Upper GI

Question 1

Leg raising test?

Answer 1

Carnett’s test

Question 2

What is paradoxical aciduria (in GOO)?

Answer 2

Vomiting - loss of H+ and Cl- ➡️ metabolic alkalosis ➡ ️kidney compensate by excreting bicarbonate and sodium ➡️ hyponatraemia ➡️ hypovolaemia and hyponatraemia triggers aldosterone effect ➡️ to conserve sodium ion, K+ and H+ is excreted in urine.
So we get hypocholeremic hypokalemic metabolic alkalosis with paradoxical aciduria.

Question 3

Forrest’s classification

Answer 3

Grade Ia - Active, pulsatile bleeding (High rebleeding rate)
Grade Ib - Active, nonpulsatile bleeding (High )
Grade IIa - Nonbleeding visible vessel (high)
Grade IIb - Adherent clot (Intermediate)
Grade IIc - Ulcer with black spot (Low)
Grade III - Clean, nonbleeding ulcer bed (Low)

Question 4

Approach to lower thoracic esophagus and cardiacs tumour

Answer 4

Abdominal - right thoracic approach as in Lewis Tanner esophagectomy
Left thoraco abdominal incision
Abdominal approach to the lower esophagus by widening the hiatus and anastamosis with stapler