miscellaneous

Question 1

Two types of oesophageal cancer and which is more common?

Answer 1

adenocarcinoma and squamous cell. Adenocarcinoma is more common

Question 2

What section of the oesophagus do most cancers present?

Answer 2

middle third

Question 3

Risk Factors for oesophageal cancer?

Answer 3

smoking, drinking, Barretts, GORD, achalasia

Question 4

What does oesophageal cancer most commonly present with?

Answer 4

dysphagia

Question 5

What is the first investigation carried out in suspected oesophageal cancer?

Answer 5

upper GI endoscopy

Question 6

How do you stage oesophageal cancer?

Answer 6

CT of chest, abdomen and pelvis

Question 7

When does UC typically present?

Answer 7

bimodall - 15-25 and 55-65

Question 8

Is H pylori gram negative or gram positive?

Answer 8

negative (H)

Question 9

eradication therapy for H Pylori?

Answer 9

7 day treatment with either
PPI + amoxicillin+clarithromycin
or
PPI + metronidazole + clarithromycin

Question 10

what is H pylori associated with?

Answer 10

peptic ulcer disease, gastric cancer and atrophic gastritis

Question 11

what is the triad of ascending colangitis

Answer 11

fever, RUQ pain and jaundice

Question 12

What is ascending cholangitis?

Answer 12

infection of the common bile duct

Question 13

what is a gallstone ileus?

Answer 13

gallstone in intestine

Question 14

first line pharmacological treatment of IBS?

Answer 14

antispasmodic agents for pain,
laxatives for constipation
diarrhoea: loperamide is first line

Question 15

second line treatment of IBS?

Answer 15

low dose tri cyclic antidepressants (ami tryptaline 5-10mg)

Question 16

if symptoms are not improved by pharmacological intervention, can consider what?

Answer 16

CBT, hypnosis therapy or psychological therapy

Question 17

what is primary biliary cirrhosis?

Answer 17

Interlobular bile ducts become damaged by a chronic inflammatory process causing progressive cholestasis which may eventually progress to cirrhosis. The classic presentation is itching in a middle-aged woman

Question 18

what age and sex of people develop PBC?

Answer 18

middle aged women

Question 19

what is the change in epithelium in barretts oesophagus?

Answer 19

SSC - squamous to columnar

Question 20

There is a 50-100 fold increase in which type of cancer with Barretts?

Answer 20

adenocarcinoma

Question 21

is alcohol an individual risk factor for barretts?

Answer 21

no, although it is for GORD and oesophageal cancer

Question 22

What are the 3 Ms of primary biliary cirrhosis?

Answer 22

IgM, Anti mitochondrial antibodies, middle aged females