Dysphagia Flashcards

1
Q

What are extrinsic causes of dysphagia?

A

mediastinal masses
cervical spondylosis
systemic sclerosis

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2
Q

What are oesophageal wall causes of dysphagia?

A

achalasia
diffuse oesophageal spasm
hypertensive LOS

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3
Q

What are intrinsic causes of dysphagia?

A

tumours
strictures
oesophageal strictures

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4
Q

What are neuro causes of dysphagia?

A
CVA 
Parkinsons 
MS
Myasthenia gravis
Lateral medullary syndrome
Bulbar palsy
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5
Q

if fluid can be drunk as fast as usual, what would u suspect?
if it can’t, what would u suspect?

A

YES - stricture (benign or malignant)

NO - motility disorder (achalasia, neuro cause)

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6
Q

If it is difficult to make the swallowing movement? what would u suspect?

A

bulbar palsy (esp if they cough on swallowing)

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7
Q

If the dysphagia is constant and painful what would u suspect?

A

malignant stricture

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8
Q

If the neck bulges or gurgles on drinking what would u suspect?

A

pharyngeal pouch

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9
Q

What tests would u do for dysphagia?

A

Upper GI endoscopy
Oesophageal motility studies
Barium swallow
FBC, ESR

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10
Q

What is oesophageal carcinoma associated w?

A

achalasia
alcohol
smoking
barretts

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11
Q

What causes benign oesophageal strictures?

A

reflux
swallowing corrosives
foreign body
trauma

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12
Q

what is. rx of benign oesophageal strictures?

A

dilatation

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13
Q

What is rx of pharyngeal pouch?

A

endoscopic stapling.

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14
Q

What clinical features would make u think of oesophageal cancer?

A

weight loss
anorexia
vomiting during eating

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15
Q

what are the clinical features of oesophagitis?

A

hx of heartburn

odynophagia but NO WL + systemically well

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16
Q

What features in a hx may suggest oesophageal candidiasis?

A

hx of HIV

Steroid inhaler use

17
Q

What features in a hx may suggest achalasia?

A

dysphagia of both liquids and solids from the start
heartburn
regurgitation of food

18
Q

what are the risks of achalasia?

A

regurgitation may lead to aspiration pneumonia

19
Q

What features alongside dysphagia may suggest myasthenia graves?

A

extra ocular muscle weakness or ptosis

dysphagia is w liquids as well as solids

20
Q

What is globus pharyngeus?

A

sensation of a lump in the throat when not swallowing food w no primary swallowing difficulty

21
Q

What is globus hystericus?

A

sensation of lump in the throat
associated w anxiety
sx intermittent and relieved by swallowing
usually painless