Esophagus Q 41-50

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Q 41) Eosinophilic esophagitis - all are true except?
A.Most common presenting symptom is Dysphagia
B .Stricture develops in proximal esophagus
C . IL4 plays major role in eosinophil recruitment
D. Diagnosis established by Endoscopic biopsy


Q 42 ) Most common cause of  pseudo achalasia is ?
(a) Benign tumors of esophagus
(b) Chagas disease
(c) Caustic injury
(d) Adenocarcinoma of cardia
Answer 42


Q  43) Which has no part in management of corrosive injury of esophagus?

a) Repeated Endoscopies routinely

b) Esophagectomy in some cases

c) Early emergency surgery routinely

d) Steroid use routinely
Answer 43


41) c

Because IL 5 plays major role in eosinophil recruitment...

So immunotherapy against IL5 used in esonophilic esophagitis

Bailey page 1101 27th edition


Answer

42) d
Pseudoachalasia is an achalasia-like disorder that is usually produced by adenocarcinoma of the cardia
Other uncommon causes are
 1.benign tumours at this level.
2, Tumors of bronchus, pancreas

Ref Bailey page 1097


Answer
43) c

Other than the need for emergency surgery for bleeding or perforation, elective oesophageal resection should be deferred for at least 3 months until the fibrotic phase has been established.

Oesophageal replacement is usually required for very long or multiple strictures. Resection can be difficult because of perioesophageal inflammation in these patients.

Regular endoscopic examinations are the best way to assess stricture development (Figure 62.12). Significant stricture formation occurs in about 50% of patients with extensive mucosal damage

corrosives, can cause significant pharyngolaryngeal oedema

In unusual circumstances, e.g. with extensive necrosis after corrosive ingestion, emergency oesophagectomy may be necessary.

Bailey 27th page 1075