Gastroenterology

Question 1

appendicitis

Answer 1

migratory pain, mild pyrexia, anorexia, RIF tenderness

Question 2

migratory pain, mild pyrexia, anorexia, RIF tenderness

Answer 2

appendicitis

Question 3

mesenteric adenitis

Answer 3

recent URTI, high fever, generalised abdo discomfort

Question 4

recent URTI, high fever, generalised abdo discomfort

Answer 4

mesenteric adenitis

Question 5

ruptured AAA

Answer 5

sudden onset, radiating to back, collapse

Question 6

sudden onset, radiating to back, collapse

Answer 6

ruptured AAA

Question 7

perforated peptic ulcer

Answer 7

sudden onset, EG pain, preceding upper abdo pain, develops generalised abdo pain, peritonitis

Question 8

sudden onset, EG pain, preceding upper abdo pain, develops generalised abdo pain, peritonitis

Answer 8

perforated peptic ulcer

Question 9

intestinal obstruction

Answer 9

colicy pain, V, abdo distension, constipation, peritonism

Question 10

colicy pain, V, abdo distension, constipation, peritonism

Answer 10

intestinal obstruction

Question 11

mesenteric infarction

Answer 11

sudden pain, forceful evacuation, pain greater than physical signs

Question 12

sudden pain, forceful evacuation, pain greater than physical signs

Answer 12

mesenteric infarction

Question 13

appendicitis investigations

Answer 13

WCC, pregnancy test, CRP, amylase, urine dip

Question 14

WCC, pregnancy test, CRP, amylase, urine dip

Answer 14

appendicitis investigations

Question 15

mesenteric adenitis investigations

Answer 15

FBC, urine dip, TAUS

Question 16

FBC, urine dip, TAUS

Answer 16

mesenteric adenitis investigations

Question 17

ruptured AAA investigations

Answer 17

CT when HD stable

Question 18

CT when HD stable

Answer 18

ruptured AAA investigations

Question 19

perforated peptic ulcer investigations

Answer 19

erect CXR, CT if diagnostic doubt

Question 20

erect CXR, CT if diagnostic doubt

Answer 20

perforated peptic ulcer investigations

Question 21

intestinal obstruction investigations

Answer 21

plain AXR, CT if diagnostic doubt

Question 22

plain AXR, CT if diagnostic doubt

Answer 22

intestinal obstruction investigations

Question 23

mesenteric infarction investigations

Answer 23

ABG, arterial phase CT

Question 24

ABG, arterial phase CT

Answer 24

mesenteric infarction investigations

Question 25

enterovesical fistula

Answer 25

communication between bowel and bladder

Question 26

enterovesical fistula symptoms

Answer 26

bubbly urine, recurrent UTIs

Question 27

enterovesical fistula - think!

Answer 27

CRC

Question 28

enterocutaneous fistula

Answer 28

between the intestines + the skin, high (duodenal/jejunal) vs low (colo) output

Question 29

enteroenteric/enterocolic/enterovaginal fistula

Answer 29

involving the large/small intestine/vagina

Question 30

dupdenal/jejunalcutaneous fistula

Answer 30

tend to be high output, electrolyte rich, leading to skin excoriation

Question 31

colocutaneous fistula

Answer 31

tend to be low output, faeculent material,

Question 32

enterocutaneous fistula may result from a

Answer 32

spontaneous rupture of an abscess, or iatrogenic

Question 33

the problem with enteroenteric/enterocolic/enterovaginal fistula

Answer 33

bacterial overgrowth may precipitate malabsorption Ss which is particularly serious in IBD

Question 34

octreotide

Answer 34

reduces pancreatic secretions

Question 35

reduces pancreatic secretions

Answer 35

octrecotide

Question 36

fistula management

Answer 36

will heal on their own if no pathology + if left, fit a stoma bag, TPN if causing nutritional deficiency