Gastroenterology

Question 1

4 diagnostic criteria for functional dyspepsia

Answer 1

Bothersome:
post prandial fullness
early satiety
epigastric pain
epigastric fullness

Question 2

treatment for functional dyspepsia

Answer 2

first line PPI, 70% of patients will still have symptoms after 8 week trial.
Second line Nortriptyline NNT = 6 (10mg Daily and can titrate up 10mg every few weeks)

Question 3

Common Causes of Peptic Ulcer disease

Answer 3

NSAIDs

H. Pylori

Question 4

idiopathic/ iatrogenic causes of Peptic ulcer disease

Answer 4

SSRI's
Smoking
Stress
Cocaine
Methamphetamines
Bisphosphonates 
Alcohol

Question 5

Rare Causes of PUD

Answer 5

gastronoma (Zollinger-ellison syndrome)
COPD
systemic mastocytosis
a1-antitrypsin deficiency
CKD
Gastric Ca
Gastric Lymphoma
Chrons Disease
Eosinophillic gastroenteritis
HSV
CMV

Question 6

features of gastric ulcers which are suspicious for malignancy

Answer 6

Dirty base
raised ulcer border
irregular ulcer margins

Question 7

Indications for follow up Gastroscopies for ulcers

Answer 7

Features which rise suspicion of malignancy
ulcers greater than 3cm (risk of rebleeed/ perforation)
unclear aetiology
ongoing symptoms despite adequate treatment

Question 8

Management of PUD secondary to ASA for cardiovascular prevention

Answer 8

Restart ASA 1-7 days after initiation of PPI

Question 9

Interleukins associated with colitis

Answer 9

IL- 13

Question 10

Interleukins associated with Crohns

Answer 10

IL-12, 17, 23 + IFNgamma

Question 11

Indications for H. Pylori testing

Answer 11

PUD
gastric mucosa-associated lymphoid tissue lymphoma
history of endoscopic resection for early gastric Ca.
Dyspepsia
Before long term ASA or NSAID use