a few GI Q-s - mamamia

[ArchivalUser]

33 y.male.2 -3 m.history of dificulty swaliowing .Can not eat,can not drink.Lost 10 kg. for 1 mounts.
Barium swallow =contrast material slowly passes in to the stomach.Manometry Incomplit relaxation of the LES in response to swolowing.
Which of the folowing Tx is use to block excitatory neurotransmitors in this condition?
1.Isosorbite dinitrate
2.Nifedipine
3.Botulin toxin
4.Pneumatic dilatation
5Laparoscopic Heller myotomy
6.Partial fundoplication
7.Ranitidin
8.Omeprazole
==========================================
Same patient .Next step :

1.Treatment
2.other test

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Same patient.Which of the drug options lower the pressure in smoot muscles of the vasels in LES?

[ArchivalUser]

Q1-Bo-tox

Q2-part1 = pneumatic dilation
part 2= EGD to rule out lymphoma or Gastric CA

Q3- isosorbide dinitrate, Nifedipine

good one

[ArchivalUser]

hi R about second Q what is next?
U are goung to treat first or u are going to do endogastroduodenoscopy with biopsy first?

[ArchivalUser]

EGD- w/biopsy first
pneumatic dilation Tx second

[ArchivalUser]

in diagnosing any esophageal pathology-
1)barium swallow
2)manometry
3)EGD to rule out lymphoma or CA

I thought in this order w/ barium swallow being most common and least invasive.

[ArchivalUser]

rhodesta
you got it almost!
its actually
first barium swallow
second EGD (although invasive but very simple so not the third one)
next is confirmation - with MONOMETRY

[ArchivalUser]

ok- so....

barium, egd, manometry-

do you know why manometry is last?

I don't think it's invasive

[ArchivalUser]

yes because its diagnostic.. for sure...
so first by looking you rule out there is no other means ie. ca, webs,
then diagnose it - with monometery