Dysphagia Mnemonic (difficulty swallowing):
Having trouble remembering all the important questions to ask during your patient encounter? Then try this Dysphagia Mnemonic (difficulty swallowing) for USMLE Step 2 CS.
PHYSICAL EXAMINATION Dysphagia mnemonic
NOTE: Make sure to wash your hands or wear gloves before you start physical examination. Make sure to ask for permission before you start each physical exam. Make sure to use proper draping (don’t forget to tie back patient’s gown). Make sure to explain each physical examination in layman’s term to your patient. Do NOT repeat painful maneuvers.
- HEENT: Check throat for erythema and exudate
- Neck exam: Check for lymphadenopathy, thyromegaly
- Cardiovascular exam: Auscultation
- Pulmonary exam: Auscultation
- Abdominal exam: Inspection, auscultation, palpation, percussion.
- Skin: check for signs of scleroderma/CREST.
DIFFERENTIAL DIAGNOSIS
- Esophageal cancer (Dysphagia starts with Solids and progresses to liquids. Hx of chronic alcoholism, smoking & weight loss )
- Achalasia (Dysphasia for BOTH solid and liquids)
- Esophagitis (Pain on swallowing. Immunocompromised “e.g. HIV, Corticosteroids”)
- Systemic Sclerosis (Look for CREST syndrome)
- Gastroesophageal Reflux Disease ‘GERD’ (Cough at nights, Hoarseness, sore throat)
- Plummer-Vinson syndrome (Iron deficiency anemia, sore throat, craving ice, dirt, clay…)
- Zenker diverticulum (Halitosis, regurgitation)
- Pill-induced esophagitis (e.g. Bisphosphonates)
- Mitral Stenosis (look for an immigrant or a pregnant female)
DIAGNOSTIC WORKUP
- CBC
- Serum iron, ferritin, TIBC
- Throat culture
- HIV antibody and viral load, CD4 count
- Chest X-ray
- Barium swallow
- Endoscopy
- Esophageal manometry
- Chest CT
USEFUL LINKS:
- BEST Tips on how to Pass USMLE Step 2 CS
- Physical Exam Videos
- BLUE SHEET Mnemonic (pdf file)
- CS Timer
- Official USMLE Step 2 CS Site
- Official Content Description & General Information Booklet (includes the list of abbreviation, you can use on your exam)
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Dysphagia Mnemonic (difficulty swallowing). Dysphagia Mnemonic (difficulty swallowing). Dysphagia Mnemonic (difficulty swallowing).