Esophageal Disorders: Definition, Classification, and Management

Question 1

What is the definitive diagnostic modality for esophageal varices?

Accepted Answer

Upper endoscopy

Answer

Computed tomography scan

Answer

Magnetic resonance imaging

Answer

Barium swallow

Question 2

What is the most common cause of esophageal perforation?

Accepted Answer

Iatrogenic injury during endoscopic procedures

Answer

Foreign body ingestion

Answer

Blunt chest trauma

Answer

Spontaneous rupture

Question 3

What is the primary antifungal class used to treat esophageal candidiasis?

Accepted Answer

Azoles

Answer

Echinocandins

Answer

Polyenes

Answer

Triazoles

Question 4

Which of the following is a characteristic symptom of esophageal candidiasis?

Accepted Answer

Painful swallowing (odynophagia)

Answer

Difficulty swallowing (dysphagia)

Answer

Heartburn

Answer

Wheezing

Question 5

Which of the following is the most common histological type of esophageal cancer?

Accepted Answer

Squamous cell carcinoma

Answer

Adenocarcinoma

Answer

Small cell carcinoma

Answer

Lymphoma

Question 6

Which diagnostic test provides the most accurate measurement of esophageal motility?

Accepted Answer

Esophageal manometry

Answer

Upper endoscopy

Answer

Barium esophagram

Answer

pH monitoring

Question 7

What is the preferred initial treatment for uncomplicated gastroesophageal varices?

Accepted Answer

Endoscopic band ligation

Answer

Sclerotherapy

Answer

Pharmacotherapy

Answer

Surgery

Question 8

What is the primary diagnostic method for identifying Barrett's esophagus?

Accepted Answer

Upper gastrointestinal endoscopy with biopsy

Answer

Esophageal manometry

Answer

24-hour pH monitoring

Answer

Capsule endoscopy

Question 9

During an endoscopic examination, which characteristic appearance is indicative of esophageal varices?

Accepted Answer

Linear, dilated vessels within the esophageal lining

Answer

Yellowish-white plaques on the esophageal lining

Answer

Superficial breaks and sores on the esophageal lining

Answer

Narrowing and rigidity of the esophageal passage

Question 10

Which diagnostic test is considered the gold standard for evaluating esophageal motility disorders?

Accepted Answer

Esophageal manometry

Answer

Upper gastrointestinal endoscopy

Answer

24-hour pH monitoring

Answer

Capsule endoscopy

Question 11

For achalasia, a condition marked by impaired esophageal relaxation and propulsion, what is the initial treatment of choice?

Accepted Answer

Balloon dilation of the lower esophageal sphincter (LES)

Answer

Proton pump inhibitors (PPIs)

Answer

Esophagectomy

Question 12

What is the predominant mechanism of action of proton pump inhibitors (PPIs) in alleviating GERD symptoms?

Accepted Answer

Reducing gastric acid secretion

Answer

Neutralizing gastric contents

Answer

Enhancing esophageal motility

Answer

Stimulating lower esophageal sphincter tone

Question 13

Which endoscopic finding is characteristic of achalasia?

Accepted Answer

Dilated esophagus with weak or absent peristalsis

Answer

Increased esophageal mucosal inflammation

Answer

Hiatal hernia with esophageal shortening

Answer

Ulceration and bleeding esophageal mucosa

Question 14

Surgical resection is typically considered the primary treatment option for what stage of esophageal cancer?

Accepted Answer

Locally advanced, resectable disease

Answer

Early-stage, localized disease

Answer

Locally advanced, unresectable disease

Answer

Metastatic disease

Question 15

What is the primary goal of palliative care in patients with advanced esophageal cancer?

Accepted Answer

Symptom management and improving quality of life

Answer

Extending survival and achieving remission

Answer

Curing the disease and preventing recurrence

Answer

Preventing complications and reducing healthcare costs

Question 16

Which layer of the esophageal wall is primarily responsible for propelling food and liquid into the stomach?

Accepted Answer

Muscularis layer

Answer

Mucosa

Answer

Submucosa

Answer

Adventitia

Question 17

Which endoscopic procedure is commonly used to diagnose and treat esophageal stenosis?

Accepted Answer

Esophagogastroduodenoscopy

Answer

Esophageal manometry

Answer

Barium swallow

Answer

Upper gastrointestinal series

Question 18

What is the primary goal of surgical management for esophageal cancer?

