Sunday, May 02, 2010

Finals Post 1 - Dysphagia

Dysphagia = difficulty in swallowing.

Causes: Mechanical, Motility and Others.

1. Mechanical - Benign , malignant, extrinsic pressure, pouch.

A. Benign - Oesophageal web ring (dunno, but i remembered because its so funny...web ring...), peptic stricture.

B. Malignant - Cancers of any 3 structures: Pharyngeal, oesophageal, and stomach

C. Extrinsic - Mass from nearby structures: Lung cancer, mediastinal - lymphnodes, lymphoma, aortic aneuryms, goitre...hmm..

D. Pharygeal pouch - food stuck in the blardy bag.

2. Motility - Neuro vs Non Neuro

Neuro: Bulbar palsy, stroke, GBS, MG,

Non: Systemic Sclerosis: CREST syndrome..just learned today, Achalasia (from malaysia), Chagas disease - like this.

3. Others - Food stuck at the stricture, psychiatric - globus thing. Oesophagitis caused by infection of candida.

Symptoms: Ask further info: pain? solid? liquid? Onset? Site? Getting better? PMH? etc etc etc. and all the GI questions la. From head down to asshole. Any vomiting, nausea? Mouth ulers? Waterbrash? Heartburn? Dyspepsia? Distension? Bowel habit? Jaundice? Shit blood? Vomit blood? what else? itu saja kot.

Signs - Cancer systemic signs. Weight loss, Anemia, Cachexic, Night sweats, erm....itu saja kot. And other signs of the differentials above.

Investigation:
1. Bloods: FBC (anaemia), U and E's (hydration), ESR (Any inflam? disease)...erm...itu saja kot.
2. Imaging: CXR. Barium. Upper GI endoscopy. Dx, biopsy and Rx.
3. Special test: Erm....tadak kot.

Management:
1. Underlying cause.
2. Endoscopy: Dilate the stricture.
2. Medical and surgical management as per cause.

Hooray. Spent sometime blogging...but feel good coz macam studying...

4 comments:

ihsan_huhu said...

wah dis blog is becoming academic

Windchaser said...

you should have started this since 1st year.

angchoonseong said...

argh

Pei said...

finally i manage to learn stg from your blog..