Esophagus post test

Which of the following can decrease LES pressure?

• Metoclopramide

• Gastrin

• Calcium channel blockers

• VIP

Which of the following is a characteristic of a permanently defective sphincter?

• LES resting pressure of 5mmHg

• Sphincter length 2cm

• Intra-abdominal sphincter length 1cm

• Salivary pH 6.5

The indications for antireflux surgery are the following except:

• Objectively proven gastroesophageal reflux disease

• Typical symptoms of GERD despite adequate medical therapy

• Presence of Barretts esophagus

• Younger patient unwilling to take lifelong medication

A patient is being worked up for esophageal cancer. Which diagnostic test provides the most reliable method of determining depth of cancer invasion?

• EUS

• CT scan

• MRI

• PET scan

45/M s/p Nissen fundoplication with Collis gastroplasty for GERD underwent endoscopy for dysphagia. Endoscopy with biopsy was done revealing low grade dysplasia. What is your next course of action?

• High dose PPI for 12 weeks then repeat biopsy

• EMR

• Endoscopic ablation

• Esophageal resection

This type of hiatal hernia is characterized by an upward dislocation of the gastric fundus alongside a normally positioned cardia

• I

• II

• III

• IV

73/M with multiple co-morbidities compliant to maintenance medications came in due to dysphagia. EGD was done revealing stenosis on the distal esophagus, further studies showed competent sphincter. What is the appropriate management for this patient?

• EGD dilatation

• POEM

• Nissen fundoplication

• Esophageal resection

  Which of the following manometric studies is characteristic of DES?

• Elevated LES pressure

• Repetitive and multipeaked contractions

• Decreased or absent amplitude of esophageal peristalsis

• Incomplete LES relaxation

50/M was diagnosed with esophageal adenocarcinoma Siewart 2 involving the muscularis mucosa with no nodal involvement nor distant metastasis. What is the preferred treatment option for this patient?

• EMR

• ESD

• Distal esophagectomy, proximal gastrectomy

• Distal esophagectomy, total gastrectomy

59/M was diagnosed with esophageal adenocarcinoma Siewart 2. On preop workup, FEV1 is 1.1 L and EF 45%. Albumin is 4g/dL and no reported significant weight loss. Tumor stage is T1aN0M0. What is your preferred surgical plan?

• EMR

• Transhiatal esophagectomy

• Ivor lewis esphagectomy

• Mckeown esophagectomy