GI

Question 1

progressive dysphagia, regurgitation, can get oesophageal spasms (chest pain)

Answer 1

achalasia

Question 2

barium swallow - birds beak appearance

Answer 2

achalasia

Question 3

management of achalasia

Answer 3

nifedipine

Question 4

who gets oesophageal varices

Answer 4

those with portal hypertension, cirrhosis, jaundice, ascites

Question 5

management of oesophageal varcies

Answer 5

propranolol

Question 6

epigastric pain worse after eating, pain eases with antacids

Answer 6

gastric ulcer

Question 7

epigastric pain relieved by eating, pain worse lying flat

Answer 7

duodenal ulcer

Question 8

investigations for gastric and duodenal ulcers

Answer 8

H.pylori breath test
if red flag symptoms - endoscopy

Question 9

what rash do you get with coeliac disease

Answer 9

dermatitis herpetiformis

Question 10

what is a main cause for diverticular disease

Answer 10

low fibre diet

Question 11

LIF pain, constipation, bloating

Answer 11

diverticulitis

Question 12

management of diverticulitis

Answer 12

well balanced fibre diet
surgery - Hartmanns

Question 13

pathology in crohns disease

Answer 13

skip lesions
total colitis - whole colon
fistulae
aphthoid ulceration
transmural
non-caseating lesion
goblet cells

Question 14

diarrhoea with blood, colicky abdominal pain weight loss, lethargy, erythema nodosum, uveitis, RIF pain

Answer 14

crohns
can affect anywhere from mouth to anus

Question 15

investigations for crohns

Answer 15

bloods - FBC, CRP, albumin
stool sample
colonoscopy with biopsy
CT/ ultrasound

Question 16

management of crohns

Answer 16

1. stop smoking
2. glucocorticoids (for attacks)
3. azathioprine
4. anti TNF - infliximab

Question 17

diarrhoea with blood, increased bowel frequency, incontinence, lower abdominal pain, starts in the rectum and moves proximally

Answer 17

ulcerative colitis

Question 18

investigations for ulcerative colitis

Answer 18

bloods - CRP, pANCA +ve
stool sample
colonoscopy - polyps
Xray - thumbprinting

Question 19

management of ulcerative colitis

Answer 19

1. 5 ASA - sulphalazine
2. corticosteroids
3. immunosuppression - methotrexate
4. anti TNF - infliximab
5. surgery - currative

Question 20

pain on defecating feels like broken glass

Answer 20

anal fissure

Question 21

management of anal fissure

Answer 21

1. diet - high fibre
2. GTN cream
3. diltiazem
4. surgery

Question 22

painless bright red bleeding on the tissue paper, perianal itch

Answer 22

haemorrhoids

Question 23

have not looked at liver or gallbladder