Gastrointestinal Flashcards
Initial management for ascites, pyrexia and ascitic fluid WCC of 340 neutrophils/ml?
Spontaneous bacterial peritonitis
Treatment with Co-Trimethazole
Initial management for alcohol related cirrhosis and alcoholic hepatitis, with anuric and CVP of 12?
Hepato-renal syndrome
Terlinpressin (improves renal blood flow)
Initial management for patient with PBC whose bilirubin rose to 110 over 6 moths, with normal bile ducts on abdominal US?
Raised bilirubin in absence of biliary disease shows deteriorating liver function and liver failure
Transplantation needed
Most appropriate investigation for 55 year old man with anaemia and no other symptoms?
Most common cause of isolated anaemia in this game and sex is colorectal cancer
Colonoscopy
Most appropriate investigation for 55 year old with anaemia, weight loss and early satiety?
Alarm symptoms for upper GI tract malignancy
Gastroscopy
Most appropriate investigation for 22 year old with anaemia who travelled through southern Russia for several months?
Could be Giardia or Coeliac disease
Distal duodenal biopsy (gold standard for both)
Most appropriate management of Grade C Oesophagitis, with intermittent dysphagia for solids and heartburn?
Proton pump inhibitor
Most appropriate management for tight benign peptic stricture chasing vomiting and dysphagia to solids?
Balloon oesophageal dilatation
Most appropriate management for dilated oesophagus, bird beak appearance at gastro-oesophageal junction with gullet full of food?
Classic appearance of achalasia
Ballon oesophageal dilatation or cardiomyotomy
For young and fit, Cardiomyotomy has more advantages
20 year old with lethargy, headaches, fever, nausea and abdominal pain for 4 days
No rash, but yellow sclera
Backpacking in India 28 days ago
Hepatitis A
Most appropriate investigation for 50 year old male alcoholic with history of recurrent abdominal pain and central abdominal calcification
Likely chronic pancreatitis
Faecal elastase
Best test of pancreatic function
Faecal elastase
Most appropriate investigation for 24 year old backpacker with difficult to flush pale floating stools who has recently traveled to Russia
Steatorrhoea suggests small bowel malabsorption
Possible giardia, or coeliac disease
Esophagogastroduodenoscopy (OGD) and duodenum (D2) biopsy
Most appropriate test for: 18 year old student 1 week history of lethargy, headaches, painful sore throat No travel Widespread rash on taking antibiotics Sore abdomen over liver and spleen Lymphadenopathy Jaundiced sclera
Mononucleosis, Glandular Fever, Epstein-Barr Virus
Monospot test
Most appropriate investigation for 55 year old obese woman with RUQ pain and normal LFTs
Biliary colic within cystic duct, or cholecystitis
Abdominal Ultrasound
