General - Amir Sam

Question 1

management of acute GI bleed

Answer 1

ABC
IV access (cannula fluids)
G&S, X-match blood
OGD

(w/ variceal bleed: antibiotics & terlipressin)

Question 2

management of acute abdomen

Answer 2

Investigations:
FBC, U&Es, LFTs, CRP, Clotting, G&S, X-match
Erect CXR (air under the lung)
CT

Management:
NMB
Fluids
3As - analgesic, anti-emetics, antibiotics (cefphlosporin & metronidazole)
Monitor Vitals & UO

Question 3

what investigation is always done before surgery?

Answer 3

Clotting

Question 4

Two common antibiotics given

Answer 4

Cephalosporin & Metronidazole

Question 5

Investigations to perform with Jaundice presentation

Answer 5

Bloods: FBC, LFTs, CRP
Abdominal USS (after a fast as gallstones better visualised in a distended, bile-filled gallbladder)

Question 6

What is an OGD?

Answer 6

a camera test that looks at your stomach

Oesophago-gastro Duodenoscopy

Question 7

Investigations to perform with dysphagia & weight loss presentation

Answer 7

OGD & Biopsy

Question 8

Investigations to perform with PR bleed & weight loss presentation

Answer 8

Colonoscopy

Question 9

What is the management for ascites?

Answer 9

diuretics (spironolactone ± furosemide) (to treat the secondary hyperaldosteronism)
dietary sodium restriction
fluid restriction in patients with hyponatraemia
monitor weight daily
therapeutic paracentesis (with IV human albumin)
can give lactulose (reduces gut transit time i.e. quickens it, so bacteria have less time to do their thing)
(diuretics, dietary sodium, monitor)

Question 10

How to diagnose type of ascites?

Answer 10

look at ascites albumin
if >11g/L = cirrhosis, cardiac failure
<11g/L = TB, Cancer, (Nephrotic Syndrome)

Question 11

Encephalopathy management

Answer 11

Lactulose
Phosphate enemas

avoid sedation
treat infections (spontaneous
exclude a GI bleed

Question 12

Post-op care complications and some of their features

Answer 12

wound infection: erythematosus, discharge

anastomic leak: diffuse abdo tenderness, guarding rigidity, hyptoensive, tachycardic

pelvic abcess: pain, fever, sweats, mucus diarrhoea

Question 13

What are two perianal diseases?

Answer 13

Perianal disease & Anal Fissure

Question 14

What is a difference between IBS & IBD?

Answer 14

In IBS don’t wake up with diarrhoea

In IBD do wake up with diarrhoea

Question 15

How can IBS present?

Answer 15

As diarrhoea and/or constipation