Dysphagia Flashcards
1
Q
Cause of dysphagia
A
Mechanical block
Motility disorders
Others
2
Q
What types of mechanical block cause dysphagia
A
Malignant stricture -pharyngeal cancer -oesophageal cancer -gastric cancer Benign stricture - oesophageal web or ring -peptic stricture Extrinsic pressure -lung cancer -mediastinal lymph nodes -retrosternal goitre -aortic aneurysms -left atrial enlargement Pharyngeal pouch
3
Q
What motility disorders cause dysphagia ?
A
Achalasia Diffuse oesophageal spasm Systemic sclerosis Neurological bulbar palsy -pseudo bulbar palsy -Wilson’s or PD -syringobulbia -bulbar poliomyelitis - Chagas’ disease -Myasthenia gravis
4
Q
What other causes of dysphagia are there
A
Oesophagitis
Globus pharyngis
5
Q
Tests performed
A
FBC - anaemia
U&E - dehydration
Upper GI endoscopy +-biopsy
If suspect pharyngeal pouch consider contrast swallow +- ENT opinion
Video fluoroscopy may help identify neurogenic causes
Oesophageal manometry for dysmotility
6
Q
Signs to look for
A
Cachexic
Anaemic
Examine the mouth
Virchow mode - intracardiac abdominal malignancy
Systemic disease signs -systemic sclerosis
CNS disease
7
Q
Important red flags to ask
A
Weight loss
Lumps
Progressive dysphagia
Dyspepsia
