Gastro Lower GI

Question 1

Anorectal
haemoorhoids Mx?
minimally symptomatic piles?

Answer 1

stool softners
high fibre diet
lidocaine for relief

Question 2

when is haemorrhoidectomy indicated

Answer 2

Haemorrhoidectomy is the excision of piles and is used in the treatment of higher grade piles, piles which persistently bleed and in patients with recurrent thrombosis

Question 3

bowel obstruction management ?

conservastive

Answer 3

NBM and NG tube
IV fluids and urinary catheter
analgesia

Question 4

acute bowel obstruction?

Answer 4

laparotomy

Question 5

if SB obstruction secondary to adhesion?

Mx?

Answer 5

conservative Mx- contrast enema within 24 hours to check

Question 6

Ix for bowel obstruction

Answer 6

abdominal xray
which if it is small bowel - 3-5cm dilatation
lines go all the way across

large bowel : >5cm so really big and haustra doesn’t go all the way across

Question 7

mx of sigmoid volvulus

Answer 7

sigmoidoscopy with detorsion

surgergy

Question 7

mx of sigmoid volvulus

Answer 7

sigmoidoscopy with detorsion

surgergy

Question 8

caecal volvulus mx

Answer 8

immediate surgery

no colonoscopy as risk of perforation

Question 9

acute pancreatitis 1st line imaging?

Answer 9

USS
erect cxr

CT

Question 10

ix for peritonitis

Answer 10

blood cultures
ascitic tap
erect CXR -air under diaphragm

Question 11

what does a caecal voluvlus look like on xray?

Answer 11

dilated air - triangle sign above diaphragm

dilated in RLQ and extends to LUQ

Question 12

sigmoid volvulus on xray sign?

Answer 12

coffee bean sign

Question 13

mild to medium flare of UC mx?

Answer 13

oral and rectal aminosalyclates

Question 14

investigation for pancreatic cancer?

Answer 14

USS sensitivity of 60-90%

gold standard is HRCT

Question 15

acute mesenteric ischaemia first line investigation?

Answer 15

VBG

Question 16

when is abdominal xray used?

Answer 16

diagnose obstruction

perforation - erect

Question 17

what shows thumb printing on abo xray?

Answer 17

ischaemic colitis- Ischaemic colitis describes an acute but transient compromise in the blood flow to the large bowel

mucosal oedema and haemorrhage

Question 18

acute mesenteric ischaemia investigation

Answer 18

ct angiography with contrast

Question 19

TIBC is raised in which anaemia?

Answer 19

iron deficient anaemia

Question 20

how do you image suspected appendicitis?

Answer 20

USS