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GI signs symptoms dysphagia

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Question
Answer
Rationale
oropharyngeal dysphagia   difficulty in swallowing    
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esophageal dysphagia   difficulty having food pass from mouth down to the esophagus to the stomach    
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odynophagia   painful swallowing    
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alarm symptom that requires immediate evaluation to determine cause and treatment   odynophagia    
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orophagyngeal dysphasia   nasal regurgitation    
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esophageal dysphasia   sensation of food "sticking" after it is swallowed    
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clinical presentation of dysphagia   difficulty swallowing solids or liquids, trouble initiating swallow; coughing, choking, chest pain    
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prevention and screening of dysphagia: identify at risk persons   previous stroke, cervical spinal cord injury    
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symptoms associated with dysphagia   heartburn, weight loss, hematemesis, coffee ground emesis, anemia & regurgitation    
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physical exam for dysphagia   ENT, nueromuscular (CN V, VII, XII), pulmonary & cardiac exam    
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diagnostic workup for dysphagia   CBC & stool for occult blood-evaulate bleeding; LFT-evaluate metastic process; BUN, albumin-evaluate nutritional status; thryoid function test- rule out hypothyroidism; ECG & cardiac workup-if chest pain is presenting symptom; esophageal pH-evaluate GERD    
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standard test for diagnosis & management of esophageal diseases   endoscopy   allows for biopsy & definitive tissue diagnosis  
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often done first to differentiate between mechanical lesion and esophageal motlitiy problems   barium swallow or upper GI series   if a motlity problem is suspected barium swallow should be done first; if a mechanical lesion is suspected, an endoscopy is often done first  
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differential diagnosis for dysphagia   esophageal cancer, vascular rings, achalasia, radiation injury, scleroderma    
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achalasia   failure of lower esophageal sphincter to relax    
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standard for detecting and evaluating swallowing abnormalities   videofluroscopic swallowing studies    
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management of dysphagia   outpatient-if patient not malnourished & not at high risk for aspiration; goal-treat underlying cause & maintain nutritional status during workup; elderly may have poor fitting dentures that contribute to the problem; use thickened liquids    
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dysphagia: when to consult, refer, hospitalize   refer any patients with new symptoms and no obvious treatable cuase to GI, especially older patient, those with weight loss, bleeding, iron deficiency anemia, history of chronic GERD, heavy alcohol & tobacco use    
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etiology of dysphagia   structural abnormalities, muscular weakness or incoordination of swallow, peristalis or empyting of esophagus    
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