Gastro upper GI

Question 1

gold standard Ix for achalasia?

Answer 1

oesophageal manometry

incomplete relaxation and aperistalsis

Question 2

barium swallow

for achalasia

Answer 2

bird’s beak appearance

Question 3

Gold standard GORD ix?

Answer 3

24-hr oesophageal pH monitoring (the gold standard test for diagnosis)

Question 4

GORD ix?

Answer 4

OGD- ulceration

oesophageal manometry with pH monitoring

Question 5

Mx of GORD

Answer 5

weight loss
small regular meals
smoking cessation
avoid food items

Question 6

GORD mx

medical?
symptom relief?
surgical?

Answer 6

ppi add H2 block
antacids for symptom relief

surgical?
Nissen fundoplication

Question 7

what is aim of nissen fundoplication

Answer 7

aim to increase LOS pressure so food can stop regurg

Question 8

PUD gold standard?

Answer 8

upper GI endoscopy - ulceration

Question 9

H pylori test for PUD

Answer 9

urea carbon 13 breath test and stool antigen test retest 6-8 weeks

Question 10

serum fasting gastrin level Ix is good at what?

Answer 10

Zollinger Elison disease - benign gastrinoma
= increased gastrin +++++++
= increased ulcers

Question 11

H pylori + PUD

Answer 11

7 days triple therapy

PII + 2 abx - metronidazole and amoxicilin or clarithromycin

Question 11

H pylori + PUD

Answer 11

7 days triple therapy

PII + 2 abx - metronidazole and amoxicilin or clarithromycin

Question 11

H pylori + PUD

Answer 11

7 days triple therapy

PII + 2 abx - metronidazole and amoxicilin or clarithromycin

Question 11

H pylori + PUD

Answer 11

7 days triple therapy

PII + 2 abx - metronidazole and amoxicilin or clarithromycin

Question 11

H pylori + PUD

Answer 11

7 days triple therapy

PII + 2 abx - metronidazole and amoxicilin or clarithromycin

Question 11

H pylori + PUD

Answer 11

7 days triple therapy

PII + 2 abx - metronidazole and amoxicilin or clarithromycin

Question 11

H pylori + PUD

Answer 11

7 days triple therapy

PII + 2 abx - metronidazole and amoxicilin or clarithromycin

Question 11

H pylori + PUD

Answer 11

7 days triple therapy

PII + 2 abx - metronidazole and amoxicilin or clarithromycin

Question 11

H pylori + PUD

Answer 11

7 days triple therapy

PII + 2 abx - metronidazole and amoxicilin or clarithromycin

Question 12

H pylori + PUD

Answer 12

7 days triple therapy

PII + 2 abx - metronidazole and amoxicilin or clarithromycin

Question 13

H pylori - PUD

Answer 13

stop drug causing ulcer

4-8 weeks PPI

Question 14

Hiatus hernia
surgical mx?
medical mx?

Answer 14

nissen fundoplication

PPI 4-8 weeks

Question 15

oesophageal cancer gold standard?

Answer 15

OGD

Question 16

oesophageal cancer Mx

Answer 16

resection and chemo

Question 17

gastric cancer Ix? | what finding?

Answer 17

upper gi endoscpoy with biopsy | signet ring cells

Question 18

gastric cancer mx

Answer 18

resection and adjuvant chemo

Question 19

Current guidelines include urgent referral (within 2 weeks) for patients with

Answer 19

Dysphagia (at any age) Aged 55 and over with weight loss AND – Upper abdominal pain OR reflux OR dyspepsia Upper abdominal mass consistent with stomach cancer

Question 20

Indications for Non-Urgent Referral for OGD

Answer 20

Haematemesis (at any age) Aged 55 and over with either – Treatment-resistant dyspepsia Upper abdominal pain and low haemoglobin Raised platelet count AND any of the following – Nausea, vomiting, reflux, weight loss, dyspepsia epigastric pain Nausea or vomiting AND any of the following – Weight loss, reflux, dyspepsia, epigastric pain

Question 21

what staging of gastric cancer is inoperable?

Answer 21

any metastatic spread

Question 22

upper Gi bleed distinguished from lower Gi bleed?

Answer 22

urea is raised in Upper GI

Question 23

MALLORY WEISS TEAR GOLD STANDARD bloods? imaging

Answer 23

upper gi endoscopy FBC Urea CXR- rule out perforation

Question 24

mx of mallory weiss tear

Answer 24

endoscopy inject adrenaline | conduct band ligation

Question 25

2nd line for a mallory weis tear that won't stop?

Answer 25

sengstaken blakemore tube

Question 26

acute management of oesophageal varices?

Answer 26

IV fluids - crystalloid correct clotting - FFP, Vit K vasoactive agent- terlipressin abx- ciprofloxacin

Question 27

scc associated with what condition?

Answer 27

plummer vinson

Question 28

osephageal cancer ix

Answer 28

upper GI endoscopy with biopsy endoscopic uss CT CAP

Question 29

oesophageal cancer mx?

Answer 29

ivor lewis surgergy

Question 30

most common type of cancer? in stomach?

Answer 30

adenocarcinoma

Question 31

gastric cancer Mx

Answer 31

endoscopic mucosal resection | gastrectomy

Question 32

Ix for gastroeneteritis?

Answer 32

faecal microscopy bloods -u&es axr/uss sigmoidoscopy

Question 33

what are risk factors for ulcer perforation?

Answer 33

NSAIDS bisphosphonates steroids

Question 34

1st line imaging is GI perfoartion?

Answer 34

erect cxr

Question 35

H2 antagonists

Answer 35

(e.g. ranitidine) 

Question 36

haitus hernia most definative imaging modality?

Answer 36

barium meal upper GI | OGD

Question 37

stimulant laxatives?

Answer 37

docusate sodium senna not indicated in gastrointestinal obsrtruction

Question 38

what is the most common cause of GI bleed

Answer 38

peptic ulcers mallory weis tears varices