Prof Russell: Dysphagia

Question 1

2 phases of swallowing

Answer 1

initiation

deglutition

Question 2

if just solids

Answer 2

intraluminal obstruction

Question 3

if problems fluids and solids together?

Answer 3

possibly motility problem

Question 4

symptoms of Acid Reflux?

Answer 4

bitter taste
hoarse voice/laryngitis
nocturnal cough
morning nausea

Question 5

lips to the UES and diaphragm how long?

Answer 5

40cm to the lower esophageal sphincter (LES)

22cm to the Upper esophageal sphincter

Question 6

sliding hiatus hernia how to see the Z-line?

Answer 6

measure the Z-line is higher than diaphragm

Question 7

symptoms and endoscopy correlation?

Answer 7

Poor, could have big ulcer with little symptoms

Question 8

how does hiatus hernia cause dysphagia?

Answer 8

esophageal angina (comes on after eating, spasm looks like AMI)
stricture from chronic ulceration

Question 9

achalasia is?

Answer 9

no relaxation of lower esophageal reflux

Question 10

other factors that affect Lower esophageal sphincter?

Answer 10

avoid lying down (don't put them in a C-shape)
lose weight
fatty foods
avoid smoking
caffeine
\+++ventolin
anticholinergics (anti-depressants)
eat earlier

Question 11

achalasia manometry pressure?

regular LES pressure?

Answer 11

regular 25mmHg

Achalasia 60-70mmHg

Question 12

when to take the PPI?

Answer 12

15-30 min BEFORE your meal

Question 13

when to check for H. pylori eradication

Answer 13

C14 Urea breath test 2 months after

Question 14

esophagus drains where?

Answer 14

scalene nodes

Question 15

how much jejenum and ileum length do you have?

Answer 15

4m

Question 16

drugs that cause esophageal ulcers?

Answer 16

Slow K+
tetracycline
bisphosphinates
aspirin
NSAIDS

Question 17

def’n of Barrett’s oesophagus?

Answer 17

gastric looking epithelium lining the esophagus

Question 18

goblets cells where in GIT?

Answer 18

small intestines, NOT the stomach of esophagus

Question 19

PPIs if you stop, what happens?

Answer 19

reflex hypergastric secretion due to rebound and increased gastrin secretions

Question 20

dysphagia definition

Answer 20

sense of blocking or obstruction in the oesophagus