Tear in the esophageal mucosa due to vomiting or straining usually present in alcoholics.
  • Esophageal varices: Enlarged and tortuous superficial esophageal veins due to portal hypertension.
  • Diffuse esophageal spasm (DES): Spasms of the esophagus that create chest pains mimicking angina.
  • Eosinophilic esophagitis (EoE): Allergic condition of the esophagus (can be identified by the presence of eosinophils in the esophageal tissue).
  • Cholelithiasis: Gallstones.
  • Cholecystitis: Inflammation of the gallbladder (often due to gallstones).
  • Choledocholithiasis: Gallstones in the common bile duct.
  • Gallstone pancreatitis: Gallstones in the common bile duct block the hepatopancreatic ampulla, leading to the backflow of pancreatic enzymes causing pancreatitis.
  • Cholangitis: Infection of the bile ducts.
  • Acute pancreatitis: Inflammation of the pancreas.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Quiz Team

Related Documents

HY Gastrointestinal PDF

Description

This quiz covers important aspects of salivary gland tumors, including benign and malignant types, as well as common esophageal disorders. It addresses diagnostic tools, symptoms, and associated risks in various conditions. Test your knowledge on these critical clinical topics!

More Like This

Are You an Expert on Benign Salivary Gland Tumors?
12 questions

Are You an Expert on Benign Salivary Gland Tumors?

InterestingSuccess5125 avatar
InterestingSuccess5125
Salivary Gland Tumors Quiz
20 questions

Salivary Gland Tumors Quiz

InterestingSuccess5125 avatar
InterestingSuccess5125
Salivary Gland Tumors Quiz
60 questions

Salivary Gland Tumors Quiz

WellPinkTourmaline avatar
WellPinkTourmaline
Pathology of Salivary Gland Tumors
20 questions

Pathology of Salivary Gland Tumors

ImportantHolmium avatar
ImportantHolmium
Use Quizgecko on...
Browser
Open
Browser
Browser