EMQ: 11
Dysphagia
a)
Pharyngeal pouch
b)
Carcinoma of the oesophagus
c)
Benign stricture of the oesophagus
d)
Left atrial dilatation
e)
Aneurysm of the aorta
f)
Achalasia of the cardia
g)
Systemic sclerosis
h)
Bulbar palsy
i)
Impacted foreign body
j)
Schatzki ring
Match the description below to one of the conditions
listed above
1) A 70-year-old female with difficulty in swallowing.
She has not lost any weight. She has a history of rheumatic fever as a child
and on examination she is in atrial fibrillation, has a tapping apex and a
loud first heart sound with a rumbling mid-diastolic murmur best heard just
medial to the apex beat.
2) A 63-year-old male has a long-standing history of
gastro-oesophageal reflux disease. He does not use the medications prescribed
but uses antacids as required. He complains of difficulty in swallowing but
has not lost any weight.
3) A 67-year-old male with a history of ischaemic heart
disease and stroke presents with a few months difficulty in swallowing. To
begin with it affected solids more than liquids but he is now having
difficulty with liquids as well. He has lost weight.
4) A 35-year-old male has long standing difficulty in
swallowing. He has difficulty with both solids and liquids. He has not lost
weight. Endoscopy shows a dilated oesophagus with food debris in it.
5) A 54-year-old male presents as an emergency with
sudden onset of pain in his chest and difficulty in swallowing. This came on
whilst he was having a meal in a restaurant. There is complete dysphagia with
inability to swallow saliva.
