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Gastrointestinal > Clinical- Dysphagia > Flashcards

Clinical- Dysphagia Flashcards

1
Q

Define “dysphagia”

A

difficulty swallowing due to malfunctioning oropharyngeal or esophageal transport of food

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2
Q

What are the 3 main causes of dysphagia?

A
  1. oropharyngeal- bad transfer of a food bolus from the oropharynx to the esophagus
  2. mechanical- anatomically compromised esophageal lumen
  3. motor- motility disorder
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3
Q

Why might solid food cause dysphagia but liquid food not cause dysphagia?

A

mechanical obstruction

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4
Q

What might be the cause if there is dysphagia with both solid and liquid food?

A

Neuromuscular disorder

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5
Q

This is the first test that should be done in the evaluation of dysphagia.

A

Esophagogastrodueodenoscopy (EGD)

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6
Q

This is the faulty transfer of a food bolus from the oropharynx into the esophagus.

A

Oropharyngeal dysphagia

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7
Q

Amyloidosis, dermatomyositis, hyper/othryroidism, MG, and myopathies are classified as what causitive type of oropharyngeal dysphagia?

A

structural abnormalities

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8
Q

ALS, CVA’s, Huntingtons, MS, parkinsons and tetanus are classified as what causitive type of oropharyngeal dysphagia?

A

Neurological disorders

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9
Q

Cervical osteophytes, cricopharyngeal dysfxn, goiters, lymphadenopathy and zenker diverticulum are classified as what causitive type of oropharyngeal dysphagia?

A

Muscular disorders

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10
Q

This is the failure of the esophagus to relax due to degeneration of the Auerback ganglion cells in the LES.

A

Achalasia

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11
Q

What is the clinical presenstation of achalasia?

A

years of dysphagia to both solids and liquids, may vomit upundigested food, NO HEARTBURN cuz LES is always contracted

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12
Q

What shows on CXR for achalasia?

A

air-fluid level within the esophagus in advanced cases

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13
Q

What shows on barium esophagography for achalasia?

A

dilated esophagus with a beak-like tapering at the LES

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14
Q

What is the triad of conditions in achalasia?

A
  1. incomplete relaxation of the LES
  2. hypterensive LES
  3. aperistalsis in the esophageal body
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15
Q

Why must u do a EGD to rule out cancer in achalasia?

A

Cuz cancer could be infiltrating near the esphogaastric jxn and look the same way on radiographs

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16
Q

What is the bug that produces a neurotoxin that destroys the myenteric plexus, and produces achalasia?

A

Trypanosoma cruzi (Chagas)

17
Q

This autoimmune condition has secondary involvement with the esophagus, and presents as dysphagia with both solids and liquids and heartburn.

A

Scleroderma

18
Q

Break down the CREST acronym for scleroderma

A 
Calcinosis
Raynauds
Esophageal dysfunction
Sclerodactyly
Telangiectasias
19
Q

What will a barium study show for sclerodermal involvement of the esophagus?

A

rigid esophagus with widely patent LES, aperistalsis of the esophagus and decreased tone of the LES

20
Q

This condition presents as chest pain, intermittent dysphagia with solids or liquids, and can be aggravated by stress. Barium swallow shows a corkscrew esophagus.

A

Diffuse esophageal spasm

21
Q

This is the condition when the mere is mechanical compromise of the esophageal lumen to a diameter <12mm

A

Mechanical dysphagia

22
Q

What is the cause of peptic strictures?

A

prolonged GERD

23
Q

Where is the most common site of peptic strictures?

A

it’s a short narrowing of the distal esophagus immediately at or above the esophogastric jxn

24
Q

What are the 2 main causes of alkaline strictures?

A
  1. post-gastrectomy

2. Inducing vomiting after lye ingestion

25
Q

Lye-induced strictures are associated with an increased incidence of what type of cancer of the esophagus?

A

Squamous cell cancer

26
Q

This condition is in females with iron-deficiency anemias, and presents as glossitis with proximal esophageal webs/rings.

A

Plummer-vinson syndrome

27
Q

This is the most common benign tumor of the esophagus.

A

Leiomyoma

28
Q

How do leiomyomas appear on radiographs?

A

smooth, noncircumfrential filling defect with normal overlying mucosa located in the wall of the esophagus

29
Q

Achalasia, lye-induced strictures, plummer-vinson syndrome, HPV, tylosis, and smoking/drinking can predispose you to what type of cancer?

A

Squamous cell carcinomas

30
Q

What is the most common risk factor for adenocarciomas for the esophagus?

A

Barretts esophagus

31
Q

How do patients with esophageal carcinomas typically present?

A

Progressive dysphagia accompanied by weight loss

32
Q

So how do you treat esophageal cancers?

A

Surgical resection if early, chemo if advanced

33
Q

This term is for painful swallowing

A

Odynophagia

34
Q

What are the 2 most common causes of odynophagia?

A

inflammation or spasm

35
Q

What is the most common fungal infection to cause odynophagia?

A

candida albicans

Gastrointestinal (14 decks)

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