Esophageal Diagnostic Procedures Questions

Flexible esophagoscopy is preferred in patients with Zenker's diverticulum to avoid perforation.

Most perforations during rigid esophagoscopy occur just below the cricopharyngeus.

Endoscopic findings of reflux esophagitis poorly correlate with pathologic changes on biopsy.

Esophagoscopy during active variceal bleeding greatly increases the incidence of perforation.

The combination of forcep and brush biopsy will give an endoscopic diagnosis of about 75% in esophageal carcinoma.

Question 2: Which of the following statements is true regarding therapeutic esophagoscopy?

Foreign bodies most commonly lodge at the midthoracic level due to esophageal spasm.

Olive-tipped dilators over a swallowed string provide the safest method of stricture dilation.

Caustic burns should be dilated prophylactically to prevent late stenosis.

Nd:YAG laser therapy can be performed in a single setting for widening the lumen in esophageal carcinoma.

Achalsia can be successfully treated with successive dilations of the GE junction using Savary dilators from above.

Question 3: Which of the following statements is true regarding physiologic studies of the esophagus?

Esophageal manometry is most accurate when deep breathing and Valsalva maneuvers are used to increase reflux.

Fall in the pH below 6.0 indicates reflux during the pH reflux test.

The acid perfusion (Bernstein) test has high sensitivity for atypical chest pain.

Contrast studies of the esophagus have high sensitivity and specificity for demonstrating pathologic reflux.

24-hour pH monitoring provides the most objective evidence of reflux.