Dysphagia Flashcards

1
Q

Define it

Intraluminal causes:

  • Infection - 4
  • Common in children
  • Also found in colon which is precancerous
A

Difficulty swallowing

Candiadiasis
Pharyngitis
Retropharyngeal abscess
Oesophagitis

Foreign body

Polyps

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2
Q

Intramural (in muscular layer) causes:

  • What can GORD cause?
  • Starts with A
  • Can be caused by iron deficiency anaemia
  • Similar to above
  • you can get these in any muscle of the body
A

Benign strictures - can also get malignant strictures

Achalasia

Oesophageal web

Oesophageal ring

Oesophageal spasm

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3
Q

Extramural causes:

  • Something pharyngeal
  • A type of hernia
  • Possibly involved in every compressive process
A

Pharyngeal pouch

Rolling hiatus hernia

Malignancy

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4
Q

Neurological causes:

List a few

A
Stroke
Myasthenia gravis 
MS
MND
Parkinson's
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5
Q

Mneumonic for history - MUNCH LOT

A
Movement 
Underweight 
Neck bulges 
Cough on lying 
Heartburn

Liquids
Odynophagia - painful swallowing
Time pattern

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6
Q

MUNCH LOT

What does difficulty making swallowing movement mean?

What does being underweight indicate?

What does a bulging neck when drinking indicate?

A

Bulbar/pseudobulbar palsy - have you had difficulty initiating swallowing

Malignancy - have you unintentional weight recently

Pharyngeal pouch - do you find your neck bulging or some gurgling when drinking?

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7
Q

MUNCH LOT

What does a cough on lying down mean? - 2

Has it been a problem with liquids and solids from start?

  • Yes???
  • No? - solids then liquids
A

Achalasia
Pharyngeal pouch

(The food is coming back up causing them to cough)

The food is going back up causing them to cough

Motility problem - systemic sclerosis, mysasthenia gravis
Pharyngeal problem

Stricture - benign or malignant

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8
Q

MUNCH LOT

What does heart burn indicate?

Do you have pain swallowing? - Yes

A

GORD

Cancer
Ulcer
Oesophageal spasm - relieved GTN

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9
Q

MUNCH LOT

Time:

What does it mean if it is:

  • intermittent
  • constant/worsening
  • both
A

Spasm

Malignant stricture

Achalasia

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10
Q

Signs on examination:

What does cachexia indicate?

What does Virchows node suggest?

What other examinations can you do for systemic disease?

A

Malnutrition

Intra-abdominal malignancy

Neuro exam - CNS disease

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11
Q

Investigations:

Why do FBC and U&E?

Imaging for general upper GI pathology?

Test for pharyngeal pouch?

How to test for dysmotility?

A

Anaemia
Dehydration

Upper GI endoscopy +/- biopsy

Barium/contrast swallow - pouch

Oesophageal manometry

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12
Q

Oesophageal spasm

2 symptoms

2 ways to investigate?

A

Intermittent dysphagia
Chest pain

Contrast swallow
Manometry

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13
Q

Achalasia

What is it?

Big differentiating symptom

A

LES fails to open during swallowing

Regurgitation of food

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14
Q

What causes a benign oesophageal stricture?

1 way to treat?

A

GORD
Surgery
Corrosives
Radiotherapy

Endoscopic balloon dilatation

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