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Questions and Answers
What is a potential consequence of a sharp object cutting through the oesophagus?
What is a potential consequence of a sharp object cutting through the oesophagus?
What symptoms should always be queried in a patient with potential dysphagia?
What symptoms should always be queried in a patient with potential dysphagia?
Which type of stricture can result from chronic gastroesophageal reflux?
Which type of stricture can result from chronic gastroesophageal reflux?
Which investigation is least useful for diagnosing dysphagia?
Which investigation is least useful for diagnosing dysphagia?
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Which clinical condition is characterized by widening of the oesophagus and is more common in elderly men?
Which clinical condition is characterized by widening of the oesophagus and is more common in elderly men?
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Which condition is associated with trismus due to irritation of the masseter muscles?
Which condition is associated with trismus due to irritation of the masseter muscles?
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What serious effect can occur due to battery ingestion?
What serious effect can occur due to battery ingestion?
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What is a common local cause of dysphagia associated with poorly masticated food?
What is a common local cause of dysphagia associated with poorly masticated food?
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How is a caustic burn from a foreign body best characterized?
How is a caustic burn from a foreign body best characterized?
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What is a common symptom associated with epiglottitis?
What is a common symptom associated with epiglottitis?
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Which of the following is NOT a cause of dysphagia related to oropharyngeal factors?
Which of the following is NOT a cause of dysphagia related to oropharyngeal factors?
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Which type of stricture results from gastroesophageal reflux?
Which type of stricture results from gastroesophageal reflux?
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What condition is caused by iron deficiency anemia and leads to an anatomical abnormality in the oesophagus?
What condition is caused by iron deficiency anemia and leads to an anatomical abnormality in the oesophagus?
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Which intervention may assist a patient with a foreign body obstruction in the esophagus?
Which intervention may assist a patient with a foreign body obstruction in the esophagus?
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Which condition is NOT typically associated with oropharyngeal causes of dysphagia?
Which condition is NOT typically associated with oropharyngeal causes of dysphagia?
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Which of the following is a potential neurological cause of dysphagia?
Which of the following is a potential neurological cause of dysphagia?
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Study Notes
Dysphagia Study Notes
- Definition: Difficulty swallowing
- Duration: Information about how long the difficulty has persisted is crucial.
- Type of Diet: Solids only or solids and liquids? Important for assessment.
- Symptoms: Dysphonia (hoarseness) and dyspnoea (difficulty breathing), cough, vomiting, haematemesis (vomiting blood), regurgitation (bringing up food) are all potential signs. Regurgitation may point to a pharyngeal pouch. Weight loss may indicate a serious underlying condition, such as cancer
- Risk Factors: Alcohol and tobacco use.
- Physical Exam: Often limited unless severe cachexia (wasting) is present. Checks for anaemia and signs of pallor. A neck lump might be noted.
- Investigations: Basic blood tests (CBC), barium swallow, and oesophago-gastroduodenoscopy (OGD) are common initial investigations. Ultrasound of the neck and CT/MRI scans can aid diagnosis, especially in identifying possible causes.
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Causes (Oropharyngeal):
- Tonsillitis, quinsy (peritonsillar abscess), causing trismus (difficulty opening the jaw).
- Tongue and palate tumours or trauma.
- Epiglottitis (inflammation of the epiglottis), often presenting with odinophagia (painful swallowing) and some hoarseness.
- Ill-fitting dentures.
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Causes (Local - Intraluminal):
- Foreign bodies, such as large meat boluses (poorly chewed meat), sharp objects, or batteries. Foreign bodies may require specific removal techniques.
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Causes (Local - Luminal):
- Tumours in the oesophagus.
- Strictures (narrowing of the oesophagus), potentially from malignant disease, caustic injury, or oesophagitis (inflammation from acid reflux).
- Zenker's diverticulum (bulge in the oesophagus)
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Causes (Oesophageal):
- Oesophageal atresia and/or tracheo-oesophageal fistula
- Achalasia (weakening of the muscles in the oesophagus)
- Plummer-Vinson syndrome (oesophageal web) associated with iron deficiency anaemia.
- Diffuse spasm.
- Scleroderma (an autoimmune disease affecting smooth muscle).
- Chagas' disease (rare parasitic infection causing oesophageal spasm).
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Causes (Extraluminal):
- Thyroid tumours, goitre, lymph nodes (mediastinal), lymphoma, bronchogenic carcinoma (lung cancer), large aortic aneurysm, cardiomegaly, aberrant subclavian artery, osteophytes (bone spurs).
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Causes (General):
- Neuromuscular disorders like Amyotrophic Lateral Sclerosis (ALS).
- Stroke.
- Myasthenia gravis.
- Bulbar palsy.
- Encephalitis.
- Hysteria (rarely).
- Important Note: Accurate diagnosis and management of dysphagia require thorough evaluation and often involve consulting with other specialists.
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Description
Explore key concepts and factors related to dysphagia, including its definition, duration, symptoms, and potential causes. This quiz also covers risk factors, physical examinations, and investigations necessary for proper diagnosis. Use this study material to test your knowledge on this critical topic.
