PAEA Surgery End Of Rotation (EOR) Practice Exam

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Barrett's esophagus is a pre-malignant condition resulting from what?

Viral infection
Radiation exposure
Chronic esophageal reflux
Genetic predisposition

The correct answer is: Chronic esophageal reflux

Barrett's esophagus is a condition characterized by changes in the cells lining the esophagus, specifically the replacement of squamous epithelium with columnar epithelium, known as intestinal metaplasia. This transformation is primarily induced by chronic irritation and damage due to gastroesophageal reflux disease (GERD). The acid and bile present in stomach contents that reflux into the esophagus cause repeated injury, leading to an adaptive response from the esophageal lining. Over time, this persistent inflammation can increase the risk of developing esophageal adenocarcinoma, making Barrett's esophagus a significant precursor to esophageal cancer. In contrast, viral infections are not directly linked to the development of Barrett’s esophagus, focusing instead on viral-induced esophagitis or other complications. Radiation exposure is generally associated with damage to tissues and organs, but it does not specifically result in Barrett’s esophagus. Genetic predisposition can play a role in the overall risk of developing various conditions, including cancers, but the primary driver for Barrett's esophagus is the chronic irritation caused by reflux, rather than genetic factors alone. Therefore, chronic esophageal reflux is the most critical factor in the development of Barrett's esophagus.