Flashcards in 6. Dysphagia Deck (16)
What is dysphagia?
What is odynophagia?
What is globus?
Sensation of a lump in the throat without dysphagia
What are the differentials for dysphagia?
Functional high dysphagia: Stroke, Parkinson's
Functional low dysphagia: Achalasia
Structural low dysphagia: Cancer, stricture
What 3 things should you establish in the presenting complaint for dysphagia?
Short (days to weeks)= cancer. Longer= chronic motility disorders
Progressive or intermittent?
Progressive= stricture. intermittent= motility disorder
Solids, fluids or both?
What causes of dysphagia occurs usually only with solids?
Strictures (benign or malignant)
What causes of dysphagia occurs with fluids only?
Motility disorders e.g. achalasia
What causes of dysphagia occurs with solids and fluids?
What associated symptoms should you ask about in someone with dysphagia?
Halitosis: pharyngeal pouch
Heartburn/ water brash
Hoarseness of the voice: laryngeal nerve involvement
Gurgling/ dysphonia: pharyngeal pouch
What PMHx is relevant in someone with dysphagia?
What drugs can contribute to dysphagia?
CCB's + nitrates: relax smooth muscle
NSAIDs, aspirin, steroids, bisphosphonates: predispose to peptic ulceration
What 5 features are relevant on examination in someone with dysphagia?
Cranial nerve pathology
Signs of GI malignancy: virchow's node
Features of CREST syndrome
Koilonychia: severe iron deficiency anaemia
What are 4 of the main investigations for dysphagia?
What is new onset dysphagia assumed to be in middle aged to elderly patients until proven otherwise?
What does CREST syndrome comprise of?