NURS 5461 GI Questions With
Expert Solutions 100% Pass
dysphagia - CORRECT ANSWER-Subjective sebsation of difficulty
swallowing May be due to physiological or anatomical abnormalities along any
portion of the esophagus, including the upper and lower sphincters An alarm
symptom that must prompt evaluation and should never be attributed to normal
aging without an appropriate evaluation
Dysphagia Types - CORRECT ANSWER-oropharyngeal (above the esophagus)
and esophageal-->most common is achalasia-disorder of esophageal nerves
preventing food movement.
Structural starts with solids r/o malignancy (adenocarcinoma distal esophagus)
infection involves PAINFUL swallowing, viral (CMV usually immunosuppressed)
or fungal (candida-inhaled asteroid)
Chewing [mastication] - CORRECT ANSWER-involves CNV [trigeminal], CNVII
[facial], CNIX [glossopharyngeal], and CNXII [hypoglossal], in addition to muscles
of jaw, cheeks, tongue and palate
,Clinical characteristics of Dysphagia - CORRECT ANSWER-Problems in the oral
phase include - Poor bolus control - Spillage from lips or into pharynx - Dry oral
membranes (xerostomia) - Pocketing of oral residue - Difficulty with chewing
Pharyngeal dysphagia results from
weakness or poor coordination of pharyngeal
muscles, which can cause→
- Delayed swallowing
- Failure of airway protection
- Nasal or oral regurgitation
- Residue remaining in pharynx after swallowing
manifested as coughing, choking or gurgling
Clinical Presentation - CORRECT ANSWER-- Short duration with weight loss
suggests malignancy - Abrupt onset associated with neuro changes suggests CVA
¼ - ½ of new stoke patients will have dysphagia
gradual progressive onset-PD, ALS, MG
medications that can contribute to Dysphagia - CORRECT ANSWER-
Antidepressants, Antihistamines, Fosamax, NSAIDS, K, Fe, Nitates, BB, CCB
COPYRIGHT ©️ 2025, ALL RIGHTS RESERVED.
,diagnostics for dysphagia - CORRECT ANSWER- Cineesophagram (video
swallow study or videofluoroscpy) Modified barium swallow, endoscopy NOT
helpful, alone but may need to r/o other causes
DDx dysphagia - CORRECT ANSWER-Acute inflammation [infection; bone and
mucosal disorders] Stroke syndromes and vascular disorders Myasthenia Gravis
Dementias Chemical agents Parkinson's disease Neuromuscular esophageal
disorders Multiple Sclerosis Medications Huntington's disease Scleroderma
Tuberculosis Muscle anomalies Tetanus Achalasia Syphilis Pharyngoesophageal
diverticulum ALS Diffuse spasm NeoplasmsCarcinoma Recurrent laryngeal
neuropathies Degenerative disorders Irradiation Guillain-Barre' syndrome
Psychopathology Esophageal stenosis Diabetes Feeding phobias Esophageal webs,
rings or stricture Cerebral palsy Sensory deficits
Management of Dysphagia - CORRECT ANSWER-Medication review,
particularly focusing on anticholinergic drugs Oropharyngeal dysphagia:
Swallowing rehabilitation, dietary modifications such as thickening liquids, or
careful hand feeding Achalasia: Surgical or endoscopic myotomy (SOE=A);
injection of the lower esophageal sphincter with botulinum toxin may provide
months of symptomatic relief in patients who are not surgical candidates
Spastic motility disorders: Calcium channel blockers or phosphodiesterase
inhibitors may provide relief (SOE=B) Strictures: Endoscopic dilation has a
very high success rate, although patients often require ongoing medical treatment
, of the underlying cause as well Aspiration and Nonoral Feeding in Dysphagia
of Functional Origin - Patients with severe aspiration, which is not treatable with
dietary or positional modifications, should receive nonoral feedings to prevent
aspiration Head positioning, swallowing maneuvers and dietary textural
modifications seem to demonstrate clear evidence of benefit in treating functional
dysphagia - Refer to speech pathologist for evaluation
Indications for Hospitalization/Referral - CORRECT ANSWER-Dietary
consultation GI consult Will need intervention if patient has structural problem
Speech therapy Neurology may be needed
Dyspepsia (heartburn) - CORRECT ANSWER- Most commonly associated
with peptic ulcer disease, GERD, biliary colic, or medication-induced discomfort
Whether gastritis due to Helicobacter pylori can cause symptoms of dyspepsia
is debated Consider prompt endoscopy in older adults because of the
increased rate of organic disease, including malignancy ➢ Associated with
significant reduction in PPI use and improved qualify of life (SOE=B) ➢ Safe for
older adults who are otherwise healthy ➢
Differential Diagnoses Dyspepsia - CORRECT ANSWER- Heartburn is
occasionally described as extreme—and may make if difficult to differentiate from
angina or MI These folks describe pain as radiating to the back, arms or jaw—
COPYRIGHT ©️ 2025, ALL RIGHTS RESERVED.
