Esophageal disease
A. Hepatitis A
B. Coxsackie virus
C. CMV
D. HSV
ANSWER -D.
D. HSV
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Increasing evidence suggests that the ultimate cause of ganglion cell degeneration in achalasia is an autoimmune process attributable to a latent infection with human herpes simplex virus 1 combined with genetic susceptibility
A. Parrot beak esophagus
B. Jackhammer esophagus
C. corkscrew esophagus
D. rosary bead esophagus
ANSWER -A.
A. Parrot beak esophagus
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The barium swallow x-ray appearance is of a dilated esophagus with poor emptying, an air-fluid level, and tapering
at the LES giving it a beak-like appearance
A. Boerhaave syndrome
B. Carcinoma Esophagus
C. Achalasia
D. Barrett’s Esophagus
ANSWER -C.
C. Achalasia
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Corkscrew esophagus (also referred as rosary bead esophagus) is a classic finding of diffuse esophageal spasm (DES) in barium studies
A. Boerhaave syndrome
B. Carcinoma Esophagus
C. Achalasia
D. Barrett’s Esophagus
ANSWER -C.
C. Achalasia
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Heller myotomy helps 90% of achalasia patients.
A. Diffuse esophageal spasm
B. Carcinoma Esophagus
C. Achalasia
D. Esophageal varices
ANSWER -C.
C. Achalasia
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Barium swallow -acute tapering at the lower esophageal sphincter and narrowing at the gastro-esophageal junction, producing a “bird’s beak” or “rat’s tail” appearance.
A. Incomplete LES relaxation
B. Presence of fibrosis at Lower Esophagus
C. Lack of peristalsis
D. Increased LES tone
ANSWER -C.
C. Achalasia
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characterized by
– incomplete LES relaxation,
– increased LES tone,
– lack of peristalsis of the esophagus
– in the absence of other explanations like cancer or fibrosis.
A. Pressure of LES > 25 mm Hg
B. Pressure of LES > 50 mm Hg
C. Pressure of LES > 75 mm Hg
D. Pressure of LES > 100 mm Hg
ANSWER -D.
D. Pressure of LES > 100 mm Hg
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Pressure of LES <26 mm Hg is normal, >100 is considered achalasia
A. Gothenburg criterion
B. Castell criteria
C. Achem criteria
D. Heller Criteria
ANSWER -D.
D. Pressure of LES > 100 mm Hg
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Most commonly used criteria for diagnosis of Nutcracker esophagus is the Castell criteria
A. Beta-Blockers
B. calcium-channel blockers
C. Nitrates
D. Phenobarbital
ANSWER -A.
A. Beta-Blockers
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In-Shorts
Most commonly used Criteria for – Nutcracker esophagus.
Castell criteria include
– one major criterion: a mean peristaltic amplitude in the distal esophagus of more than 180 mm Hg.
– minor criterion is the presence of repetitive contractions (meaning two or more) that are greater than six seconds in duration.