Gastro

Question 1

What percentage of cancers occur in the GI tract?

Answer 1

20%

Question 2

What is stomatitis?

Answer 2

inflammation in the mouth from any cause

Question 3

What is angular stomatitis?

Answer 3

inflammation of the corners of the mouth

Question 4

Define dyspepsia

Answer 4

collection of symptoms including:
Abdo discomfort
Bloating
Siaty
Nausea
Vomiting
Loss of appetite
Regurgitation

Question 5

What are the alarm symptoms when accompanying dyspepsia?

Answer 5

Dysphagia
Weight loss
Vomiting
Anorexia
Haematemesis 
Melaena

Question 6

What is the vomiting reflex?

Answer 6

Involves central neural control centres located in the lateral reticular formation of the medulla which are stimulated by the chemoreceptor trigger zones (CTZs) in the floor of the fourth ventricle, and also by vagal afferents from the gut.

The central zones are directly stimulated by toxins, drugs, motion sickness and metabolic disturbances.

Question 7

What is nausea?

Answer 7

Feeling of wanting to vomit, often associated with autonomic effects including salivation, pallor, sweating

Question 8

What is Reidel’s lobe?

Answer 8

Anatomical variant consisting of a palpable enlargement of the lateral portion of the right lobe of the liver

Question 9

Causes of oral neoplasia?

Answer 9

tobacco,
heavy alcohol consumption
areca nut
HPV 16

Question 10

What are the premalignant lesions in oral cancers?

Answer 10

leucoplakia
lichen planus
submucous fibrosis
erythroplakia

Question 11

What is the common type of oral cancer?

Answer 11

squamous cell carcinoma

Question 12

What are the risk factors for oral candidiasis?

Answer 12

post abx therapy
inhaled steroids
diabetes
immunocompromise

Question 13

What would a biopsy of leucoplakia show?

Answer 13

alteration in keratinization and dysplasia of epithelium

Question 14

Causes of dry mouth

Answer 14

Sjögren’s syndrome
Drugs (e.g. antimuscarinic, antiparkinsonian, antihistamines, lithium, monoamine oxidase inhibitors, tricyclic and related antidepressants, and clonidine)
Radiotherapy
Psychogenic
Dehydration, shock and chronic kidney disease.

Question 15

What is dysphagia?

Answer 15

a sensation of obstruction during the passage of liquid or solid through the pharynx or oesophagus

Question 16

Causes of dysphagia

Answer 16

Disease of mouth and tongue - tonsilitis

neuromuscular disorders - bulbar palsy, myasthenia gravis

oesophageal motility disorders - achlasia, scleroderma, diffuse oesophageal spasm

intrinsic lesion - foreign body, stricture, oesophogeal web

Question 17

What features suggest a diagnosis of IBS?

Answer 17

The diagnosis of IBS should be considered if the patient has had the following for at least 6 months:
abdominal pain, and/or
bloating, and/or
change in bowel habit

Question 18

What is the criteria for diagnosing IBS?

Answer 18

A positive diagnosis of IBS should be made if the patient has abdominal pain relieved by defecation or associated with altered bowel frequency stool form, in addition to 2 of the following 4 symptoms:
altered stool passage (straining, urgency, incomplete evacuation)
abdominal bloating (more common in women than men), distension, tension or hardness
symptoms made worse by eating
passage of mucus

Question 19

What blood tests should be taken if IBS is suspected?

Answer 19

full blood count
ESR/CRP
coeliac disease screen (tissue transglutaminase antibodies)