Expert Solutions 100% Pass
dysphagia - CORRECT ANSWER-Subjective sebsation of difficulty
swallowing May be due to physiological or anatomical abnormalities along any
portion of the esophagus, including the upper and lower sphincters An alarm
symptom that must prompt evaluation and should never be attributed to normal
aging without an appropriate evaluation
Dysphagia Types - CORRECT ANSWER-oropharyngeal (above the esophagus)
and esophageal-->most common is achalasia-disorder of esophageal nerves
preventing food movement.
Structural starts with solids r/o malignancy (adenocarcinoma distal esophagus)
infection involves PAINFUL swallowing, viral (CMV usually immunosuppressed)
or fungal (candida-inhaled asteroid)
Chewing [mastication] - CORRECT ANSWER-involves CNV [trigeminal], CNVII
[facial], CNIX [glossopharyngeal], and CNXII [hypoglossal], in addition to muscles
of jaw, cheeks, tongue and palate
,Clinical characteristics of Dysphagia - CORRECT ANSWER-Problems in the oral
phase include - Poor bolus control - Spillage from lips or into pharynx - Dry oral
membranes (xerostomia) - Pocketing of oral residue - Difficulty with chewing
Pharyngeal dysphagia results from
weakness or poor coordination of pharyngeal
muscles, which can cause→
- Delayed swallowing
- Failure of airway protection
- Nasal or oral regurgitation
- Residue remaining in pharynx after swallowing
manifested as coughing, choking or gurgling
Clinical Presentation - CORRECT ANSWER-- Short duration with weight loss
suggests malignancy - Abrupt onset associated with neuro changes suggests CVA
¼ - ½ of new stoke patients will have dysphagia
gradual progressive onset-PD, ALS, MG
medications that can contribute to Dysphagia - CORRECT ANSWER-
Antidepressants, Antihistamines, Fosamax, NSAIDS, K, Fe, Nitates, BB, CCB
COPYRIGHT ©️ 2025, ALL RIGHTS RESERVED.
,diagnostics for dysphagia - CORRECT ANSWER- Cineesophagram (video
swallow study or videofluoroscpy) Modified barium swallow, endoscopy NOT
helpful, alone but may need to r/o other causes
DDx dysphagia - CORRECT ANSWER-Acute inflammation [infection; bone and
mucosal disorders] Stroke syndromes and vascular disorders Myasthenia Gravis
Dementias Chemical agents Parkinson's disease Neuromuscular esophageal
disorders Multiple Sclerosis Medications Huntington's disease Scleroderma
Tuberculosis Muscle anomalies Tetanus Achalasia Syphilis Pharyngoesophageal
diverticulum ALS Diffuse spasm NeoplasmsCarcinoma Recurrent laryngeal
neuropathies Degenerative disorders Irradiation Guillain-Barre' syndrome
Psychopathology Esophageal stenosis Diabetes Feeding phobias Esophageal webs,
rings or stricture Cerebral palsy Sensory deficits
Management of Dysphagia - CORRECT ANSWER-Medication review,
particularly focusing on anticholinergic drugs Oropharyngeal dysphagia:
Swallowing rehabilitation, dietary modifications such as thickening liquids, or
careful hand feeding Achalasia: Surgical or endoscopic myotomy (SOE=A);
injection of the lower esophageal sphincter with botulinum toxin may provide
months of symptomatic relief in patients who are not surgical candidates
Spastic motility disorders: Calcium channel blockers or phosphodiesterase
inhibitors may provide relief (SOE=B) Strictures: Endoscopic dilation has a
very high success rate, although patients often require ongoing medical treatment
, of the underlying cause as well Aspiration and Nonoral Feeding in Dysphagia
of Functional Origin - Patients with severe aspiration, which is not treatable with
dietary or positional modifications, should receive nonoral feedings to prevent
aspiration Head positioning, swallowing maneuvers and dietary textural
modifications seem to demonstrate clear evidence of benefit in treating functional
dysphagia - Refer to speech pathologist for evaluation
Indications for Hospitalization/Referral - CORRECT ANSWER-Dietary
consultation GI consult Will need intervention if patient has structural problem
Speech therapy Neurology may be needed
Dyspepsia (heartburn) - CORRECT ANSWER- Most commonly associated
with peptic ulcer disease, GERD, biliary colic, or medication-induced discomfort
Whether gastritis due to Helicobacter pylori can cause symptoms of dyspepsia
is debated Consider prompt endoscopy in older adults because of the
increased rate of organic disease, including malignancy ➢ Associated with
significant reduction in PPI use and improved qualify of life (SOE=B) ➢ Safe for
older adults who are otherwise healthy ➢
Differential Diagnoses Dyspepsia - CORRECT ANSWER- Heartburn is
occasionally described as extreme—and may make if difficult to differentiate from
angina or MI These folks describe pain as radiating to the back, arms or jaw—
COPYRIGHT ©️ 2025, ALL RIGHTS RESERVED.
