GI

Question 1

GORD

2

Answer 1

PPI

Fundoplication if that fails

Question 2

Peptic Ulcer

Answer 2

H. Pylori positive:

• PPI
• Amox
• Clarith/ Metro

H. Pylori negative:
- PPI

Lifestyle changes e.g. stop smoking, alcohol, weight, NSAIDs

Question 3

UC maintaining remission

Answer 3

topical/ oral Aminosalicylates e.g. mesalazine

then add oral prednisone if that doesn’t work

Question 4

UC acute flare up

Answer 4

IV steroids (hydrocortisone)

then add IV cyclosporin if that isn’t working

Question 5

Acute GI bleed

acute and once stable

Answer 5

IV fluids

Blood transfusion

Oxygen if hypoxic

Endoscopic clipping once stable

Question 6

Chronic Pancreatitis

Answer 6

Analgesia

Treat u/l cause e.g. alcohol cessation

Replace lost enzymes and give insulin if secondary diabetes

Question 7

Bowel obstruction

Answer 7

Drip and suck

IV fluids

NG tubs and NBM to suck up poo

Question 8

Acute pancreatitis

Answer 8

Analgesia (opioids)

oxygen if hypoxic

Fluids

Treat U/L cause e.g. ERCP for gallstones

Question 9

Femoral/ Inguinal hernias

Answer 9

Femoral is more dangerous as increased risk of strangulation

so surgery

low approach is slow and easier

high approach preferred in emergencies but can damage inguinal structures

high= above inguinal ligament

inguinal hernias don’t usually need treatment unless symptomatic

Question 10

Crohn’s remission maintenance

Answer 10

Azathioprine (immunosuppressant)

or Methotrexate if CI

Question 11

Crohn’s acute flare

Answer 11

Oral pred or IV hydrocortisone

can add azathioprine