Accepted Answer

Complete resection of the tumor

Answer

Restoration of esophageal continuity

Answer

Prevention of recurrence

Answer

Improvement of dysphagia

Question 19

Which imaging modality is most appropriate for assessing esophageal motility?

Accepted Answer

Esophageal manometry

Answer

Barium swallow

Answer

Upper gastrointestinal series

Answer

Computed tomography

Question 20

Which diagnostic test is considered the gold standard for evaluating abnormal esophageal contractility?

Accepted Answer

High-resolution esophageal manometry

Answer

Upper endoscopy

Answer

Barium swallow

Question 21

In surgical management of esophageal cancer, what is the paramount objective?

Accepted Answer

Achieve complete tumor resection with clear margins

Answer

Enhance patient survival

Answer

Improve swallowing function

Answer

Preserve the larynx and vocal cords

Question 22

Which endoscopic finding is most indicative of Barrett's esophagus?

Accepted Answer

Salmon-colored mucosa with abnormal blood vessels

Answer

White patches with a cobblestone texture

Answer

Ulcers with a yellow-white base

Question 23

Which endoscopic finding is indicative of Barrett's esophagus?

Accepted Answer

Irregular Z-line and salmon-colored mucosa

Answer

Erythema and friability

Answer

Nodularity and erosions

Answer

Circumscribed white plaques

Question 24

What is the primary objective of medical management in GERD?

Accepted Answer

Acid suppression

Answer

Motility enhancement

Answer

Mucosal protection

Answer

Surgical intervention

Question 25

What is the preferred endoscopic treatment for esophageal varices?

Accepted Answer

Endoscopic variceal ligation

Answer

Balloon tamponade

Answer

Sclerotherapy

Answer

Transjugular intrahepatic portosystemic shunt (TIPS)

Question 26

What is the most commonly encountered benign esophageal tumor?

Accepted Answer

Leiomyoma

Answer

Squamous cell papilloma

Answer

Carcinoid tumor

Answer

Gastrointestinal stromal tumor (GIST)

Question 27

Which of the following is a hallmark symptom of gastroesophageal reflux disease (GERD)?

Accepted Answer

Heartburn (burning sensation in the chest)

Answer

Chronic cough

Answer

Difficulty swallowing (dysphagia)

Answer

Hoarseness due to acid reflux

Question 28

Identify the primary pathophysiological abnormality underlying GERD:

Accepted Answer

Weakened lower esophageal sphincter (LES), allowing stomach contents to flow back into the esophagus

Answer

Reduced esophageal peristalsis, impairing the clearance of esophageal contents

Answer

Delayed gastric emptying, causing increased pressure within the stomach and pushing gastric contents into the esophagus

Answer

Increased esophageal mucosal resistance, making it more susceptible to acid damage

Question 29

Which diagnostic test provides the most definitive evaluation of GERD:

Accepted Answer

24-hour pH monitoring, assessing the frequency and duration of acid reflux episodes

Answer

Esophageal manometry, measuring esophageal muscle contractions and sphincter function

Answer

Upper endoscopy, visualizing the esophageal lining and identifying any abnormalities

Answer

Barium swallow, using X-rays to evaluate esophageal structure and function

Question 30

Which class of medication is the first-line pharmacological treatment for GERD:

Accepted Answer

Proton pump inhibitors, potently suppressing stomach acid production

Answer

H2-receptor antagonists, moderately reducing stomach acid secretion

Answer

Sucralfate, forming a protective layer over the esophageal lining

Answer

Antacids, neutralizing stomach acid on contact

Question 31

Define the anatomical condition in which the stomach protrudes through a weakened esophageal hiatus into the chest cavity:

Accepted Answer

Hiatal hernia, allowing stomach contents to enter the esophagus

Answer

Achalasia, characterized by impaired esophageal muscle relaxation and esophageal dilation

Answer

Dysphagia, difficulty swallowing due to esophageal obstruction or dysfunction

Answer

Eosinophilic esophagitis, an inflammatory condition with eosinophil infiltration of the esophageal mucosa

Question 32

Identify the characteristic endoscopic appearance of achalasia:

Accepted Answer

Dilated esophageal lumen, resembling a bird's beak, due to impaired esophageal emptying

Answer

Narrowed esophageal lumen, causing difficulty in passing food

Answer

Ulcerations within the esophageal mucosa, resulting from acid reflux

Answer

Barrett's esophagus, with abnormal mucosal changes, increasing cancer risk

Question 33

Describe the typical histological finding in eosinophilic esophagitis:

Accepted Answer

Eosinophilic infiltration of the esophageal mucosa, with increased numbers of eosinophils, a type of white blood cell

