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15 Cards in this Set
- Front
- Back
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Three types of Dysphagia |
Oropharyngeal Mechanical Motor |
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Oropharyngeal Dysphagia Px Dx |
Px: coughing, choking, asp pna, nasal regurg Dx: Video Fluoroscopic swallowing test (MBS) |
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Motor Dysphagia 3 Most common, are SAD |
Scleroderma Achalasia Diffuse Esophageal Spasm |
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Achalasia Px Txt |
Px: Chronic, progressive, dysphagia to solids and liquids with regurgitation of UNDIGESTED FOOD
Txt: Surgery, pneumatic dilation, botox
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Achalasia Dx |
Dx: Manometry will show: 1. Failed LES relaxation. 2. HTN LES resting tone 3. Aperistalis of the esophgeal body. Also...Barium Esophogram- Bird's Beak Must also get EGD to r/o pseudoachalasia |
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Scleroderma Px Dx |
Px: chronic, progressive dysphagia with both solids and lidquids along withs ever heart burn and reflux
Dx: Barium Swallow Fluorscopy shows rigid esophagus and widely patent LES. Manometry shows Decreased tone of the LES |
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Diffuse Esophageal Spasm Px Dx Txt |
Dx: Barium imaging shows corkscrew esophagus
Txt: Trial of acid reflux meds |
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Mechanical Dysphagia Differential "PALE SEA" |
Peptic stricture Alkali-induced Strictures Lower Esophageal Ring (Schatzki Ring) Esophageal web (found throughout Eso)
Squamous Cell Carcinoma of Eso Esinophilic Esophagitis Adenocarcinoma of Eso |
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Eosinophilic Esophagitis Px Dx Txt |
Px: Young atopic men Dx: EGD shows concentric esophageal rings and biopsies show >15 eo's per Hpf. Txt: PPI and swallowed fluticasone |
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Esophageal Squamous Cell Carcinoma RF: Survival: |
RF: achalasia, lye-induced stricture, plummer-vinson syndrome HPV, tylosis, smoking and Etoh
Survival: 5 year 7-15% mortality 2/2 late presentation |
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H. Pylori Manifestations |
PUD/Duodenal Ulcers more common Atrophic Gastritis MALT Lymphoma Gastric Malignancy |
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H. Pylori Txt |
PPI based Triple Therapy PPI + Amoxicillin + Clarithromycin x10-14d |
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Zollinger-Ellison Syndrome Px Dx Txt |
Px Triad: Gastrin Hypersecretion (>1000) + PUD, esophagitis, diarrhea
Dx: Octreotide Scan
Txt: Surgery when possible. Not always feasible given that 50% are metastatic (think MEN-1) |
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Gastroparesis Px Dx Txt |
Px: N/V, bloating, early satiety, anorexia, weight loss Dx: 4hr gastric scintigraphy w/ a solid meal Txt: reglan or erythromycin which both have nasty side effects |
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Dumping Syndrome Def: Px: Txt: |
Def: hyperosmolar substances rapidly exiting the stomach into the small bowel
Px: diarrhea, bloating, sweating and palpitations in patient who had gastric antrum/pyloric resection
Txt: Diet modification w/ more fats and proteins
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