Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GENERAL SURGERY > APPROACH TO DYSPHAGIA > Flashcards

APPROACH TO DYSPHAGIA Flashcards

1
Q

Common causes of dysphagia

A

Benign- peptic stricters
Motility disorders (achalasia)
Diverticulae (e.g Zenkers)

Malignant- oesophageal cancer
Extrinsic compression (thyroid/ other neck masses)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Types of oesophageal cancer

A

Squamous cell carcinoma
Adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

11 SCC risk factors

A

Alcohol
Smoking
Achalasia
Tylosis
Caustic injury
Radiation
Poor oral health
Low socioeconomic conditions
Poor diet
Plummer- Vinson syndrome
Prev head/neck SCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

8 Adenocarcinoma risk factors

A

Obesity
GORD
Males
Family history
Diet: low in fruit and veg
Radiation
Smoking
Increased age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q
  1. CXR findings in dysphagia
A

Bulky superior mediastinal silhouette (may see air fluid level if oesophagus dilated)
Pleural collection
Pulmonary nodules (metastases)
Pulmonary infiltrates/ opacification (aspiration/TOF)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Barium swallow in dysphagia 5

A

Mucosal irregularity
Irregular stricture with proximal dilatation of the oesophagus
Shouldering / Obvious mass lesions
Presence of TOF
Look for features of irresectability(advanced disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Features of irresectability(advanced disease) in dysphagia

A

Length> 8cm
Angulation > 30 degrees
Axis deviation > 2cm
Fistulae
Sinuses / Fissuring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

4 Investigations in dysphagia

A

CXR
Barium swallow
Flexible endoscopy + biopsy
Endoscopic ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

2 Endoscopic ultrasound indications

A

For T-stage evaluation (Depth of invasion through oesophageal wall)
May also be used to sample suspicious lymphadenopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

SCC

A

Proximal 2/3 of oesophagus
Lymphatic spread to cervical, mediastinal and abdominal nodes
Spreads in linear fashion (submucosal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Adenocarcinoma

A

Distal 1/3 and gastric cardia involved
Associated with GERD, Barrett’s
Spread transversely through the wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Palliation for advanced oesophageal cancer

A
  1. Endoscopic -dilation, stent
  2. RadioXT- Intraluminal/ Brachy/ Selectron/ ext beam radiation

3.Operative- stent, surgical bypass

  1. Analgesia
  2. Dietary modification
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Peptic stricture Ix

A

Barium swallow (to check extent of stricture)
Endoscopy and biopsy (to exclude malignancy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Peptic stricture Mx

A

Manage reflux with PPIs
Progressive dilation
Oesophagectomy only in pts with failed dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Achalasia Ix

A

CXR
Ba swallow
Endoscopy
Manometry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Achalasia treatment modalities (5)

A

1.Medical Treatment
2.Endoscopic Botox Injection
3.Pneumatic (Balloon) Dilatation
4.Surgical Myotomy
5.Peoral Endoscopic Myotomy (POEM)

GENERAL SURGERY (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions