Examination and investigations

Question 1

Dysphagia examination cranial nerve pathology?

Answer 1

important if it could be functional dysphagia.

Question 2

Dysphagia examination signs of GI malignancy?

Answer 2

cachexia, virchows lymphadenopathy, GI malignancies can metastisize in the liver, so hepatomegaly.

Question 3

Dysphagia examination neck mass?

Answer 3

maybe palpate large pharyngeal pouch in thin patients, A goitre maybe palpable causing extrinsic pressure, head and neck cancers can cause cervical lymphadenopathy.

Question 4

Dysphagia examination features of crest?

Answer 4

calcinosis, Raynauds phenomenon, Oesophageal dysmotility, sclerodactly, telangiectasia.

Question 5

Dysphagia examination Koilonychia?

Answer 5

iron deficiency.

Question 6

Dysphagia Barium swallow?

Answer 6

Monitor the passage of a bolus of barium contrast medium from the upper to the lower oesophageal sphincter while supine. Useful for patients with a high lesion as in endoscopy top parts intubated blindly. Barium swallow is also indicated in patients with suspected achalasia.

Question 7

Dysphagia barium swallow oesophageal cancer?

Answer 7

stricture

Question 8

Dysphagia barium swallow achalasia

Answer 8

birds neck appearance

Question 9

Dysphagia Endoscopy?

Answer 9

first line investigation for low dysphagia, allows treatment of lesions and biopsies and visualisation of luminal lesions.

Question 10

Dysphagia videofluoroscopy?

Answer 10

modified barium swallow for upright patient, therapist can modify technique throughout study, for functional dysphagia.

Question 11

Dysphagia manometry?

Answer 11

assess the pressure in the lower oesophageal sphincter and the peristaltic wave, key for diagnosing a motility disorder and distinguishing types.