6. Dysphagia Flashcards

1
Q

What is dysphagia?

A

Difficulty swallowing

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2
Q

What is odynophagia?

A

Painful swallowing

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3
Q

What is globus?

A

Common sensation of a lump in the throat without dysphagia

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4
Q

What are the differentials for dysphagia?

A

Functional high dysphagia- stroke, parkinsons
Functional low dysphagia- Achalasia
Structural low dysphagia- cancer, stricture

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5
Q

What are neurological causes of dysphagia?

A

Achalasia, myasthenia gravis, oesophageal spasm

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6
Q

What are structural causes of dysphagia?

A

Pharyngeal pouch, stricture and oesophageal cancer

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7
Q

What 3 things should you establish in the presentic complain for dysphagia?

A

Duration- short (days to weeks): cancer, longer: chronic motility disorders

Is it progressive or intermittent- progressive: stricture, intermittent: motility disorder

Does dysphagia occur with solids, fluids or both?

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8
Q

What causes of dysphagia occurs with solids only usually?

A

Strictures, may be benign or malignant

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9
Q

What causes of dysphagia occurs with fluids only?

A

Motility disorder like achalasia

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10
Q

What causes of dysphagia occurs with solids and fluids?

A

Severe strictures, cancer

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11
Q

What associated symptoms should you ask about in someone with dysphagia?

A

Any pain, halitosis- pharyngeal pouch, cough, regurgitation, hoarseness of the voice- laryngeal nerve involvement, gargling- pharyngeal pouch

FLAWS- cancer

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12
Q

What PMHx is relevant in someone with dysphagia?

A

GORD and peptic ulcers

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13
Q

What drugs can contribute to dysphagia?

A

Calcium channel blockers and nitrates- relax smooth muscle

NSAIDs, aspirin, steroids, bisphosphonates- predispose to peptic ulceration

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14
Q

What 5 features are relevant on examination in someone with dysphagia?

A
Cranial enrve pathology
Signs of GI malignancy- virchow's node
Neck mass
Features of CREST syndrome
Koilonychia- suggests severe iron deficiency anaemia
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15
Q

What are 4 of the main investigations for dysphagia?

A

Barium swallow, endoscopy, videofluoroscopy, manometry

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