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1- GIT Medicine > Dysphagia > Flashcards

Dysphagia Flashcards

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1
Q

Definition Dysphagia

A

Difficulty in eating due to disruption in swallowing process

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2
Q

Main symptom of oesophageal disease

A

Dysphagia

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3
Q

Complications of Dysphagia

A

Aspiration pneumonia
Malnutrition
Weight loss
Dehydration
Airway obstruction

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4
Q

Main dx of surgical importance leading to Dysphagia

A

Achalasia
Carcinoma
Corrosive Eosophageal stricture (accidental/suicidal)
Peptic oesophagitis
Esophageal atresia in neonates

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5
Q

2 types of classification of Dysphagia etiology

A

Anatomical
Systemic

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6
Q

Types of anatomical classification of causes of Dysphagia

A

Longitudinal
Transverse

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7
Q

Types of longitudinal etiology of Dysphagia

A

Pre œsophageal
Esophageal
Post Esophageal

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8
Q

Inflammatory pre eosophageal dx leading to Dysphagia

A

stomatitis
Tonsillitis
Pharyngitis
Ludwigs angina
Retropharyngeal abscess

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9
Q

Tumors in pre eosophageal dx leading to Dysphagia

A

Cancer of the tongue
Cancer of buccal cavity
Cancer of pharynx

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10
Q

Swellings in pre eosophageal dx leading to Dysphagia

A

Sublingual dermoid’
Lingual thyroid

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11
Q

Pharyngeal weaknesses/paralysis in pre eosophageal dx leading to Dysphagia

A

Bulbar paralysis
Poliomyelitis
myasthenia gravis

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12
Q

Congenital esophageal causes of Dysphagia

A

Atresia
Stenosis
Dysphagia lusoria

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13
Q

Oesophageal anatomical transverse classification

A

Luminal
Mucosa
Muscle
Extrinsic

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14
Q

Acquired intraluminal Oesophageal causes of Dysphagia

A

Foreign body
Food obstruction
Polyps

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15
Q

Acquired mucosal Oesophageal causes of Dysphagia

A

NSAIDS
potassium chloride tablets
Antibiotics -doxycycline, clindamycin, tetracycline
Radiation
Infection ( HIV, candida, herpes )

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16
Q

Acquired dx of wall Oesophageal causes of Dysphagia

A

Benign tumors
Carcinoma
Oesophagitis (corrosive, foreign body, reflux )
Neuromuscular dysfunction (Achalasia, diffuse spasm, spinal muscular atrophy, polymyositis, dematomyositis)
Perforation (foreign body, instrumentation )
Connective tissue dx (scleroderma)
Paterson Kelly syndrome
Diverticular dx
Barrett’s esophagus
Muscular dystrophies

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17
Q

Acquired extrinsic pressure Oesophageal causes of Dysphagia

A

Pharyngeal pouch
Intrathoracic goitre
Enlarged mediastinal lymph nodes
Mediastinal tumors
Aortic aneurysm

18
Q

Systemic classification of disease causing Dysphagia

A

Surgical;
Central
Endocrine
Psychogenic
Pharmacologic
Motility disorders

19
Q

Surgical causes of Dysphagia

A

laryngectomy
Pharyngectomy
Oesophagectomy
Head and neck surgery
Pharyngeal plexus in surgery
Tracheostomy

20
Q

Central causes of Dysphagia

A

decreased range of motion of muscles of mastication and bolus propulsion

Decreased sensation

Delayed or absent pharyngeal swallowing

Reduced pharyngeal peristalsis

Delayed or absent laryngeal adduction and elevation

21
Q

Effects of central Dysphagia

A

pocketing of food in mouth
Circumoral leakage
Early pharyngeal spill
Weak posterior tongue causin tongue thrusting

22
Q

CNS lesions leading to Dysphagia

A

Alzheimer’s dx
Brain tumors
Guillain barre syndrome
Huntington dx
CNS infection
Stroke
Traumatic brain injury
Parkinson dx
Poliomyelitis
Cerebral palsy
Multiple sclerosis
Amyotrophic lateral sclerosis

23
Q

Endocrine dx leading yo Dysphagia

A

Cushing syndrome
Hyperthyroidism
Hypothyroidism
Vitamin b12 deficient

24
Q

Presentation of psychogenic Dysphagia

A

oral apraxia
Intact speech
Intact pharyngoesophageal and neurologic function

25
Q

Drugs causing myopathies leading to Dysphagia

A

CNS depressants
Antipsychotics
Corticosteroids
lipid lowering agents
Colchicine
Aminoglycosides
Anticholinergic

26
Q

Drugs affecting mucosa leading to Dysphagia

A

potassium chloride tablet
NSAIDs
Antibiotics (doxycycline, tetracycline, clindamycin, trimethoprim-sulfamethoxazole )

27
Q

Motility disorder causing Dysphagia

A

diffuse esophageal spasm
Achalasia
Scleroderma
Cricopharyngeal dysfunction

28
Q

Main post esophageal dx leading to Dysphagia

A

Gastric carcinoma

29
Q

History key point

A

History of ingestion (accidental, suicidal, corrosive poisoning, foreign body, temporary dentures )

Duration of Dysphagia ( very short like inflammation /infection, long intermittent like in achalasia, long and progressive like in stricture, short and progressive like ion malignancy )

Pain for inflammation or trauma
Post prandial epigastric pain radiating retrosternally which worsens by bending in oesophagitis

Site of obstruction (mouth , throat, posteriorly to sternum , epigastric )

Fever in inflammation, perforation
Suppurative lung dx)

Weight loss

Solids but ot liquids - fixed obstruction or tight stricture

Liquids but not solid like in Achalasia

30
Q

Point to note in neck exam for Dysphagia

A

Lymph nodes
Goitres
Pharyngeal pouch
Surgical emphysema

31
Q

Points to note in general exam for Dysphagia

A

Weight loss
Dehydration
Manutrition

32
Q

Oropharynx exam in Dysphagia findings

A

carcinoma
Inflammatory lesions
Swellings
abnormalities demonstrating Paterson Kelly syndrome (cheilosis, Spoon shaped nails ,Smooth tongue )

33
Q

Chest exam findings in dysphagia

A

Sternum bulging with pulsation

Decreased breath sounds , rhonchi, wheeze in suppurative lung dx

34
Q

Abdominal exam findings in dysphagia

A

epigastric mass -gastric ca
Hepatomegaly
Localized or generalized tenderness

35
Q

Findings on hands suggesting scleroderma

A

Thickening and pigmentation/depigmentation

36
Q

CNS exam findings in dysphagia

A

Diplopia, drooping of eyelids , difficulty speaking in myasthenia gravis

37
Q

Imaging techniques required in case of dysphagia

A

Plain x ray
Barium swallow
Endoscopy

38
Q

Findings on X ray

A

foreign body
Retrosternal thyroid
Mediastinal swelling
Mega esophagus containing fluid

39
Q

Barium swallow findings

A

Diffuse irregularity in nutcracker oesophagus

Irregular filling defect - malignancy

Dilated oesophagus looking like birds beak in Achalasia

Strictures in corrosive injury

40
Q

Role of endoscopy

A

Diagnosis and cure
Helps determine cause, location, biopsy

41
Q

When is manometry useful

A

In neuromuscular disorder

42
Q

Lab investigation

A

24h ph - if low reflux of gastric secretion

FBC for iron deficiency anemia in Plummer Vinson/Paterson-Kelly syndrome

Edrophonium test in myasthenia gravis

1- GIT Medicine (20 decks)

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