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Yr 3 Surgery General > Dysphagia > Flashcards

Dysphagia Flashcards

1
Q

Likely diagnosis if there was difficulty swallowing solids and liquids from the start

A

Motility disorder

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2
Q

Likely diagnosis if there is difficulty initiating the swallowing movement

A

Bulbar palsy

patient may cough on swallowing

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3
Q

What is the term used to describe painful swallowing?

A

Odynophagia

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4
Q

What is a possible cause of painful swallow?

A

ulceration

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5
Q

What is a possible cause of dysphagia without a painful swallow?

A

Spasm

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6
Q

What is a possible cause of intermittent dysphagia?

A

Oesophageal spasm

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7
Q

What is a possible cause of dysphagia that is constant and getting worse?

A

Malignant stricture

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8
Q

What is the likely diagnosis if the neck bulges or gurgles upon drinking?

A

Pharyngeal pouch

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9
Q

What is the relevance of Virchows node?

A

GI malignancy

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10
Q

What test could be done to confirm a pharyngeal pouch?

A

Contrast swallow

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11
Q

What test can be performed for dysmotility?

A

Oesophageal manometry

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12
Q

What can cause oesophagitis?

A

Complication of GORD

corrosives, NSAIDS, herpes, candida, duodenal ulcer, gastric ulcer, cancer

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13
Q

What would the PC of diffuse oesophageal spasm be?

A

Intermittent dysphagia +/- chest pain

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14
Q

What is achalasia?

A

Degeneration of the myenteric plexus leads to loss of coordinated peristalsis and a failure of the LOS to relax

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15
Q

What are the symptoms of achalasia?

A

Dysphagia, regurgitation, weight loss

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16
Q

Investigations for achalasia and what may they show

A

Manometry

Contrast swallow - shows dilated tapering oesophagus (birds beak)

17
Q

What is the treatment for achalasia?

A

Endoscopic balloon dilation
Hellers cardiomyotomy (then PPI)
Botox
CCB and nitrates to relax sphincter

18
Q

What are the benefits and problems with botox treatment for achalasia?

A

Non invasive

Has to be repeated every few months

19
Q

Name some causes of a benign oesophageal stricture

A

GORD
Surgery
Corrosives
Radiotherapy

20
Q

How can benign oesophageal stricture be treated?

A

Endoscopic balloon dilatation

21
Q

Name some risk factors for oesophageal cancer

A

Diet, alcohol excess, smoking, achalasia, reflux oesophagitis, barretts oesophagus, obesity, hot drinks, nitrosamine exposure, plummer-vinson, male

22
Q

What are the three features of Plummer-Vinson?

A

Post-cricoid dysphagia
Upper oesophageal web
Iron deficiency anaemia

23
Q

Where are most oesophageal cancers?

A

50% middle

20% upper, 30% lower

24
Q

What types of cancer can be found in the oesophagus and where?

A

Proximal -> Squamous cell

Distal -> Adenocarcinoma

25
Q

Test for oesophageal cancer

A

Oesophagoscopy with biopsy

26
Q

CNS causes of dysphagia

A

Stroke
Bulbar nerve palsy
ALS
MS

27
Q

What is globus?

A

Feeling like you have a lump in your throat

Feels like you can’t swallow

Yr 3 Surgery General (3 decks)

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