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Year 3 Conditions > Dysphagia > Flashcards

Dysphagia Flashcards

(67 cards)

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1
Q

First thing to ask with dysphagia

A

If difficulty initiating- neuro

If feel get stuck- gastro causes

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2
Q

What is word for painful swallowing

A

Odynophagia

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3
Q

What normally causes odynophagia

A

Candidiasis

Cancer

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4
Q

What is globus

A

The feeling of having lump in throat without true dysphagia

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5
Q

Functional causes of high dysphagia

A 
Stroke
Parkinsons
MG
MS
MND
Inadequate saliva
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6
Q

What could result in inadequate saliva production

A

Sjogrens

Anticholinergics

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7
Q

Structural causes of high dysphagia

A

Cancer

Pharyngeal pouch

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8
Q

Lower causes of functional dysphagia

A

Achalasia
CREST syndrome
Oesophagitis

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9
Q

Luminal cause of low dysphagia

A

Foreign body

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10
Q

Mural causes of low dysphagia

A

Cancer
Stricture
Oesophageal webs

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11
Q

Extrinsic causes of low dysphagia

A 
Mediastinal mass
Retrosternal goitre
Pancoast tumour
Aortic aneurysm
Pericardial effusion
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12
Q

What are progressive vs intermittent dysphagia symptoms indicative of

A

Progressive- cancer

Intermittent- functional

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13
Q

What does new onset dysphagia suggest

A

Structural

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14
Q

What does chronic dysphagia suggest

A

Functional

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15
Q

What does dysphagia progression from solids to liquid suggest

A

Stricture

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16
Q

What does dysphagia progression from liquid to solids suggest

A

Functional

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17
Q

Absolute dysphagia

A

To everything including saliva
Foreign body
Stricture

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18
Q

Repeated absolute dysphagia

A

Cancer

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19
Q

What does choking right after eating suggest

A

Functional cause

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20
Q

What does a nocturnal cough suggest

A

Achalasia- when lying down

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21
Q

What does a cough some time after eating suggest

A

Either a pharyngeal pouch
Food that was stuck at sphincter junction and has now aspirated- achalasia
GORD

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22
Q

What does halitosis suggest

A

Zenckers diverticulum( pharyngeal pouch)

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23
Q

What is other word for pharyngeal pouch

A

Zenckers diverticulum

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24
Q

What does gurgling after eating when trying to speak suggest

A

Zenckers diverticulum- could see bulge in neck

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25
What does dysphonia with dysphagia suggest
Recurrent laryngeal involvement- extrinsic tumour
26
What is dysphonia
Abnormal voice
27
What does chest burn suggest
GORD predisposes to oesophageal cancer | 40% achalasia patients present with this
28
What does slow eating suggest about dysphagia
Functional
29
What does tiredness after eating suggest
Functional
30
What does extra effort needed to swallow suggest
Functional
31
Why ask about rheum symptoms in dysphagia
CREST syndrome
32
CREST syndrome sx
``` Calcinosis Raynauds phenomena Eosophageal immobility Sclerodactyly Telengectasia ```
33
Why is telengectasia important in abdo exam
CREST -> dysphagia
34
Medical conditions to ask about in history dysphagia and why
Peptic ulcer- lead to scarring and strictures at junction GORD- predisposes to oesophageal cancer, could have had due to hiatus hernia which would mean had fundoplication of lower oesophageal sphincter leading to post op dysphagia as stitches too tight MS and parkinsons may lead to it
35
Drugs to ask about in dysphagia history
NSAIDS, steroids and bisphosphonates may lead to ulcers | CCB and nitrates can relax muscle of oesophagus
36
What is name for oesophageal webs
Plummer vinson syndrome
37
Cranial nerve pathology in dysphagia exam
Functional cause
38
Virchows node in dysphagia exam
Cancer
39
Hepatomegaly in dysphagia exam
Met to liver
40
Neck mass in dysphagia exam
Goitre-> external compression | Pharyngeal pouch
41
Koilonychia in dysphagia exam
Plummer vinson syndrome
42
4 main investigations for dysphagia
Barium swallow Endoscopy Videofluoroscopy Manometry
43
Difference between barium swallow and barium meal
Swallow from upper to lower sphincter | Meal watches in stomach and duodenum too
44
Indications of barium swallow
Suspected high lesion as in OGD this area gets intubated and also is risk of perf here Achalasia
45
When is endoscopy indicated
Lower lesion suspected | Much more sensitive
46
When is videofluroscopy indicated
Functional high dysphagia
47
Difference between videofluoroscopy and barium swallow
Videofluoroscopy given barium in liquid or semi solid form and therapist adjest swallowing technique
48
When is manometry indicated
Other imaging inconclusive | Used to differentiate between functional causes
49
How does achalasia appear on barium swallow
Birds beak
50
On endoscopy how is barretts oesophagus described
Velvety epithelium
51
What elective operation has highest mortality rate
Oesophagectomy | 2/3 candidates deemed unfit due to advanced disease stage
52
What investigations are used to stage oesophageal cancer
CT PET Endoscopic US Laparascopy
53
What happens to oesophagus in achalasia
Becomes dilated
54
What is nutcracker dysphagia
Strong spasms when trying to eat- from hypertensive crises
55
What is manometry used to differentiate achalasia from
Nut cracker syndrome
56
Dysphagia with SOB
Tumour compressing oesophagus
57
2 most common oesophagus cancers
Adenocarcinoma | Squamous cell carcinoma
58
Risk factors for squamous cell carcninoma of the oesophagus
``` Alcohol Smoking Achalasia Plummer vinson Coeliac ```
59
Risk factors for adenocarcinoma
Barretts oesophagus | Smoking and alcohol
60
What is plummer vinson syndrome
Dysphagia due to keratonised webs in the oesophagus associated with IDA
61
What is danger of plummer vinson syndrome
Premalignant to cricopharyngeal cancer
62
Risk factors for oesophageal cancer
Middle aged to elderly women
63
What is aetiology of achalasia
Absence of ganglion cells within the myenteric plexus of oesophagus leading to failure of lower oesophageal sphincter and lower oesophagus
64
Charcteristics of left recurrent laryngeal damage
Bovine cough | Hoarse voice
65
How can the recurrent left laryngeal nerve be damaged in dysphagic patients
Infiltration from oesophageal malignancy Mediastinal malignancy Ortners syndrome
66
What is Ortner syndrome
When the recurrent laryngeal nerve is compressed by the CVS system normally by left atria enlarged due to mitral stenosis
67
How can oesophageal cancer present
``` Dysphagia Weight loss GI reflux Odynophagia Dyspnoea ```

Year 3 Conditions (33 decks)

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