EMQs in Clinical Medicine.pdf - Peshawar Medical College

Dysphagia 159
71 Dysphagia
A
B
C
D
E
F
bulbar palsy
pharyngeal pouch
Plummer–Vinson syndrome
obstructing foreign body
seventh nerve palsy
Sturge–Weber syndrome
G
H
I
J
K
L
oesophageal achalasia
retrosternal goitre
oesophageal carcinoma
caustic stricture
diffuse oesophageal spasm
globus hystericus
For each clinical scenario below, give the most likely cause for the dysphagia.
Each option may be used only once.
1 A 35-year-old woman presents with dysphagia for solid and liquids associated
with regurgitation and weight loss. Barium swallow shows a dilated tapering
oesophagus.
2 A 65-year-old smoker presents with a history of severe oesophagitis and
gradually worsening dysphagia.
3 A 28-year-old woman presents with a feeling of a lump in her throat that
causes some discomfort on swallowing. Examination and imaging of the
pharynx and oesophagus reveal no abnormality.
4 A 40-year-old man complains of intermittent dysphagia associated with chest
pain. Barium swallow reveals a corkscrew oesophagus.
5 A 55-year-old man presents coughing when he tries to swallow. On examination
he has a flaccid fasciculating tongue.
Answers: see page 185.