GI Surgery

Question 1

Type fo jaundice- Haemolytic, unconjugated hyperbilirubinaemia

Answer 1

Pre hepatic jaundice

Question 2

Type of jaundice- Autoimmune, infective, drugs, malignancy

Answer 2

Hepatic Jaundice

Question 3

Type of jaundice- Conjugated hyperbilirubinaemia, obstruction via gallstone, tumour, infection/inflammation

Answer 3

Post-hepatic jaundice

Question 4

Fever, RUQ pain, nausea, icteral sclera
Worse with fatty foods
Female, fat, forty, fertile

Answer 4

Biliary Colic

Question 5

Charcot’s triad: fever, rigors, jaundice Gram –ve, e-coli

Answer 5

Ascending cholangitis

Question 6

Unexplained dyspepsisa, dysphasia, melaena, anorexia, >55, anaemia Acanthosis Nigricans (axilla)
Signet ring cells (biopsy), leather bottle stomach
Virchow’s node

Answer 6

Gastric Carcinoma

Question 7

Abdo pain after meals CLO test positive

Answer 7

Peptic Ulcer

Question 8

Raised INR, haematemesis

Answer 8

Oesophageal varices

Question 9

Metaplasia of distal oesophagus from squamous to columnar epithelium
Caused by GORD

Answer 9

Barrett’s Oesophagus

Question 10

Better with meals, pain 2-3h after food

Pain at night

Answer 10

Duodenal Ulcer

Question 11

H. pylori, plasma cell and lymphoid follicles, erythematous, typical lymphocytes

Answer 11

Chronic Gastritis

Question 12

Ulcerated, heaped epithelium around crater, rolled, raised, everted

Answer 12

Malignant Ulcer

Question 13

Impact pain, regurgitation

Answer 13

Oesophageal Stricture

Question 14

“Student night out”
Tear in mucosa at gastro-oesophageal jn
Repeated retching and vomiting

Answer 14

Mallory Weiss Tear

Question 15

Fullness, epigastric pain, nausea Radiates to back, relieved by sitting forwards
Hypokalaemia + anaemia
Modified Glasgow Score >3 = severe

Answer 15

Acute Pancreatitis

Question 16

Pancreatitis symptoms + fullness

Answer 16

Pancreatic Pseudocyst

Question 17

Hypoglycaemia upon fasting/exercise

Palpitation, dizziness, syncope, diplopia

Answer 17

Insulinoma

Question 18

Painless, progressive jaundice DM, smoking, alcohol

Dark urine, pale stools, ALP>AST Ca19-9

Answer 18

Pancreatic Adenocarcinoma

Question 19

Severe, acute onset abdo pain

Expansile mass, tachycardia, hypotensive

Answer 19

AAA

Question 20

Hepatosplenomegaly

Lipid accumulation in cells

Answer 20

Gauchers disease

Question 21

Weight loss + anaemia

Answer 21

Caecal Carcinoma

Question 22

Lumbar TB

Abdo pain, fever, mass Hip held in flexed position

Answer 22

Psoas Abscess

Question 23

Shock, severe epigastric pain
History of dyspepsia
Rigid abdomen, absent bowel sounds

Answer 23

Perforated PU

Question 24

Pain, nausea, vomiting Bloody diarrhoea

Febrile, tachycardic, distended >6cm

Answer 24

Toxic Megacolon

Question 25

Umbilical à RIF pain
Nausea, vomiting
Rosving’s sign positive Tender over McBurney’s point

Answer 25

Appendicitis

Question 26

Disrupted and dilated anal cushions

Prolapse on defaecation

Answer 26

Haemorrhoids

Question 27

Pain, vomiting, altered blood per rectum

Pale, tachycardic, shock

Answer 27

Mesenteric Ischaemic

Question 28

Beak-like barium swallow

Chest pain + regurg solids/liquids

Answer 28

Achalasia