Dysphagia Flashcards
(18 cards)
Site
Where does the food get stuck?
Quality
Are you finding it difficult to swallow?
Does the food get stuck after swallowing?
Severity
What type of food usually gets stuck?
Is there any difference when the food is soft?
Time course
Did it start suddenly?
How long have you had difficulty swallowing for?
Has it been getting worse?
Has this ever happened before?
Context
What were you doing when you first had difficulty swallowing?
Relieving
Normal
Aggrevating
Normal
Associated features
Have you lots any weight since this started?
Have you lost you appetite at all?
Smoking
Normal
Drinking
Normal
Past hist
Normal
Fam Hist
Normal
Social hist
Normal
Occupational hist
Normal
What are some associated features we are looking for?
Past stroke Parkinson’s disease Multiple Sclerosis Coughing Choking/ Gaging (initiation problem) Reflux (causing stricture) Loss of appetite
What are the reasons for the site and quality questions?
To determine if the problem is oropharayngeral or oesophageal
What is the point of the severity question
To differentiate between a motility/mechanical problem
Differential diagnosis
Stroke – family history, past history of cardiovascular problems, high cholesterol, hypertension, sensorimotor loss, sudden onset, other neurological problems
Parkinson’s Disease – short steps, tremors, loss of smell, rigid movements
Multiple Sclerosis – Muscle Weakness, Visual disturbances, Hearing disturbances, Dizziness
Reflux – past history, chest pain, pain with or after eating
Oesophageal Cancer – past history, family history, weight loss, chest pain, history of reflux, coeliac disease, fever, initially solids only
Achalasia (loss of peristalsis in oesophagus) – context, rule out cancer, liquids from onset
