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Flashcards in 6. Dysphagia Deck (16)
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1

What is dysphagia?

Difficulty swallowing

2

What is odynophagia?

Painful swallowing

3

What is globus?

Sensation of a lump in the throat without dysphagia

4

What are the differentials for dysphagia?

Functional high dysphagia: Stroke, Parkinson's
Functional low dysphagia: Achalasia
Structural low dysphagia: Cancer, stricture

5

What 3 things should you establish in the presenting complaint for dysphagia?

Duration?
Short (days to weeks)= cancer. Longer= chronic motility disorders
Progressive or intermittent?
Progressive= stricture. intermittent= motility disorder
Solids, fluids or both?

6

What causes of dysphagia occurs usually only with solids?

Strictures (benign or malignant)

7

What causes of dysphagia occurs with fluids only?

Motility disorders e.g. achalasia

8

What causes of dysphagia occurs with solids and fluids?

Severe strictures
Cancer

9

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

Cough
Halitosis: pharyngeal pouch
Heartburn/ water brash
Hoarseness of the voice: laryngeal nerve involvement
Gurgling/ dysphonia: pharyngeal pouch
FLAWS: cancer
Neurological symptoms
Rheumatological symptoms

10

What PMHx is relevant in someone with dysphagia?

GORD
Peptic ulcers

11

What drugs can contribute to dysphagia?

CCB's + nitrates: relax smooth muscle
NSAIDs, aspirin, steroids, bisphosphonates: predispose to peptic ulceration

12

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

Cranial nerve pathology
Signs of GI malignancy: virchow's node
Neck mass
Features of CREST syndrome
Koilonychia: severe iron deficiency anaemia

13

What are 4 of the main investigations for dysphagia?

Barium swallow
Endoscopy
Videofluoroscopy
Manometry

14

What is new onset dysphagia assumed to be in middle aged to elderly patients until proven otherwise?

Carcinoma

15

What does CREST syndrome comprise of?

Calcinosis
Raynauds
Esophageal dysmotility
Sclerodactyly
Telangiectasia

16

Give 3 treatments for loosening the lower oesophageal sphincter

Pneumatic balloon dilatation
Surgical (Heller's) myotomy
Botox injections