Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

VET433: Gastroenterology > Dysphagia & Regurgitation > Flashcards

Dysphagia & Regurgitation Flashcards

1
Q

history questions for dysphagic patients

A
  1. solids or liquids?
  2. intermittent or progressive?
  3. temporal pattern? (which phase of swallowing is affected)
  4. recent general anesthesia?
  5. age of onset
  6. dysphonia?
  7. odynophagia?
  8. recent medications?
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

ddx for dysphonia

A
  • myopathy
  • neuropathy
  • junctionopathy

ex. GOLPP (geriatric onset laryngeal paralysis + polyneuropathy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

localizing dysphagia

A
  1. oropharyngeal - oral, pharyngeal, cricopharyngeus muscle
  2. esophageal
  3. gastroesophageal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

BOAS

A

brachycephalic obstructive airway syndrome

  • hypoplastic trachea
  • elongated soft palate
  • hypertrophic tongue
  • stenotic nares
  • everted laryngeal saccules

predisposes brachycephalics to hiatal hernia due to increased negative intrathoracic pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

diagnostics for dysphagic/regurgitating patients

A
  1. observation
  2. PE
  3. neuro exam
  4. minimum database
  5. radiographs
  6. esophagram vs video fluoroscopy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what type of radiographs are indicated

A

3 view thoracic
1 lateral cervical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

esophagram vs video fluoroscopy

A

esophagram - static image at time intervals after swallowing barium bolus

video fluoroscopy - dynamic imaging of barium bolus moving throughout the swallow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

masticatory muscle myositis

A

immune mediated attack on the muscles of mastication

targets the 2M myofibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

clinical signs of MMM

A

inability to open jaw

acute: inflammation + pain
chronic: fibrosis + scarring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

diagnosis of MMM

A

2m antibody ELISA
muscle biopsy (if chronic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

treatment of MMM

A

immunosuppression
- corticosteroids
- cyclosporine

can NOT treat chronic cases when muscles already fibrosed down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

cricopharyngeus muscle dysfunction

A

failure of the UES to open or open at the correct time

two forms:
- achalasia
- asynchrony

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

CMD achalasia

A

failure of the UES to open

mini long hair dachshunds
toy breeds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

CMD asynchrony

A

failure of the UES to open at the same time as pharyngeal contraction

young golden retrievers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

clinical signs of CMD

A
  • regurgitation immediately after swallowing
  • WORSE with water
  • nasal reflux
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

diagnosis of CMD

A

video fluoroscopy

can NOT do static imaging

17
Q

treatment of CMD

A

ALWAYS modify water texture - ice, thickening agents

surgical: open myotomy of CP muscle

medical:
- botox of CP muscle
- pneumonic dilation of UES

18
Q

megaesophagus

A

dilation and loss of motility of the esophagus (primary or secondary)

primary: idiopathic
secondary:
- myasthenia gravis
- NM disease
- esophageal foreign body
- vascular ring anomaly
- esophageal neoplasia
- Addison’s disease

19
Q

clinical signs of megaesophagus

A

acute onset dysphagia
regurgitation
ptyalism
dysphonia

20
Q

esophageal achalasia like syndrome

A

common cause of megaesophagus

hypertonic LES preventing the bolus from entering the stomach

21
Q

types of treatment for megaesophagus

A
  1. management (for primary idiopathic ME)
  2. medical (for EALS)
  3. surgical (for EALS)
22
Q

management of primary idiopathic megaesophagus

A
  • modify diet (wet food)
  • elevated feeding (Bailey chair)
23
Q

medical treatment for EALS

A
  • botox of the LES
  • sildenafil (viagra)

temporary - only lasts 3-4 months

24
Q

surgical treatment for EALS

A
  • pneumonic dilation
  • heller myotomy + fundoplication
25
Q

heller myotomy + fundoplication

A

heller myotomy: incising into the LES and pulling the mucosa through the incision to release tension of hypertonic muscle

fundoplication: wrapping the fundus around the base of the esophagus in order to resolve potential reflux from heller myotomy alone

26
Q

myasthenia gravis

A

muscle weakness and fatigue caused by deficient Ach receptors

congenital vs acquired

27
Q

congenital myasthenia gravis

A

deficient Ach receptors at the NM junction

occurs in YOUNG PUPPIES

signs:
- exercise intolerance
- generalized weakness
- megaesophagus

diagnosis: muscle biopsy

28
Q

acquired myasthenia gravis

A

immune mediated attack on Ach receptors

occurs in ADULTS

signs:
- megaesophagus alone
- ME + generalized weakness

diagnosis: Ach receptor antibody test
- normal <0.6
- if Ab > 0.3 with acute clinical signs –> retest in 3-6 weeks

29
Q

hiatal hernia

A

stomach pushes through the diaphragm at the hiatus

common in brachycephalics due to BOAS and pyloric hypertrophy

30
Q

clinical signs of hiatal hernia

A

regurgitation
dysphagia
hypersalivation

31
Q

diagnosis of hiatal hernia

A

video fluoroscopy to ID esophageal dysmotility

32
Q

treatment of hiatal hernia

A

ALWAYS treat the BOAS before doing surgical hernia repair - can often resolve the hernia

surgical management is ideal - L sided gastropexy, esophagopexy, diaphragmatic hiatal plication

medical: PPIs, cisapride, LF diet

33
Q

esophagitis

A

inflammation of the esophagus

34
Q

common causes of esophagitis

A
  1. general anesthesia
  2. medication induced
  3. chronic vomiting
  4. foreign body
  5. ingestion of caustic material
35
Q

anesthesia induced esophagitis

A

occurs 1 week after anesthesia

drugs used for anesthesia + loss of swallow reflex/LES tone while unconscious –> reflux –> acidic contents remain in esophagus during duration of procedure

36
Q

what medications can cause esophagitis

A

doxycycline
clindamycin

37
Q

treatment of esophagitis

A

PPIs, H2 blockers
sucralfate
cisapride, metoclopramide
LF diet

38
Q

esophgeal strictures

A

narrowing of the lumen following esophagitis

common consequence of esophagitis caused by anesthesia, trauma, foreign body, etc

39
Q

treatment of esophgeal strictures

A

esophageal balloon dilation + antifibrotics

VET433: Gastroenterology (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions