Barrett esophagus
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Gastrointestinal system
Pathology
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Barrett esophagus
USMLE® Step 1 style questions USMLE
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 |
Barrett esophagus exam links
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.