The Oesophagus -regurgitation & dysphagia Flashcards

1
Q

Regurgitation

A

Passive evacuation of food and/or fluid from oesophagus
Results from local mechanical events within oesophagus

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

Dysphagia

A

Difficulty swallowing

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

Differentiating between oropharyngeal and osophageal dysphagia

A

Oropharyngeal (oral, pharyngeal, cricopharyngeal)
Try & swallow repeatedly but gag, retch, struggle to drink & may eject food from mouth (immediately after eating)

Oesophageal
Usually only 1 swallowing attempt, may or may not be able to drink, may bring up food at any time after eating

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

Regurgitation versus vomiting

A

Nasusea is before vomitting not regurgitation
Retching before vomitting not regurgitation
Food partially digested in vomiting not regurgitating

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

Clinical signs of Aspiration pneumonia

A

Soft cough, dyspnoea, tachypnoea, pyrexia, lung crackles, +/- nasal discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Predilection site for aspiration pneumonia

A

Right middle lung lobe

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

Aspiration pneumonia Treatment

A

Oxygen therapy if needed
Fluid therapy if needed
Broad spectrum antibiotics
Nebulisation
Coupage

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

Oesophageal diseases can be split into 2 catergories which are…?

A

Obstructive E.g Foreign body, Neoplasia, Vascular ring anomaly
Functional E.g. Megaesophagus, Gastroesophageal reflux

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

Signs of oesophageal disease

A

Regurgitation
Dysphagia
+/- Odynophagia- Painful swallowing
+/- Ptyalism- Too much saliva
+/- Ravenous or reduced appetite
+/- Weight loss
+/- Respiratory signs due to secondary aspiration pneumonia

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

Type of contrast used in visualsing oesophagus

A

Barium sulphate

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

Vascular ring anomaly

A

Congenital vascular anomaly
Persistant right aortic arch (most common)
Causes significant narrowing & obstruction of oesophagus

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

Clinical signs of vascular ring anomaly

A

Start regurgitating when weaned
Often have weight loss & stunting

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

Breeds predisposed to vascular ring anomaly

A

GSDs & Irish Setters

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

Treatment to treat vascular ring anomaly

A

Surgery to transect ligamentum arteriosum

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

Foreign body treatment

A

Medical emergency
Stabilise patient
General anaesthesia
Endoscopic removal – 1st choice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What happens if you are unable to remove foreign body via endoscopic removal

A

Oesophagotomy or oesophagectomy
Oesophagotomy – incision into lumen
Oesophagectomy – removal of portion

17
Q

Strictures

A

Circular band of scar tissue
Secondary to severe oesophagitis

18
Q

Signs of strictures

A

Circular band of scar tissue
Secondary to severe oesophagitis

19
Q

Strictures diagnosis

A

Difficult to see on plain films
Contrast radiography
Number, length, location
Endoscopy

20
Q

Strictures treatment

A

Endoscopic balloon dilation
Followed by medical therapy for oesophagitis
+/- steroids to reduce recurrence

21
Q

Hiatal hernia

A

Stomach moves up chest

22
Q

Dogs predisposed to hiatal hernia

A

Shar-Pei, English/French bull dogs

23
Q

Hiatal hernia clinical signs for both congenital and acquired

A

Congenital – soon after weaning
Regurgitation, vomiting, hypersalivation, haematemesis, poor body condition, dyspnoea (AP)

24
Q

Hiatal hernia Treatment

A

Small hernia
Medical management for oesophagitis

Large hernia
Surgical management
Narrow oesophageal hiatus

25
Q

Give example of Parasitic granulomas of oesophagus

A

Spirocerca lupi- Ingestion of beetle
Immature adult worms migrate to oesophageal wall & mature
Adults form granulomatous nodules in oesophageal wall

26
Q

Treatment of Parasitic granulomas of oesophagus

A

Doramectin

27
Q

Breeds predisposed to Megaoesophagus

A

Irish setter, GSD, Great Danes
Clinical signs usually start at weaning

28
Q

Megaoesophagus diagnosis

A

Contrast radiography
Oesophagoscopy
Look for secondary causes

29
Q

Suggest secondary causes of Megaoesophagus

A

Myasthenia gravis
Severe oesophagitis
Hypoadrenocorticism
Generalised myopathy

30
Q

Myasthenia gravis (MG)

A

Chronic autoimmune disorder in which antibodies destroy the communication between nerves and muscle, resulting in weakness of the skeletal muscles

31
Q

Myasthenia gravis (MG) Diagnosis

A

Tensilon test – generalised only, non-specific
Acetyl choline receptor antibody assay - acquired only

32
Q

Myasthenia gravis (MG) Treatment

A

Pyridostigmine Injectible

33
Q

Oesophagitis Treatment

A

Small, low fat, high protein meals
+/- withhold food PO
Sucralfate liquid
Metoclopramide
Gastric acid secretory inhibitors (PPI)