History Station – Dysphagia

Total Score: ………….

1 point each Check score
1. Proper introduction. 1
2. Solid, fluids or both. 1
3. Onset and duration. 1
4. Pain on swallowing. 1
5. Progression. 1
6. Indigestion, heart burn, abdominal pain. 1
7. Early satiety. 1
8. Fever, weight loss, anorexia. 1
9. Hoarseness of voice. 1
10. Chest pain, cough, wheezes. 1
11. Discoloration of the limbs, skin tightness. 1
12. Fatigue, ptosis, diplopia. 1
13. Past medical and surgical history. 1
14. Drug history. 1
15. Social history: smoking and alcohol. 1
16. Family history of any illness. 1
Q1: a 57 year old female patient complaining of difficulty
swallowing. Take a relevant history.
Q2: mention 2 possible diagnoses.
Q3: mention 2 investigations you want to do.

My name is Maria.
I have difficulty swallowing.
for both solids and liquids.
It was progressive.
GI symptoms +
constitutional symptoms +

rest of symptoms are negative -

past medical GERD.
past surgical free.
drug Hx free.
Family Hx of DM and HTN.
social history: smoker of 2 packs a day for 25 years. Drinker.

Q2: mention 2 possible diagnoses (2 points).

1. Esophegeal CA.
2. Achalasia.
3. GERD.
4. Hiatal hernia.

Q3: mention 2 investigations you want to do (2 points).

1. Endoscopy.
2. Barium swallow.
3. CT. MRI. Esophageal manometry. 24 hour PH monitoring.