Upper GI pathology

Question 1

Management of variceal haemorrhage?

Answer 1

A to E assessment
FFP, vitamin K
Terlipressin or Octreotide
Prophylactic IV antibiotics (Quinolones)

Uncontrolled? Sengstaken-Blakemore tube
Transjugular Intrahepatic Portosystemic Shunt (TIPSS) if above measures fail

Question 2

Prophylaxis of variceal haemorrhage?

Answer 2

Endoscopic band ligation

better than:

endoscopic scerotherapy

Question 3

What medical conditions are associated with H. pylori infection?

Answer 3

Strongest association with duodenal ulceration

Gastric adenocarcinoma and atrophic gastritis also associated

Question 4

What is the investigation of choice for primary sclerosing cholangitis?

Answer 4

Magnetic resonance cholangiopancreatography

Question 5

Management of achalasia?

Answer 5

First line: pneumatic dilation

Surgical: Heller cardiomyotomy if severe or persistent symptoms

Question 6

what drugs are associated with drug induced cholestasis?

Answer 6

OCP

Question 7

Treatment for Wilson’s disease?

Answer 7

Penicillinamine