Gastro

Question 1

Pharyngeal pouch

Answer 1

Posteromedial diverticulum or herniation through Killian’s dehiscence

Dysphasia 
Regurgitate 
Aspiration
Halitosis 
Neck swelling

Question 2

E. coli diarrhoea

Answer 2

Travellers
Watery stool
Abdo cramps

Question 3

Giardiasis

Answer 3

Prolonged
Non blood diarrhoea
>7 day incubation

Question 4

Shigella

Answer 4

Bloody diarrhoea

Question 5

Staph aureus GI

Answer 5

Short incubation period

Severe vomiting

Question 6

Campylobacter

Answer 6

Most common cause GI in UK
Flu like prodrome then cramps abdo pain
Fever and diarrhoea, may be bloody

Complications: guillain barre

Question 7

C diff

Answer 7

Gran positive rod
Exotoxins causes intestinal damage leading psuedomembranous colitis

Leading cause: ciprofloxacin

Tx: PO metronidazole or vanc

Question 8

Bacterial overgrowth

Answer 8

Gold standard is small
Bowel aspiration and culture

Associations: systemic sclerosis, diverticulae, blind loop

Question 9

Cholera toxin

Answer 9

Activates adenylate Cyclades and increased cAMP leading to increased chloride secretion

Question 10

Oesophageal varies

Answer 10

Terlipressin (octreotide in ihd)

Endoscopic band ligation with PPI cover

Question 11

Barrett’s oesophagous

Answer 11

Metaplasia lower oesophagous
50-100x risk adenocarcinoma

Endoscopic surveillance
Low grade dysphasia high dose ppi 8-12wks
High grade surgery or cryotherapy

Question 12

Indications upper GI endoscopy

Answer 12

GORD 24hr oesophageal pH monitoring

Indications for endoscopy
>55yrs
Symptoms over 4weeks or persistent despite tx
Dysphasia
Relapsing symptoms 
Wt loss