OESOPHAGUS AND GI DISEASE

Question 1

Medications for upper GI disease

Answer 1

antacids
H2 receptor blockers and PPIs

Question 2

antacids action

Answer 2

elimination of formed acids

Question 3

H2 receptor blockers and PPIs action

Answer 3

reduction of acid secretion

Question 4

what neurotransmitters are triggers to stomach acid production

Answer 4

acetylcholine
gastrin
histamine

Question 5

h2 receptor antagonists

Answer 5

cimetidine
ranitidine

Question 6

PPI examples

Answer 6

omeprazole
lanzoprazolem
pantoprazole

Question 7

GORD cause

Answer 7

defective lower oesophageal sphincter
impaired lower clearing
impaired gastric emptying

Question 8

GORD results

Answer 8

ulceration, inflammation and metaplasia
Barretts Oesophagitis

Question 9

signs and symptoms of GORD

Answer 9

epigastric burning, dysphagia, GI bleeding, severe pain which mimics MI

Question 10

hiatus hernia

Answer 10

part of the stomach is in the thorax

Question 11

GORD management

Answer 11

stop smoking
lose weight
antacids
H2 blockers and PPIs

Question 12

where can you find peptic ulcer disease

Answer 12

any acid affected site - oesophagus, stomach, duodenum

Question 13

cause of peptic ulcer disease

Answer 13

high acid secretion (duodenal)
normal acid secretion (stomach)
drugs (NSAIDs, and steroids)

Question 14

what microbes can cause gastritis

Answer 14

helicobacter pylori

Question 15

gastritis symptoms

Answer 15

sometimes asymptomatic
burning pain and bleeding
chronic gastric wall inflammation can lead to lymphoma of the stomach

Question 16

peptic ulcer disease management

Answer 16

triple therapy
2 antibiotics and 1 PPI

Question 17

peptic ulcer disease investigations

Answer 17

endoscopy
radiology (barium meal)
anaemia blood test
H.Pylori breath
antibodies
mucosa

Question 18

local complications of PUD

Answer 18

perforation and escape of gastric contents into peritoneum
haemorrhage
structure
malignancy

Question 19

what does a haemorrhage look like if thrown up

Answer 19

brown coffee grains

Question 20

systemic complications of PUD

Answer 20

anaemia

Question 21

PUD tx medical

Answer 21

H2 receptor blockers
PPIs
NSAIDs - reduce steroid use
triple therapy

Question 22

triple therapy

Answer 22

amoxycillan
metronidazole
omeprazole

Question 23

PUD tx surgical

Answer 23

endoscopy
surgical repair - gastrectomy
vagotomy

Question 24

ceoliac and penicious anaemia

Answer 24

malabsorption - small bowel disease

Question 25

coeliac

Answer 25

sensitivity to A-gliden component of gluten

Question 26

coeliac aetiology

Answer 26

genetic
environment
gluten consumption
t lymphocyte damage to mucosal tissue
villous atrophy of the jejunum

Question 27

coeliac symptoms

Answer 27

weight loss
lassitude
weakness
abdominal pain/ swelling
steatorrhoea

Question 28

how does coeliac present in the mouth

Answer 28

oral apthae
tongue papillary loss

Question 29

malabsorption in coeliac

Answer 29

iron
folate
vit b12
fat

Question 30

coeliac investigations

Answer 30

autoantibody test - TTG, anti-gliadin antibodies
jejunal biopsy
faecal fat - increased
haematinics - B12, folate, ferritin

Question 31

outcome of a gluten free diet in pt with coeliac

Answer 31

reversal of jejunal atrophy
improved well being
reduced risk of lymphoma

Question 32

associated skin disease with coeliac

Answer 32

dermatitis herpetiformis
granular IgA deposit in skin and mucosa

Question 33

pernicious anaemia deficiency

Answer 33

vit B12
intrinsic factor

Question 34

Where is vitb12 absorbed

Answer 34

terminal ilium

Question 35

pernicious anaemia diagnosis

Answer 35

intrinsic factor def.
cobalamin def. and macrocytic anaemia

Question 36

cause of pernicious anaemia

Answer 36

lack of vitb12 from diet
gastric parietal cell disease
IBD of terminal ileum
bowel cancer at ilio-coecal junction

Question 37

tx for vitb12 def.

Answer 37

diet
IM injectiond of vitb12

Question 38

bowel cancer symptoms

Answer 38

anaemia
rectal blood loss

Question 39

bowel cancer aetiology

Answer 39

polyps bleed when irritated - most take 5 years to turn malignant

Question 40

bowel cancer gene

Answer 40

p53

Question 41

are polyps in the small intestine high or low risk

Answer 41

low risk (peutz-jehgers syndrome)

Question 42

are polyps in the large intestine low or high risk

Answer 42

high risk (gardiners/ cowdens syndrome)

Question 43

staging of bowel cancer

Answer 43

A - submucosal
B - muscularis
C - lymph nodes
D - liver

Question 44

bowel cancer tx

Answer 44

colon cancer surgery
hepatic metastases
radiotherapy
chemotherapy

Question 45

when does bowel cancer become incurable

Answer 45

if spread to liver

Question 46

colonic carcinoma screening

Answer 46

FiT test - all adults over 60
2 years repeat
endoscopy if positive

Question 47

ABCDE for acute severe asthma attack

Answer 47

A - wheezing on expiration
B - increased RR, decreased sp02, rapid shallow breaths
C - increased HR, hypertension, pallor
D - ACVPU: alert but anxious
E - pale, distressed, use of accessory muscles, inability to complete sentence in one breath

Question 48

ABCDE for life threatening asthma attack

Answer 48

A - severe wheeze on expiration
B - decreased RR and effort, severely decreased Sp02, laboured breathing
C - decreased HR, cyanosis in lips/ nose
D - ACVPU: confused due to hypoxia
E - grey/ blue in colour, exhausted, sleepy