Barium Swallow - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 05-06-2013
USMLE Forums Addict
 
Steps History: Step 1 Only
Posts: 122
Threads: 45
Thanked 57 Times in 34 Posts
Reputation: 67
GIT Barium Swallow

Was wondering if a pt a has difficulty swallowing and if asked best initial test to do would Barium Swallow be the choice or endoscopy?

Same with a pt you suspect with cancer - Barium or endoscopy as best initial test?

Thou endoscopy will have to be ultimately done, but to decrease the change of causing a perforation by doing Barium 1st to see if anything can cause perforation before blindly stick a scope down the pt.
Reply With Quote Quick reply to this message



  #2  
Old 05-06-2013
USMLE Forums Addict
 
Steps History: 1+CK+CS
Posts: 145
Threads: 4
Thanked 120 Times in 75 Posts
Reputation: 130
Default

There are some situations where barium would be the initial test of choice (achlasia for one), and there are others when you would do endoscopy first (i.e when there are *alarm symptoms* present, lye ingestion is an odd one where despite the possibility of esophageal perforation, you always do upper endoscopy asap). In the case of suspected esophageal perforation, contrast dye is contraindicated so you do a water esophagram. For suspected Barret you would have to do upper endoscopy to get a biopsy. My explanation may not be as good but I think in order to explain I would have to write a fairly long post explaining individually each and every disease. My suggestion would be to do a quick read of the first few pages of IM GIT from Kaplan notes. Beware of the *alarm symptoms* in patients, for them upper endoscopy is the always the right answer. Hope this helps. Good luck.
Reply With Quote Quick reply to this message
The above post was thanked by:
gear2d (05-06-2013)
  #3  
Old 05-06-2013
USMLE Forums Addict
 
Steps History: Step 1 Only
Posts: 122
Threads: 45
Thanked 57 Times in 34 Posts
Reputation: 67
Default

Thank you drsaid. I know what you mean. I was listening to Pestana on my way to rotation and he stated that if problem with swallowing you do Barium 1st. Then if motility issue to manometery. If cancer then do Endo. Was confused since MTB states Barium might be best initial test but do not mention why it is and is not in terms of cancer. Also in case of motility MTB states to do endoscopy after barium.

So
Cancer -> Barium -> endo + BX -> if positive -> do CT and PET (PET to see if resectable or not)

Achalasia -> Barium -> Endo (espically do this in pt above 60 because of Cancer) -> Tx on endo findings
Reply With Quote Quick reply to this message
 
  #4  
Old 05-06-2013
venky2600's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,186
Threads: 119
Thanked 821 Times in 434 Posts
Reputation: 831
Send a message via Yahoo to venky2600
Post

sorry, i think for achalasi--accurate is manometry not endo...
Reply With Quote Quick reply to this message
The above post was thanked by:
gear2d (05-06-2013)
  #5  
Old 05-06-2013
USMLE Forums Addict
 
Steps History: Step 1 Only
Posts: 122
Threads: 45
Thanked 57 Times in 34 Posts
Reputation: 67
Default

Quote:
Originally Posted by venky2600 View Post
sorry, i think for achalasi--accurate is manometry not endo...
Sorry you are correct. But you would still do endo to confirm the Barium study or go straight to manometry? Thou in pt over 60 you would do endo after barium to makesure no cancer. But in young pt go starlight for manometry after barium?
Reply With Quote Quick reply to this message
  #6  
Old 05-08-2013
venky2600's Avatar
USMLE Forums Master
 
Steps History: 1+CK+CS+3
Posts: 1,186
Threads: 119
Thanked 821 Times in 434 Posts
Reputation: 831
Send a message via Yahoo to venky2600
Post

Quote:
Originally Posted by gear2d View Post
Sorry you are correct. But you would still do endo to confirm the Barium study or go straight to manometry? Thou in pt over 60 you would do endo after barium to makesure no cancer. But in young pt go starlight for manometry after barium?
yes, we do manometry directly after barium in pts less than 60 yrs age

in 60 yrs age if achalasia features exist it's more likely neoplasm(pseudo achalasia) ---so should undergo endocsopy..----source uworld

and also endoscopy should be done in any pts if wt. loss, fecal occult blood +ve ,anemia (with no other clear reasons ) are seen..
----------source mtb 2ck

hope it helps....
Reply With Quote Quick reply to this message
The above post was thanked by:
PassIton (05-08-2013)



Reply

Tags
Gastroenterology-

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


Similar Threads
Thread Thread Starter Forum Replies Last Post
why gastrograffin study and not barium in esophageal perforation? bigBOSSguy USMLE Step 2 CK Forum 2 04-25-2013 12:21 PM
Dysphagia Investigation; Barium or Endoscopy! tyagee USMLE Step 2 CK Forum 1 07-14-2012 04:56 PM
Choking and abnormal Barrium swallow USMLE-Syndrome USMLE Step 2 CK Forum 5 06-26-2011 01:11 PM
Therapeutic Barium Enema? Seetal USMLE Step 2 CK Forum 0 04-21-2011 08:46 PM

RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)