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Year 3 Common cases investigation and management only > Gastro upper GI > Flashcards

Gastro upper GI Flashcards

1
Q

gold standard Ix for achalasia?

A

oesophageal manometry

incomplete relaxation and aperistalsis

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2
Q

barium swallow

for achalasia

A

bird’s beak appearance

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3
Q

Gold standard GORD ix?

A

24-hr oesophageal pH monitoring (the gold standard test for diagnosis)

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4
Q

GORD ix?

A

OGD- ulceration

oesophageal manometry with pH monitoring

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5
Q

Mx of GORD

A

weight loss
small regular meals
smoking cessation
avoid food items

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6
Q

GORD mx

medical?
symptom relief?
surgical?

A

ppi add H2 block
antacids for symptom relief

surgical?
Nissen fundoplication

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7
Q

what is aim of nissen fundoplication

A

aim to increase LOS pressure so food can stop regurg

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8
Q

PUD gold standard?

A

upper GI endoscopy - ulceration

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9
Q

H pylori test for PUD

A

urea carbon 13 breath test and stool antigen test retest 6-8 weeks

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10
Q

serum fasting gastrin level Ix is good at what?

A

Zollinger Elison disease - benign gastrinoma
= increased gastrin +++++++
= increased ulcers

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11
Q

H pylori + PUD

A

7 days triple therapy

PII + 2 abx - metronidazole and amoxicilin or clarithromycin

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11
Q

H pylori + PUD

A

7 days triple therapy

PII + 2 abx - metronidazole and amoxicilin or clarithromycin

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11
Q

H pylori + PUD

A

7 days triple therapy

PII + 2 abx - metronidazole and amoxicilin or clarithromycin

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11
Q

H pylori + PUD

A

7 days triple therapy

PII + 2 abx - metronidazole and amoxicilin or clarithromycin

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11
Q

H pylori + PUD

A

7 days triple therapy

PII + 2 abx - metronidazole and amoxicilin or clarithromycin

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11
Q

H pylori + PUD

A

7 days triple therapy

PII + 2 abx - metronidazole and amoxicilin or clarithromycin

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11
Q

H pylori + PUD

A

7 days triple therapy

PII + 2 abx - metronidazole and amoxicilin or clarithromycin

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11
Q

H pylori + PUD

A

7 days triple therapy

PII + 2 abx - metronidazole and amoxicilin or clarithromycin

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11
Q

H pylori + PUD

A

7 days triple therapy

PII + 2 abx - metronidazole and amoxicilin or clarithromycin

12
Q

H pylori + PUD

A

7 days triple therapy

PII + 2 abx - metronidazole and amoxicilin or clarithromycin

13
Q

H pylori - PUD

A

stop drug causing ulcer

4-8 weeks PPI

14
Q

Hiatus hernia
surgical mx?
medical mx?

A

nissen fundoplication

PPI 4-8 weeks

15
Q

oesophageal cancer gold standard?

16
Q

oesophageal cancer Mx

A

resection and chemo

17
Q

gastric cancer Ix?

what finding?

A

upper gi endoscpoy with biopsy

signet ring cells

18
Q

gastric cancer mx

A

resection and adjuvant chemo

19
Q

Current guidelines include urgent referral (within 2 weeks) for patients with

A

Dysphagia (at any age)
Aged 55 and over with weight loss AND –
Upper abdominal pain OR reflux OR dyspepsia
Upper abdominal mass consistent with stomach cancer

20
Q

Indications for Non-Urgent Referral for OGD

A

Haematemesis (at any age)
Aged 55 and over with either –
Treatment-resistant dyspepsia
Upper abdominal pain and low haemoglobin
Raised platelet count AND any of the following –
Nausea, vomiting, reflux, weight loss, dyspepsia epigastric pain
Nausea or vomiting AND any of the following –
Weight loss, reflux, dyspepsia, epigastric pain

21
Q

what staging of gastric cancer is inoperable?

A

any metastatic spread

22
Q

upper Gi bleed distinguished from lower Gi bleed?

A

urea is raised in Upper GI

23
Q

MALLORY WEISS TEAR
GOLD STANDARD

bloods?
imaging

A

upper gi endoscopy

FBC
Urea
CXR- rule out perforation

24
Q

mx of mallory weiss tear

A

endoscopy inject adrenaline

conduct band ligation

25
Q

2nd line for a mallory weis tear that won’t stop?

A

sengstaken blakemore tube

26
Q

acute management of oesophageal varices?

A

IV fluids - crystalloid

correct clotting - FFP, Vit K

vasoactive agent- terlipressin

abx- ciprofloxacin

27
Q

scc associated with what condition?

A

plummer vinson

28
Q

osephageal cancer ix

A

upper GI endoscopy with biopsy
endoscopic uss

CT CAP

29
Q

oesophageal cancer mx?

A

ivor lewis surgergy

30
Q

most common type of cancer? in stomach?

A

adenocarcinoma

31
Q

gastric cancer Mx

A

endoscopic mucosal resection

gastrectomy

32
Q

Ix for gastroeneteritis?

A

faecal microscopy
bloods -u&es
axr/uss
sigmoidoscopy

33
Q

what are risk factors for ulcer perforation?

A

NSAIDS
bisphosphonates
steroids

34
Q

1st line imaging is GI perfoartion?

35
Q

H2 antagonists

A

(e.g. ranitidine)

36
Q

haitus hernia most definative imaging modality?

A

barium meal upper GI

OGD

37
Q

stimulant laxatives?

A

docusate sodium
senna

not indicated in gastrointestinal obsrtruction

38
Q

what is the most common cause of GI bleed

A

peptic ulcers
mallory weis tears
varices

Year 3 Common cases investigation and management only (8 decks)

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