Gastroenterology

Question 1

what is achalasia ? pathology of what ?

Answer 1

myenteric plexus degeneration => loss of coordinated peristalsis + lower oesophageal sphincter fails to relax in response to swallowing => dysphagia, regurgitation + weight loss

Question 2

achalasia px ?

Answer 2

dysphagia to solids + liquids, regurgitation, retrosternal pain
(slowly progressive over months or years)
=> weight loss

Question 3

achalasia Ix ?

Answer 3

endoscopy (exclude malignancy)
barium swallow

Question 4

achalasia Mx ?

Answer 4

CCB (verapamil)
- endoscopic balloon dilatation + PPIs

Question 5

what is dyspepsia ?

Answer 5

sx that suggest issue of upper GI issue - epigastric pain, burning, early satiety, bleaching, bloating, nausea, disconfmot
- with no underlying cause
-

Question 6

when would you do investigations in a patient who presents with dyspepsia ? what investigations ?

Answer 6

> 60 or <60 + alarm feature => endoscopy (to rule out malignancy)
<60 => non invasive test for H.pylori

Question 7

what are the alarm features for dyspepsia ?

Answer 7

VBAD
- vomiting
- bleeding
- abdo mass
- dysphagia