phase 2 GI

Question 1

Which of the regions of the stomach is closest t oesophagealgastric junction

Answer 1

cardia

Question 2

risk factors of haemhoroids

Answer 2

• obesity
• chronic constipation (causing straining)
• coughing

Question 3

symptoms of haemarhoids

Answer 3

• fresh red blood and mucous in the
  stool
• an itchy anus
• soreness around the anus
• Bright red bleeding
• pain on passing stools
• Mucus discharge,

Question 4

most appropriate description of Barrett’s oesophagus?

Answer 4

Metaplasia of the squamous epithelium of the lower third of the oesophagus to columnar epithelium

Question 5

gold standard test for ceolaics

Answer 5

Endoscopy with duodenal biopsy

Question 6

bowel cancer screening home-test kit name

Answer 6

Faecal immunochemical tests (FIT),

Question 7

do PPIs cause peptic ulcers?

Answer 7

no they are treatment for it

causes:
NSAIDs
Helicobacter pyloric infection
Haemodynamic shock
Stress

Question 8

is sudden onset dysphagia of solids and liquids a red flag for oesophageal cancer

Answer 8

no - The dysphasia is gradual in onset, sudden onset dysphasia of solids and liquids from
the start indicated benign disease

Question 9

main types of diarrohea

Answer 9

secretory, osmotic, exudative, inflammatory, dysentery

Question 10

symptoms of small bowel obstruction

Answer 10

Vomiting, nausea, constipation, abdominal distention. Intermittent abdominal pain .

Question 11

What abdominal radiograph findings would confirm small bowel obstruction

Answer 11

Dilated jejunum and/or ileum, Absence of gas in bowel distal to the obstruction.

Question 12

Name a complication of small bowel obstruction which would lead to emergency surgery

Answer 12

Bowel Ischaemia, or strangulation

Question 13

differentials for gastritis?

Answer 13

Peptic ulcer disease, GORD, non-ulcer dyspepsia, gastric lymphoma, gastric carcinoma

Question 14

Briefly describe the pathophysiology of haemorrhoids

Answer 14

Haemorrhoids are swelling and inflammation of veins in the rectum and anus

Question 15

describe internal haemorrhoidd

Answer 15

arise internally, are painless covered in mucus, they can also
prolapse.

Question 16

describe external haemorrhoids

Answer 16

Form at the anal opening, painful, covered with skin.

Question 17

Give 2 non-surgical and one surgical treatment of haemorrhoids (

Answer 17

• stool softener
• high fibre diet
• band ligation

Question 18

NICE IBD symptoms

Answer 18

• abdominal pain or discomfort that is either relieved by defecation or associated with altered bowel
  frequency or stool form
• Altered stool passage (straining, urgency, incomplete evacuation)
• Abdominal bloating (more common in women than men), distension, tension or hardness
• Symptoms made worse by eating
• Passage of mucus

Question 19

non-pharmacological treatments for GORD

Answer 19

• Weight loss (if obese)
• Healthy eating
• Smoking cessation
• Eat smaller meals
• Eat evening meal 3-4 hours before going to bed
• Reduce alcohol consumption
• Raise the head of the bed / use more pillows

Question 20

serology for coeliacs

Answer 20

Labs often look for either IgA-tTG or IgA-EMA then, if the result is vaguely positive, will look for the
other.

Some coeliac patients are IgA deficient, in which case, IgG versions of the above would be tested for

Question 21

risk factors for colorectal carcinomas.

Answer 21

Increasing age/old age/elderly
Alcohol
Smoking
Obesity
Low fibre diet
Saturated animal fat and red meat consumption
Colorectal polyps
Family history of GI cancer
Past medical history of cancer
Presence of colorectal polyps
Ulcerative colitis and Crohn’s disease
Genetic predisposition

Question 22

potential complications of diverticulitis

Answer 22

• Large bowel perforation
• fistula formation
• large bowel obstruction
• bleeding
• mucosal inflammation

Question 23

risk factors for oesophageal cancer

Answer 23

Alcohol
* Smoking tobacco
* Obesity
* GORD
* Achalasia

Question 24

first line drug used to treat haematemesis from ruptured oesophageal varices?

Answer 24

IV Terlipressin acts as a vasodilator to control variceal bleeding.

If terlipressin is contraindicated (for example in IHD) then IV somatostatin should be
used

Question 25

differential diagnoses for acute appendicitis

Answer 25

* Crohn’s disease * Ectopic pregnancy * UTI * Diverticulitis * Perforated ulcer * Food poisoning

Question 26

extra tests for acute appendicitis

Answer 26

* WCC (blood test) – will show increased neutrophils * CRP (blood test) – will be elevated as it is a marker of inflammation * ESR (blood test) – will be elevated as it is a marker of inflammation * Ultrasound – can detect an inflamed appendix and an appendix mass, confirmation with a CT scan would then be done * Pregnancy test – to exclude an ectopic pregnancy * Urinalysis – to exclude a UT

Question 27

3 signs which may be elicited on abdominal examination of small bowel obstruction

Answer 27

Abdominal distension (1) Hyperresonant bowel (1) Tinkling bowel sounds (1

Question 28

What may be seen on an abdominal x ray of a patient with a sigmoid volvulus

Answer 28

coffee bean sign

Question 29

drug class of choice used for acute flares of UC

Answer 29

5 – Amino-Salicylates (e.g. sulfasalazine, mesalazine)