Classification systems

Question 1

What is the LA Grade classification used for?

Answer 1

To diagnose the extent of esophagitis

The LA Grade classification helps in assessing the severity of esophageal inflammation.

Question 2

What is the grading scale of the LA Grade classification?

Answer 2

Grades A through D

Each grade corresponds to specific criteria related to mucosal breaks.

Question 3

What defines Grade A in the LA Grade classification?

Answer 3

Mucosal break < 5mm in length

This grade indicates a mild form of esophagitis.

Question 4

What defines Grade B in the LA Grade classification?

Answer 4

Mucosal break > 5mm

This grade indicates a more severe form of esophagitis compared to Grade A.

Question 5

What defines Grade C in the LA Grade classification?

Answer 5

Mucosal break continuous between > 2 mucosal folds

This grade signifies a significant level of esophagitis.

Question 6

What defines Grade D in the LA Grade classification?

Answer 6

Mucosal break > 75% of esophageal circumference

This represents the most severe form of esophagitis.

Question 9

What year was the Prague classification presented?

Answer 9

2006

Question 10

What is the lower measurement boundary of Barrett’s esophagus according to the Prague classification?

Answer 10

Proximal gastric folts/GOJ

Question 11

What are the two upper measurement boundaries in the Prague classification?

Answer 11

Proximal limit of circumferential Barrett’s segment (C) and longest tongue of Barrett’s (M)

Question 12

What does ‘M’ represent in the Prague classification?

Answer 12

Longest Barrett’s segment including the longest tongue

Question 13

In the example provided, if the circumferential segment (C) is 3 cm and the tongue is 2 cm, what is the total length (M)?

Answer 13

5 cm

Question 14

How is a short Barrett’s segment with a 1-cm long circular section and an additional 1-cm long tongue reported?

Answer 14

C1M2

Question 15

What is the report format for a circular Barrett’s that is 2 cm long without tongues?

Answer 15

C2M2

Question 16

What is the reported classification for a Barrett’s segment with a 7-cm long circular section and an additional 1-cm tongue?

Answer 16

C7M8

Question 17

True or False: M must always be longer than C in the Prague classification.

Answer 17

True

Question 18

What is the visual characteristic that differentiates gastric mucosa from Barrett’s mucosa?

Answer 18

Different vascular patterns

Question 19

In the case of a Barrett’s segment with a circular part interrupted, how would it be reported if it has a 1-cm tongue-shaped section?

Answer 19

C0M1

Question 20

What does C0M2 indicate in the context of Barrett’s esophagus?

Answer 20

Short Barrett’s segment, mainly tongue-shaped with a maximum Barrett’s tongue of around 2 cm

Question 21

Fill in the blank: The maximum length of Barrett’s in the example is reported as C3M5, where C is the circumferential segment length and M is the _______.

Answer 21

maximum Barrett’s extent

Question 22

What is the proximal cardinal notch

Question 23

What is Forrest classification used for?

Answer 23

Stratifying patients with upper gastrointestinal hemorrhage into high and low risk categories for mortality

It also helps predict the risk of rebleeding and evaluates endoscopic intervention modalities.

Question 24

What does a Forrest III lesion indicate?

Answer 24

Lesions without signs of recent hemorrhage or fibrin-covered clean ulcer base

Question 25

What are the types of acute hemorrhage in Forrest classification?

Answer 25

* Forrest I a (Spurting hemorrhage) * Forrest I b (Oozing hemorrhage)

Question 26

What are the signs of recent hemorrhage in Forrest classification?

Answer 26

* Forrest II a (Non bleeding Visible vessel) * Forrest II b (Adherent clot) * Forrest II c (Flat pigmented haematin on ulcer base)

Question 27

Who first published the Forrest classification and in what year?

Answer 27

J.A. Forrest, et al. in 1974

Question 28

What is the significance of Forrest criteria in medical practice?

Answer 28

Essential for proper planning of endoscopic therapy and urgent surgery in bleeding peptic ulcers

Question 29

Fill in the blank: A Forrest II a lesion represents a _______.

Answer 29

[Non bleeding Visible vessel]

Question 30

True or False: A Forrest II c lesion indicates an adherent clot.

Answer 30

False

Question 31

What is the appearance of a Forrest II c lesion?

Answer 31

Flat pigmented haematin (coffee ground base) on ulcer base

Question 32

What does a Forrest I a lesion represent?

Answer 32

Spurting hemorrhage

Question 33

What is the role of Forrest classification?

Answer 33

It is a significant method for predicting the risk of rebleeding

Question 34

What is the purpose of the Rockall risk scoring system?

Answer 34

To identify patients at risk of adverse outcomes following acute upper gastrointestinal bleeding ## Footnote The system helps in predicting mortality accurately.

Question 35

Who identified the independent risk factors for the Rockall risk scoring system?

Answer 35

Rockall et al. in 1996 ## Footnote Their research established the basis for predicting mortality in patients with gastrointestinal bleeding.

Question 36

What types of criteria does the Rockall scoring system use?

Answer 36

Clinical criteria and endoscopic findings ## Footnote Clinical criteria include increasing age, co-morbidity, and shock; endoscopic findings include diagnosis and stigmata of acute bleeding.

Question 37

What does the mnemonic ABCDE stand for in the Rockall scoring system?

Answer 37

* Age * Blood pressure fall (shock) * Co-morbidity * Diagnosis * Evidence of bleeding ## Footnote This mnemonic helps in remembering the components of the scoring system.

Question 38

Who was the main investigator and first author of the studies that led to the Rockall scoring system?

Answer 38

Professor Tim Rockall ## Footnote He played a pivotal role in the development of the Rockall risk scoring system.

Question 39

What is one clinical criterion used in the Rockall scoring system?

Answer 39

Increasing age ## Footnote Age is considered an important risk factor for adverse outcomes in gastrointestinal bleeding.

Question 40

True or False: The Rockall risk scoring system only considers clinical criteria.

Answer 40

False ## Footnote It also includes endoscopic findings in its assessment.

Question 41

List the variables included in the Rockall score

Answer 41

Age Shock Co-morbidity diagnosis Evidence of bleeding

Question 42

Rockall score: List the age brackets and their corresponding score

Answer 42

<60 Score 0 60-79 Score 1 >80 Score 2

Question 43

Rockall score: list the brackets for assessment of shock and their score

Answer 43

Score 0: no shock Score 1 Pulse >100 and BP >100 Score 2 SBP <100

Question 44

Rockall score: list the UGI bleed diagnoses and their corresponding scores

Answer 44

Score 0: Mallory-weiss Score 1: All other diagnoses Score 2: GI malignancy

Question 45

Rockall score: list the stigmata of bleeding and their corresponding score

Answer 45

Score 0: No stigmata of bleeding Score 1: X Nil entry under this score Score 2: Blood, adherent clot, spurting vessel

Question 46

What is the Rockall score used for?

Answer 46

It is used to assess the prognosis of patients with gastrointestinal bleeding. ## Footnote The Rockall score evaluates risk based on clinical and endoscopic findings.

Question 47

How is the total Rockall score calculated?

Answer 47

By simple addition of individual scores. ## Footnote Each component of the score contributes to the final total.

Question 48

What does a Rockall score of less than 3 indicate?

Answer 48

Good prognosis. ## Footnote Patients with this score generally have a lower risk of complications.

Question 49

What does a Rockall score greater than 8 indicate?

Answer 49

High risk of mortality. ## Footnote This score suggests a significant risk for serious outcomes.