Gastro & General Surgery

Question 1

What are the initial investigations to be ordered when there is a suspicion of occult GI bleeding due to malignancy?

Answer 1

Upper GI endoscopy and colonoscopy are first line.

Question 2

Name an antimuscarinic that can be used to provide symptomatic relief of gastrointestinal disorders characterised by smooth muscle spasm.

Answer 2

Hyoscine butylbromide

Question 3

What is the medical and surgical management of pyloric stenosis?

Answer 3

Replacement of salt, water and potassium

Surgical

Question 4

What is the medical and surgical management of pyloric stenosis?

Answer 4

Replacement of salt, water and potassium

Surgical

Question 5

What causes a ‘corkscrew’ oesophagus seen on barium swallow?

How is this condition treated?

Answer 5

Diffuse oesophageal spasm.

Calcium channel blockers - nifedipine

Question 6

How does diffuse oesophageal spasm present on barium swallow?

Answer 6

Corkscrew oesophagus

Question 7

How does achalasia appear on barium swallow?

Answer 7

Tapering of the lower end of the oesophagus.

Question 8

What is indicated by tapering of the lower end of the oesophagus on barium swallow?

Answer 8

Achalasia

Question 9

Give 3 treatment options for achalasia.

Answer 9

Endoscopic pneumatic dilatation of the oesophagus

Endoscopic injection of botulinum toxin

Surgical division of sphincter

Question 10

Which HLA haplotype is associated with coeliac disease?

Answer 10

HLA-DQ2/DQ8

Question 11

What histological findings are seen in coeliac disease?

Answer 11

Subtotal or total villous atrophy with crypt hyperplasia.

Question 12

‘Subtotal or total villous atrophy’ in a question is likely to refer to which condition?

Answer 12

Coeliac disease

Question 13

‘Subtotal or total villous atrophy’ in a question is most likely to refer to which condition?

Answer 13

Coeliac disease

Question 14

What is the most common presenting symptom of acute intermittent porphyria

Answer 14

Recurrent abdo pain

Question 15

What is seen on liver biopsy in haemochromatosis

Answer 15

Perls’ Prussian blue positive deposits

Question 16

What are the significance of Perls’ Prussian blue positive deposits seen on liver biopsy

Answer 16

Indicate haemochromatosis

Question 17

Hepatitis + neuro/psychiatric symptoms should raise suspicion of which disease?

Answer 17

Wilson’s disease

Question 18

How does Wilson’s disease typically present (at least in exam questions)

Answer 18

Hepatitis and neuro/psych symptoms (tremor, depression etc)

Question 19

What substance causes kernicterus?

Answer 19

Unconjugated bilirubin

Question 20

Squamous cell carcinoma of the oesophagus is much more common in which ethnic group?

Answer 20

Iranians