Disorders Of Upper GI

Question 1

What type of abdominal tenderness is seen in gastritis?

Answer 1

Localised tenderness not four quadrant

Question 2

Hypotension, pyrexia and tachycardia are all signs of what?

Answer 2

Septic shock

Question 3

What type of abdominal tenderness is seen in a perforated bowel gastric ulcer?

Answer 3

Four quadrant tenderness

Question 4

What is characteristic on the x-ray of someone with a perforated gastric ulcer?

Answer 4

Rigler sign - air bubbles bilaterally under the diaphragm (black space)

Question 5

How would you manage a patient in septic shock with a perforated duodenal ulcer?

Answer 5

NBM
IV fluids and broad spectrum antibiotics
NG tube
Laparoscopic omental patch

Question 6

How does an anterior gut perforation differ in presentation from a posterior gut perforation?

Answer 6

Anterior = air on x-ray
Posterior - bleeding

Question 7

Which artery is the most common cause of the bleeding seen in a posterior perforated gastric ulcer?

Answer 7

Gastroduodenal artery

Question 8

Severe, constant upper abd. Pain associated with vomiting, tenderness and guarding in the epigastrium with elevated bilirubin, CRP and amylase are indicative of what condition?

Answer 8

Pancreatitis

Question 9

what criteria is used to establish the severity of pancreatitis>?

Answer 9

Modified Glasgow criteria for acute pancreatitis

Question 10

What is the first investigation done for suspected pancreatitis?

Answer 10

Ultrasound

Question 11

What is measured in the modified Glasgow criteria for acute pancreatitis?

Answer 11

PaO2
Age
Neutrophilia
Calcium
Renal function
Enzymes
Albumin
Sugar

Question 12

What are the indications for surgery in peptic ulcers?

Answer 12

• Intractability (after medical therapy)
• Haemorrhage
• Obstruction
• Perforation
• Relative: continuous requirement of steroid therapy/NSAIDs