GI

Question 1

What is the clinical presentation of oesophageal cancer?

Answer 1

• progressive dysphagia (solids to liquids)
• weight loss
• odynophagia (pain swallowing)
• hoarseness, cough
  retrosternal discomfort

Question 2

What is the clinical presentation of stomach cancer?

Answer 2

• epigastric pain
• early satiety
• wt loss
• nausea and vomiting
• iron deficiency anaemia
• virchows node

Question 3

What is the clinical presentation of right colon cancer?

Answer 3

asymptomatic early on
iron deficiency anaemia
fatigue, pallor
occult bleeding
abdo discomfort or mass

Question 4

What is the clinical presentation of left colon cancer?

Answer 4

change in bowel habits (constipation)
rectal bleeding
colicky pain
signs of bowel obstruction

Question 5

What is the clinical presentation of
rectum cancer?

Answer 5

tenesmus
mucus in stool
rectal bleeding
change in bowel habits
palpable mass on the digital rectal exam

Question 6

what bacteria increases the risk of gastric cancer?

Answer 6

H.Pylori

Question 7

What are the risk factors of gastric cancer?

Answer 7

smoking, alcohol and H.pylori

Question 8

what are the cancer tumour markers for colorectal

Answer 8

CEA

Question 9

what are the cancer tumour markers for colorectal, pancreatic/ cholangiocarcimona? (bile duct cancer)

Answer 9

CA19-9

Question 10

what are the cancer tumour markers for ovarian/endometrial?

Answer 10

CA125

Question 11

what are the cancer tumour markers for hepatocellular carcinoma?

Answer 11

AFP

Question 12

What are the features of PUD?

Answer 12

Duodenal ulcer (more common): epigastric pain relieved by eating
Gastric ulcer: epigastric pain worsened by eating
Features of upper GI bleed (haematemesis, melena)

Question 13

What are the features of appendicitis?

Answer 13

Pain central abdo before localising to RIF
anorexia
tachycardia, low grade pyrexia
Rovsing’s sign: more pain in RIF than LIF when palpating LIF

Question 14

Acute pancreatitis features

Answer 14

severe epigastric pain - radiates to back
vomiting
tenderness, ileus and low-grade fever
Cullens sign and grey-turner’s sign
main causes: alcohol, gallstones, post ERCP

Question 15

What does I GET SMASHED in pancreatitis stand for?

Answer 15

I- idiopathic
G - gallstones
E - ethanol
T - trauma
S - steroids
M - mumps
A - autoimmune
S - scorpion sting
H - hyperlipidaemia
E - ERCP
D - drugs

Question 16

What is Grey-turners sign?

Answer 16

Flank discolouration

Question 17

What is the cullens sign?

Answer 17

periumbilical discoluration

Question 18

What are the features and RFs of acute cholecystitis?

Answer 18

RUQ pain. Associated: Nausea, vomiting, fever, tachycardia. RF: known gall stone disease, woman, overweight, age 40+, caucasian.

Question 19

What are the features of ascending cholangitis?

Answer 19

Charcot’s triad: Jaundice, Fever, RUQ pain

Question 20

What are the features and RFs of Ischaemic colitis?

Answer 20

acute non-specific abdominal pain out of proportion to exam findings. RF: known AF

Question 21

Diverticulitis features and RF?

Answer 21

LIF pain. Associated: fever, diarrhoea, PR bleeding, nausea + vomiting.
RF: older age, low fibre diet, NSAID use, obesity

Question 22

What are the features of bowel obstruction and RFs?

Answer 22

Diffuse abdo pain. Associated: bilious/ faecal vomiting, constipation, absent flatus, abdo distention
RF: hernia, malignancy, adhesion

Question 23

What are the features and RFs for gastroenteritis?

Answer 23

Diffuse abdominal pain. Associated: N + V, fever, diarrhoea
RF: infectious contact, infected water/ food, immunocompromised

Question 24

What are the features of acute hepatitis?

Answer 24

Abdo: pain. fever, fatigue and flu-like symptoms and N + V
Causes: viral A/B(+/-D)/C/E, auto immune, alcoholic, NASH

Question 25

What are the features of abdominal aortic aneurysm?

Answer 25

Severe central abdominal pain that radiates to the back. Patients may suddenly collapse or severe central pain and developing shock. History of CVD