BEST ANSWERS Esophageal Disorders (PEARLS) Smarty PANCE 100% VERIFIED ANSWERS 2024/2025

Esophageal Disorders (PEARLS) Smarty PANCE 100% VERIFIED ANSWERS 2024/2025 What is esopha gitis? Esophagitis is simply inflammation that may damage tissues of the esophagus. It usually causes dysphagia or difficulty in swallowing, odynophagia or painful swallowing, and retrosternal chest pain . What are the two types of esophagitis? Infectious and non-infectious How is esophagitis diagnosed ? The usual workup includes an upper endoscopy with a biopsy . And in case of retrosternal chest pain, an electrocardiogram should always be done in order to rule out cardiac ischemia. What is the most common cause of esophagitis? The most common cause is gastroesophageal reflux disease or GERD , and in that situation, it’s called reflux esophagitis. What is the treatment of reflux esophagitis ? Treatment of reflux esophagitis starts with proton pum p inhibitor s or PPIs such as omeprazole for 8 weeks . If symptoms disappear, then the dose of PPI is gradually decreased. If PPIs are needed for more than 6 months, then it’s replaced by histamine 2 receptor agonists or H2RAs. If the symptoms recur, then th e lowest dose of the medication that last controlled the symptoms is restarted. How should patients with severe erosive esophagitis be managed? For individuals with severe erosive esophagitis, a repeat upper endoscopy should be done after 8 weeks of treatment to make sure that it’s healing and to rule out malignancy Pt with asthma symptoms and GERD not responsive to antacids. Eosinophilic esophagitis - Pt with Asthma symptoms and GERD not responsive to antacids. Allergic, eosinophilic infiltration of the esophageal epithelium. How is eosinophilic esophagiti s treated? Eosinophilic esophagitis is treated by removing foods that incite allergic response, topical steroids via inhaler An endoscopy for presumed esophagitis shows multiple shallow ulcers . What is the most likely diagnosis? Herpes simplex virus Esophagitis caused by NSAIDs or bisphosphonates Noninfectious - Medication induced esophagitis Dysphagia lasting weeks -months after radiation therapy Noninfectious - Radiation -induced esophagitis. Radi ation exposure of 5000 cGy associated with increased risk for stricture Linear yellow -white plaques with odynophagia or pain on swallowing. Infectious fungal (candida) esophagitis