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Wayne Shared "DERS" - 493 Picmonics

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DERS

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 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
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
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
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
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
Tracheoesophageal Fistula (TEF)
Cause
Esophageal Atresia
Ends in Blind Pouch
Assessment
Coughing
Choking
Cyanosis
Drooling
Considerations
NPO
Surgical Emergency
Aspiration Pneumonia
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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
Esophageal Perforation
Etiologies
Iatrogenic
Inflammation
Trauma
Boerhaave Syndrome
Presentation
Retrosternal Pain
Subcutaneous Emphysema
Pneumomediastinum
Diagnostic Workup
Chest X-Ray
Esophagram
Computed Tomography
Management
ABCs (Airway, Breathing, Circulation)
Broad-Spectrum Antibiotics
Surgical Repair
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4 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
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 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
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
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
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
Hyperbilirubinemia
Cause/Mechanism
Increased Unconjugated Bilirubin
Assessment
Jaundice
Kernicterus
Interventions
Early Feedings
Heme Oxygenase Inhibitors
Phototherapy
Protect Eyes
Monitor for Dehydration
Considerations
Monitor Bilirubin Levels
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3 mins
Clonorchis Sinensis
Pathophysiology
Trematode (Fluke)
Undercooked Fish
Biliary Tract Inflammation
Pigmented Gallstones
Associated with Cholangiocarcinoma
Treatment
Praziquantel
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1 min
Bile
Synthesis and Circulation
Synthesized Continuously By Hepatocytes
Cholesterol 7 Alpha-Hydroxylase Rate Limiting Step
Stored In Gallbladder
Secreted Into Duodenum
Bile Salts Reabsorbed In Terminal Ileum
Returned To Liver Via Portal Circulation
Composition
Bilirubin
Bile Salts
Cholesterol And Phospholipids
Ions And Water
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4 mins
Appendicitis
Mechanism and Characteristics
Fecalith leading to obstruction and infection
Most commonly affects teenagers
Presentation
Initial peri-umbilical visceral pain
Subsequent somatic right lower quadrant pain
Diagnosis
Rebound tenderness
Positive psoas sign
Pain at McBurney's point
Leukocytosis
Fever
Treatment
Appendectomy
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1 min
Acute Appendicitis Treatment
Diagnosis
CT Scan
Treatment
Immediate Appendectomy
NPO
IV Fluids
Antibiotics
Perforation
Tertiary Intention
Antibiotics Until Afebrile
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2 mins

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Wayne Shared DERS - 493 Picmonics