Clinical lectures

Question 1

What are the characteristics of heartburn?

Answer 1

Substernal discomfort
Radiation of pain towards mouth
Precipitation by meals and recumbancy
Amelioration with antacid use

Question 2

Associations of reflux

Answer 2

Increasing age 
Male 
Obesity 
Smoking 
Intellectual retardation 
Motility disorders 
Family history 
Supine position

Question 3

Symptoms of reflux

Answer 3

Heart burn 
Nausea 
Chest pain 
Flatulence 
Regurgitation 
Waterbrash

Question 4

Alarm features in GIT

Answer 4

Odynophagia 
Dysphagia 
Weight loss 
Haematemesis  
Malina 
Choking - especially nocturnal
Chronic NSAID use 
>40 
Family history of upper GIT cancer

Question 5

What are the grades of reflux oesophagitis?

Answer 5

A: one or more breaks in the mucosa no longer than 5mm that does not extend between tops of two mucosal folds

B: one or more breaks more than 5mm that does not extend between the tops of the two mucosal folds

C: One or more mucosal breaks that is continuous between the tops of two or more mucosa folds but which involves less than 75% of the circumference

D: One ore more mucosal breaks that involves at least 75% of the oesophageal circumference

Question 6

what is the step up treatment for reflux?

Answer 6

Antacids - H2RA - PPI

Question 7

Definition of diarrhoea

Answer 7

Abnormal passage of loose or liquid motions daily and/or stool volume >200ml/day

Question 8

What are the types of shock?

Answer 8

Cardiogenic
Hypovolaemic
Obstructive
Disruptive

Question 9

What are the clinical features of hypovolaemic shock?

Answer 9

Cool, pale 
Sweaty 
Tachycardia 
Hypotensive 
Signs of organ failure