Answer

Neutrophilic infiltration of the esophageal mucosa, indicating acute inflammation

Answer

Lymphocytic infiltration of the esophageal mucosa, suggesting chronic inflammation

Answer

Granulomatous inflammation of the esophageal mucosa, characterized by the presence of granulomas, small collections of immune cells

Question 34

Identify a major risk factor for developing esophageal cancer:

Accepted Answer

Chronic gastroesophageal reflux disease, with repeated exposure of the esophageal lining to stomach acid and bile

Answer

Achalasia, causing esophageal stasis and increased risk of inflammation and dysplasia

Answer

Eosinophilic esophagitis, an inflammatory condition that can lead to esophageal damage and scarring

Answer

Hiatal hernia, allowing stomach contents to reflux into the esophagus

Question 35

Which of the following is the most prevalent esophageal disorder, characterized by inflammation and ulceration of the esophageal mucosa?

Accepted Answer

Gastroesophageal reflux disease (GERD)

Answer

Esophageal cancer

Answer

Esophageal varices

Answer

Achalasia

Question 36

What is the primary pathophysiological mechanism underlying gastroesophageal reflux disease (GERD)?

Accepted Answer

Lower esophageal sphincter (LES) dysfunction

Answer

Esophageal dysmotility

Answer

Impaired esophageal clearance

Answer

Increased intragastric pressure

Question 37

Which among the following symptoms is commonly associated with achalasia?

Accepted Answer

Dysphagia

Answer

Chest pain

Answer

Regurgitation

Answer

Heartburn

Question 38

The recommended first-line diagnostic test for esophageal disorders, providing direct visualization of the esophageal mucosa, is:

Accepted Answer

Upper endoscopy

Answer

Esophageal pH monitoring

Answer

Barium swallow

Answer

Esophageal manometry

Question 39

Which of the following is a potential long-term complication of untreated GERD?

Accepted Answer

Esophageal adenocarcinoma

Answer

Hiatal hernia

Answer

Gastric ulcer

Answer

Duodenal ulcer

Question 40

The surgical intervention of choice for patients with achalasia is:

Accepted Answer

Laparoscopic Heller myotomy

Answer

Esophagectomy

Answer

Fundoplication

Answer

Balloon dilation

Question 41

Which of the following is the most prevalent esophageal disorder in the Western world?

Accepted Answer

Gastroesophageal reflux disease (GERD)

Answer

Achalasia

Answer

Esophagitis

Answer

Esophageal cancer

Question 42

The hallmark clinical manifestation of achalasia is:

Accepted Answer

Progressive difficulty swallowing (dysphagia)

Answer

Chest pain

Answer

Regurgitation

Answer

Heartburn

Question 43

Which of the following is NOT a known risk factor for developing esophageal cancer?

Accepted Answer

Obesity

Answer

Barrett's esophagus

Answer

Tobacco smoking

Answer

Excessive alcohol consumption

Question 44

The gold standard for diagnosing gastroesophageal reflux disease (GERD) is:

Accepted Answer

Extended esophageal pH monitoring

Answer

Esophageal manometry

Answer

Upper endoscopy

Answer

Contrast radiography (barium swallow)

Question 45

Which class of medications is most effective in reducing gastric acid secretion and thereby treating GERD?

Accepted Answer

Proton pump inhibitors

Answer

Antacids

Answer

Histamine-2 receptor antagonists

Question 46

Which of the following statements about esophageal cancer screening is true?

Accepted Answer

There is currently no widely accepted or recommended screening method for esophageal cancer.

Answer

Upper endoscopy every 5 years is recommended for individuals at high risk.

Answer

Annual barium swallow is the preferred esophageal cancer screening method.

Answer

Esophageal pH monitoring is useful for screening high-risk individuals.

Question 47

Which of the following is the recommended first-line treatment for gastroesophageal reflux disease (GERD)?

Accepted Answer

Proton pump inhibitor

Answer

Sucralfate

Answer

Antacid

Answer

Histamine-2 receptor antagonist

Question 48

Which of the following endoscopic procedures is used to diagnose Barrett's esophagus?

Accepted Answer

Mucosal biopsy

Answer

Video capsule endoscopy

Answer

Capsule endoscopy

Answer

Endoscopic ultrasound

Question 49

Which of the following is a potential complication of esophageal cancer?

Accepted Answer

Esophageal fistula

Answer

Hepatic failure

Answer

Gastric outlet obstruction

Answer

Pancreatitis