CSG Dysphagia & Swallowing Disorders 3

Question 1

In the IDDSI framework, which level describes 'thin' liquids such as water, coffee, and juice in their standard unmodified form?

Accepted Answer

Level 0 (Thin)

Answer

Level 1 (Slightly Thick)

Answer

Level 2 (Mildly Thick)

Answer

Level 3 (Moderately Thick)

Question 2

The supraglottic swallow technique is designed to protect the airway by instructing the patient to:

Accepted Answer

Inhale deeply, hold the breath before and during swallowing, then cough voluntarily after swallowing

Answer

Tilt the head laterally toward the stronger side before swallowing

Answer

Perform multiple dry swallows before attempting to swallow a bolus

Answer

Extend the neck during swallowing to widen the pharynx

Question 3

Fiberoptic Endoscopic Evaluation of Swallowing (FEES) is preferred over VFSS in which clinical scenario?

Accepted Answer

When radiation exposure must be minimized and bedside evaluation is needed

Answer

When precise measurement of pharyngeal transit timing is needed

Answer

When full assessment of the esophageal phase is required

Answer

When barium coating of the pharyngeal walls must be visualized

Question 4

Xerostomia (dry mouth), which is prevalent in older adults often due to polypharmacy, increases dysphagia risk primarily by:

Accepted Answer

Reducing the lubrication required for cohesive bolus formation and oral transit

Answer

Increasing salivary amylase concentration causing mucosal irritation

Answer

Thickening pharyngeal secretions that obstruct the airway

Answer

Causing esophageal dysmotility through autonomic dysfunction

Question 5

The Masako maneuver (tongue-holding maneuver) used in dysphagia rehabilitation primarily strengthens which swallowing structure?

Accepted Answer

Posterior pharyngeal wall via increased anterior bulging

Answer

Orbicularis oris muscle for improved lip closure

Answer

Upper esophageal sphincter through cricopharyngeal stretch

Answer

Epiglottis via active retroflexion exercise

Question 6

When determining nutritional support for an older adult with severe dysphagia and high aspiration risk, which principle should guide the clinical decision between enteral tube feeding and continued modified oral diet?

Accepted Answer

The patient's goals of care, quality of life preferences, and degree of aspiration risk must be weighed collaboratively

Answer

Enteral feeding is always preferred over any oral intake once aspiration is confirmed

Answer

Percutaneous endoscopic gastrostomy (PEG) tubes eliminate all nutritional deficiency risk

Answer

Modified textures should always be attempted before discussing tube feeding regardless of aspiration severity

Question 7

A gerontological nutrition specialist is evaluating a patient with Parkinson's disease who has progressive dysphagia. Which swallowing characteristic is most specific to Parkinson's disease-related dysphagia?

Accepted Answer

Reduced hyolaryngeal excursion due to rigidity and bradykinesia of swallowing musculature

Answer

Unilateral pharyngeal weakness causing food to collect on one side

Answer

Structural narrowing of the upper esophageal sphincter

Answer

Complete loss of volitional swallowing initiation