General

Question 1

Differential for constipation?

Answer 1

Mechanical obstruction: adhesions, hernia, inflammatory strictures,

Pseudo-obstruction: post-op ileus

Hypothyroidism
Reduced ca, k

Neuro: MS

Drugs: opioids

Question 2

List three agents used to treat constipation

Answer 2

Lactulose (osmotis, retains fluid in bowel)

Bisacodyl, senna (promote intestinal motility, peristalsis, and secretion)

Enema- phosphate enema

Question 3

Three differentials for dysphagia?

Answer 3

Tonsilitis
Oesophagitis
Achalasia
Stricture
Retrosternal goitre
Rolling hiatus hernia
Bulbar palsy (CVA)

Question 4

List two motility disorders that result in dysphagia

Answer 4

Achalasia
Bulbar palsy from CVA
Myasthenia gravis

Question 5

Patient has struggled to swallow both liquids and solids at the same time. What is the most likely cause of their dyaphagia?

Answer 5

motility disorder (achalasia, mysathenia gravis) rather than mechanical block or inflammatory picture

Question 6

Define dyspepsia

Answer 6

=indigestion, refers to discomfort or pain that occurs in the upper abdomen

Question 7

List three red flag symptoms of associated with dyspepsia

Answer 7

anaemia
weight loss
melaena
swallowing difficulty

Question 8

Three differentials for haematemesis?

Answer 8

Varices
Oesophageal/gastric Ca
Oesophago-gastro-duodenitis
Mallory weiss tear
Generalised bleeding- warfarin/thrombolytics
Epistaxis

Question 9

Three differentials for rectal bleeding

Answer 9

Diverticulae
Haemorrhoids
Infection
IBD
Neoplasia
Ischaemic colitis
Polyps

Question 10

List two infections that cause rectal bleeding

Answer 10

Campylobactera
shigella
e.coli
c.diff