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2024-2025 Esophageal Disorders (PEARLS) (Smarty PANCE) with Answers (57 Solved Questions)

2024-2025 Esophageal Disorders provides key insights into previous exams to help you prepare better.

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EsophagealDisorders(PEARLS)SmartyPANCE100% VERIFIED ANSWERS2024/2025What isesophagitis?Esophagitis is simplyinflammationthat may damagetissues of the esophagus.Itusually causesdysphagiaor difficulty in swallowing,odynophagiaor painfulswallowing, andretrosternal chest pain.What are thetwo types of esophagitis?Infectiousandnon-infectiousHow is esophagitisdiagnosed?The usual workup includes anupper endoscopywith abiopsy. And in case ofretrosternal chest pain, anelectrocardiogramshould always be done in order to ruleout cardiac ischemia.What is themost common causeof esophagitis?The most common cause isgastroesophageal reflux disease or GERD, and in thatsituation, it’s calledreflux esophagitis.What is thetreatmentofreflux esophagitis?Treatment of reflux esophagitis starts withproton pump inhibitors or PPIs such asomeprazole for8 weeks. If symptoms disappear, then the dose of PPI is graduallydecreased. If PPIs are needed for more than 6 months, then it’s replaced by histamine 2

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receptor agonists or H2RAs. If the symptoms recur, then the lowest dose of themedication that last controlled the symptoms is restarted.How should patients withsevere erosiveesophagitis be managed?For individuals with severe erosive esophagitis, arepeat upper endoscopy should bedone after 8 weeksof treatment to make sure that it’s healing and torule outmalignancyPt withasthma symptoms and GERDnot responsive to antacids.Eosinophilic esophagitis-Pt with Asthma symptoms and GERD not responsive toantacids. Allergic, eosinophilic infiltrationof the esophageal epithelium.How iseosinophilic esophagitis treated?Eosinophilic esophagitisis treated by removing foods that incite allergic response,topical steroids via inhalerAn endoscopy for presumed esophagitis showsmultiple shallow ulcers. What isthe most likely diagnosis?Herpes simplex virusEsophagitis caused byNSAIDsorbisphosphonatesNoninfectious-Medication inducedesophagitisDysphagialasting weeks-monthsafter radiation therapyNoninfectious-Radiation-inducedesophagitis. Radiation exposure of 5000 cGyassociated with increased risk for strictureLinear yellow-white plaqueswith odynophagia or pain on swallowing.Infectiousfungal (candida)esophagitis

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How iscandida esophagitistreated?Fluconazole100 mg PO dailyWhat isGERD? (Gastroesophageal reflux disease)Gastroesophageal reflux disease (GERD)occurs when stomach acid frequently flowsback into the tube connecting your mouth and stomach (esophagus). This backwash(acid reflux) can irritate the lining of your esophagus.What are thesigns and symptoms of GERD?-Heartburn, usually after eating, which might be worse at night-Chest pain-Dysphagia (difficulty swallowing)-Regurgitation of food or sour liquid-Sensation of a lump in your throat-Chronic cough-Laryngitis-New or worsening asthma-Disrupted sleepList fouratypical symptomsassociated with GERD1. Cough2. Hiccups3. Throat clearing4. WheezingWhat are fourdietary examples that canlower LES pressureand worsensymptoms of GERD?1. Fatty foods2. Alcohol

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3. Caffeine (coffee, tea, chocolate)4. PeppermintList fivemedicinesthat canlower LES pressures, thus leading to GERD:=1. Calcium channel blockers2. Theophylline3. Diazepam (Valium)4. Meperidine (Demerol)5. MorphineDiagnostic testsforGERD-Upper endoscopy-Ambulatory acid (pH) probe test-Esophageal manometry-X-ray of the upper digestive systemDo all patients with GERD needesophageal function testing?No, any additional testing beyond an EGD should be reserved for patients whoeitherfail medical therapy and lifestyle modificationor in whom the correlation ofreflux symptoms is in doubtProvide fiveextraesophageal manifestationsof GERD1. Asthma2. Laryngitis/pharyngitis3. Dental decay4. Recurrent sinusitis5. Recurrent otitis mediaWhat happens when thedisease worsens?
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Physician Assistant National Certifying Exam

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