Investigations Flashcards
1
Q
Who should be screened for Barrett’s oesophagus?
A
- People with chronic or severe GORD (duration >5 yrs or at least twice weekly symptoms/symptoms interfering with daily activity)
- AND at least 3 of: age >50yrs, male, white race, obese, smoking
- OR FH of Barrett’s oesophagus or oesophageal adenocarcinoma
2
Q
When is Barrett’s oesophagus diagnosed?
A
When salmon coloured columnar epithelium is clearly visualised to extend above the gastro-oesophageal junction during endoscopy.
Or intestinal metaplasia, longer segments are associated with increased risk of progression to oesophageal adenocarcinoma.
3
Q
When should people with suspected oesophageal cancer be referred for a 2 week wait?
A
Offer urgent direct access upper GI endoscopy to assess in people:
- With dysphagia OR
- Aged >55 with weight loss and any of the following: upper abdominal pain, reflux, dyspepsia
4
Q
What other symptoms would trigger a 2 week wait referral for oesophageal cancer?
A
- Haematemesis
- Treatment resistant dyspepsia
- Upper abdominal pain with low Hb levels
- Raised platelet count with any of: nausea, vomiting, weight loss, reflux, dyspepsia, upper abdominal pain
5
Q
What investigations should be done for oesophageal cancer?
A
- OGD
- Bloods - anaemia
- ECG/PFT/CXR
- CT thorax/abdomen/pelvis - staging
- EUS - endoscopic ultrasound to mark staging
- PET
- Laparoscopy
6
Q
What tests are done for H.pylori?
A
- CLO test
- Culture
- Urea breath test
- Stool antigen
- Serology
7
Q
What investigations are done for oesophageal varices?
A
Lactate
