Signs + Symptoms

Question 1

What are the clinical examination findings for Barrett’s oesophagus?

Answer 1

• General - weight loss, jaundice or pallor
• Abdominal - scaphoid, abdominal tenderness, hepatomegaly, previous scars
• Oral inspection - dry mouth, candida
• Neck palpation - lymphadenopathy, left SCF node

Question 2

What are the causes for progressive dysphagia of solids?

Answer 2

• Oesophageal cancer
• Peptic strictures
• Extrinsic compression of oesophagus

Question 3

What are the symptoms of a peptic ulcer?

Answer 3

• Pain in upper abdomen - worse after eating and fullness
• Bloating
• Retching
• Nausea and vomiting

Question 4

What are the symptoms of peptic ulcer complications?

Answer 4

1. Bleeding from ulcer
   - Haematemesis and syncope
   - Coffee-coloured vomit
   - Dark stools or melaena
2. Perforation
   - Severe pain and unwell patient

Question 5

What are the ALARM symptoms of peptic ulcers?

Answer 5

Anaemia
Loss of weight
Anorexia
Recent onset/progressive symptoms
Melaena/haematemesis
Swallowing difficulty

Question 6

What are the differential diagnoses of dyspepsia?

Answer 6

• Non-ulcer dyspepsia
• Oesophagitis/GORD
• Duodenal/gastric ulcer
• Gastric malignancy
• Duodenitis
• Gastritis

Question 7

What are the symptoms for gastric outlet obstruction?

Answer 7

• Epigastric pain
• Postprandial vomiting

Question 8

What do you ask in a history about vomiting blood?

Answer 8

• What colour is your vomit?
• When did you first notice the bleeding?
• How many times have you brought up blood?
• Have you been vomiting cups of blood or only streaks and clots?
• Have you passed any black stools? When?
• Do you feel light headed or faint?