Dysphagia :: PLAB 2 Symptomatic Differential Stations

• Oesophageal cancer:

  • Other presenting symptoms: 

    • Initially liquids and progressed to solids

    • FLAWS

  • Past history and PMAFTOSA: 

    • Rule out myasthenia (diplopia, weakness, fatigue)

    • Smoking 

    • Rule out ingestion of corrosive substances

  • Social:

    • Life effects

    • Work, Nutrition

    • Mood, living situation

  • Exam and Invs:

    • GPE, vitals

    • Abdominal examination

    • Oral cavity examination

    • Lymph nodes

    • Endoscopy

  • Referral:

    • Immediate gastro admission if not able to eat at all

    • Urgent referral if able to eat a little

  • Treatment: 

    • NG tube/IV fluids if admitting

    • General advice:

      • Stop smoking

      • Eat liquid foods

      • Support groups

  • Warning signs:

    • If completely unable to ingest anything 

    • Vomiting blood

    • Drowsiness, confusion