Upper Gastrointestinal Surgery

Question 1

What surveillance is offered in Barrett’s oesophagus?

Answer 1

2-5 yearly OGDs

Question 2

Name a drug that can be used in diabetic gastroparesis

Answer 2

Erythomycin

Question 3

Name three infections that can cause sclerosing cholangitis

Answer 3

CMV
Cryptosporidium
Microsporia

Question 4

Which inherited condition is associated with insulinomas?

Answer 4

MEN 1

Question 5

List the triad of insulinoma

Answer 5

Symptomatic hypoglycaemia during fasting
Hypoglycaemia
Relief of hypoglycaemia with use of glucose

Question 6

What is the advantage of NJ over NG?

Answer 6

Prevents feed pooling in stomach which risks aspiration

Question 7

Which operation is used to resect proximal oesophageal tumours?

Answer 7

McKeown oesophagectomy

Question 8

Which operation is used to resect middle and distal oesophageal tumours?

Answer 8

Ivor Lewis oesophagectomy

Question 9

What treatment before surgery improves survival in oesophageal cancer?

Answer 9

Chemotherapy

Question 10

Where is oesophageal rupture most common?

Answer 10

Left postero-lateral - 2-3cm from OG junction

Question 11

Which malignancy is associated with Barrett’s oesophagus?

Answer 11

Adenocarcinoma of the oesophagus

Question 12

Where does pancreatic cancer commonly metastasis?

Answer 12

Liver

Question 13

What causes pain in advanced pancreatic cancer?

Answer 13

Invasion of the coeliac plexus

Question 14

Which operation can be performed for very distal oesphageal cancers?

Answer 14

Transhiatal resection

Question 15

What is the most common cause of major haemorrhage in the duodenum?

Answer 15

Posteriorly sited duodenal ulcer

Question 16

What is the Rockall score used for?

Answer 16

To determine the risk of rebleed and mortality following endoscopy for UGIB

Question 17

What is the Glasgow Blatchford score used for?

Answer 17

To determine the need for admission in UGIB and the timing of OGD

Question 18

Which inherited disorder is associated with gastrinomas?

Answer 18

MEN 1

Question 19

Where do patients with Zollinger-Elison syndrome get ulcers?

Answer 19

Duodenum or jejunum

Question 20

What are the boundaries of the gastrinoma triangle?

Answer 20

Junction of cystic duct and CBD
Junction of D2 and D3
Junction of neck and body of pancreas

Question 21

Which hormone suppresses gastrin secretion?

Answer 21

Secretin

Question 22

Which artery is compromised by a posterior duodenal ulcer?

Answer 22

Gastroduodenal ulcer

Question 23

What causes achalasia?

Answer 23

Progressive degeneration of ganglion cells in the myenteric plexus in the oesophageal wall, leading to failure of relaxation of the lower oesophageal sphincter (LES), accompanied by a loss of peristalsis in the distal oesophagus

Question 24

Which structure is frequently divided to allow mobilisation in an oesophagectomy?

Answer 24

Azygous vein

Question 25

Which type of cancer is associated with achalasia?

Answer 25

SCC oesophagus

Question 26

What is the most common cell of origin in pancreatic cancer?

Answer 26

Ductal