Barrett esophagus

High Yield Notes

13 pages

Flashcards

Barrett esophagus

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Preguntas

Preguntas del estilo USMLE Step 1

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A 69-year-old man presents to the primary care physician with dysphagia. The patient reports progressive difficulty swallowing, now to the point where he has trouble tolerating liquids and sometimes vomits after eating. The patient has a significant history of alcohol abuse, 50-pack-year smoking history, as well as hypertension and hyperlipidemia. Temperature is 37°C (98.6°F), pulse is 68/min, respirations are 14/min and blood pressure is 130/82 mmHg. Physical exam shows a thin male with bitemporal wasting and non-tender anterior cervical lymphadenopathy. Oral and neck examination is unremarkable aside from poor dentition. Laboratory results are as follows:  
 
Laboratory value  Result 
CBC, Serum 
 Hemoglobin  11.2  g/dL 
 Hematocrit  33.6% 
 Leukocyte count  10,100 /mm3 
 Platelet count  149,000/mm3 
 MCV                        72 fL 
 RDW                    11.5-14.5% 
 Iron Studies, Serum  
          Serum Iron                     90 μg/dL  
             Ferritin            Ferritin 170 ng/mL  
 Total iron binding capacity                               220 μg/dL 
A barium swallow study reveals an esophageal mass that significantly narrows the lumen in the middle of the esophagus. Which of the following pathologic features is most likely to be found on upper endoscopy?  

External References

First Aid

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Barrett esophagus p. 385

Lower esophageal sphincter

in Barrett esophagus p. 385

Resumen

Barrett's esophagus is a condition in which the normal esophageal squamous epithelium gets replaced by a premalignant columnar epithelium. This change in cell type may be caused by long-term exposure to stomach acid. Barrett's esophagus increases the risk of developing cancer of the esophagus.

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