1. A typical patient history consistent with globus sensation contains all of the following features except:

1. difficulty swallowing pills
2. unimpaired bolus transport
3. sore throat
4. sensation worse with meals
5. continued non-painful sensation of a lump or fullness in the throat

2. Findings on video esophagram that support a diagnosis of oropharyngeal dysphagia include:

1. delay in initiation of pharyngeal swallowing
2. aspiration
3. nasopharyngeal regurgitation
4. residual contrast in pharynx after swallowing
5. weak pharyngeal muscle contraction
6. incomplete UES (upper esophageal sphincter) relaxation

3. Xerostomia is

1. the name of a new anti-depressant
2. a variant of Sjogren’s syndrome
3. dry mouth
4. a type of dysphagia
5. a copy machine made by Xerox
6. a compulsive need to "xerox" everything

4. Conditions that may cause symptoms suggestive of oropharyngeal dysphagia include

1. xerostomia
2. phenothiazine use
3. Schatzki’s ring
4. globus
5. HMG-CoA reductase inhibitor use

True or False

    5.    A normal gag reflex can be present in patients with pharyngeal dysphagia, even in those with severe              pharyngeal dysfunction, and does not protect against aspiration.

    6.    Myotomy is not recommended for the treatment of oropharyngeal dysphagia secondary to neuropathic              or myopathic causes.

    7.   The presence of a cricopharyngeus bar on barium studies indicates that malfunction of the UES is the              likely cause of the dysphagia.

    8.   Gastrostomy feeding has been shown to prevent aspiration

    9.   A history indicating that food "catches" in the neck area is highly suggestive of oropharyngeal             
          dysphagia and virtually excludes distal esophageal obstruction.

  10.   Relaxation of the UES is sufficient to result in sphincter opening during swallowing

  11.  A small lateral pharyngeal diverticulum found during evaluation for dysphagia should not be assumed
          to be the cause of the dysphagia as they are frequently found incidentally in asymptomatic patients.

  12.  In alert patients with post-stroke dysphagia and symptoms of aspiration, the decision to place a PEG
         should be delayed at least 2 weeks, as spontaneous improvement may occur.

  13. Patients with post-stroke dysphagia may benefit from swallowing while turning their head towards the
        side of pharyngeal weakness.

14. Structural causes of oropharyngeal dysphagia that should be excluded include

1. epiphrenic diverticulum
2. ENT neoplasm
3. goiter
4. Zenker’s diverticulum
5. cervical osteophytes
6. hypertensive LES
7. B- ring

15. Symptoms indicative of pharyngeal dysfunction include