GI Quiz 1 - Dysphagia Flashcards
What is dysphagia?
difficulty swallowing (not lump in throat)
What are 2 types of dysphagia?
Oropharyngeal: oropharynx -> esophagus
Esophageal: passing down esophagus
What are 2 types of etiologies for oropharyngeal and esophageal dysphagia?
Oro: neurologic or muscular
Eso: motility disorders vs. mechanical obstruction
What are some examples of neurologic and muscular causes of oro dysphagia?
Neuro: stroke, parkinson’s, MS, motor neuron disorders, bulbar poliomyelitis
Muscular: Myasthenia gravis, dermatomyositis, muscular dystrophy, cricophayngeal incoordination
What are some examples of motility disorders & mechanical causes of eso dysphagia?
Motility: achalasia, diffuse eso spasm, systemtic sclerosis, eosinophillic esophagitis
Mechanical: peptic stricture, eso CA, LE rings, Caustic ingestions, Extrinsic compression (i.e. aortic aneurysm, enlarged L atrium, etc)
What are SSx of oro vs eso dysphagia?
Oro: diff. initiating swallowing, food sticking in throat, nasal regurg., cough/choke w/swallowing, voice change
Eso: sensation of food sticking in throat/chest, oral regurg.
Both: drooling, wt loss (unexplained), recurrent pneumonia
What is the PE for Dysphagia?
Nutritional status (weight)
Neuro exam: resting tremor, CN, muscle strength, gait, balance
Skin: rashes, thickening
Muscles: wasting, fasiculations, tenderness
If you find a tremor, ataxia, balance disturbance w/dysphagia, what could the possible cause be?
If you find focal easy fatigability (facial mm) w/dysphagia, what could the possible cause be?
If you find muscle fasciculation, wasting, weakness w/dysphagia, what could the possible cause be?
Motor neuron dz vs. neuropathy
If you find rapidly progressive/constant dysphagia w/o neuro findings, what could the possible cause be?
Eso. obstruction vs. probable CA
If you find a GI reflux SSx w/dysphagia, what could the possible cause be?
If you find intermittent dysphagia, what could the possible cause be?
LE ring vs. diffuse eso spasm
If you find slow progression (months -> yrs) dysphagia to solids/liquids w/nocturnal regurg., what could the possible cause be?
If you find a neck mass/thyromegaly w/dysphagia, what could the possible cause be?