Upper GI

Question 1

Which organ in the GI tract is responsible for producing bile to metabolise carbohydrates, proteins, lipids, and drugs?

Answer 1

The liver.

Question 2

What is the primary function of the gall bladder in the digestive system?

Answer 2

It stores and concentrates bile from the liver.

Question 3

Which organ is responsible for the release of digestive enzymes into the GI tract?

Answer 3

The pancreas.

Question 4

How does the small intestine facilitate the maximum absorption of nutrients?

Answer 4

It is coated with microvilli to increase the surface area.

Question 5

What are the two primary functions of the large intestine?

Answer 5

It absorbs water and expels waste.

Question 6

The process of moving material through the gastrointestinal tract via wave-like muscle contractions is known as _____.

Answer 6

Peristalsis.

Question 7

What is the common clinical term used to describe indigestion?

Answer 7

Dyspepsia.

Question 8

What occurs physiologically in Gastro-oesophageal Reflux Disease (GORD)?

Answer 8

The oesophageal sphincter is weakened, allowing stomach contents to reflux into the oesophagus.

Question 9

Which bacterium is the most common cause of inflammation in the stomach lining (gastritis)?

Answer 9

$H. \text{pylori}$ ($Helicobacter \text{ pylori}$).

Question 10

If left untreated, what condition can chronic gastritis eventually result in?

Answer 10

Peptic ulceration.

Question 11

Which two substances are noted for increasing the risk of developing gastritis?

Answer 11

Alcohol and NSAIDs (Non-steroidal anti-inflammatory drugs).

Question 12

What is the difference between a gastric ulcer and a duodenal ulcer?

Answer 12

Gastric ulcers develop in the stomach, while duodenal ulcers develop in the duodenum.

Question 13

List three common symptoms of dyspepsia related to abdominal comfort.

Answer 13

Bloating, flatulence, and a feeling of fullness.

Question 14

Which psychological factors are identified as risk factors for dyspepsia?

Answer 14

Stress, anxiety, and depression.

Question 15

Why is it important to ask a dyspepsia patient about their use of OTC, herbal, and prescription medications?

Answer 15

Certain medications, such as NSAIDs, can cause or aggravate dyspepsia symptoms.

Question 16

At what age does the first incidence of dyspepsia become a ‘Red Flag’ requiring referral?

Answer 16

Over 50 years old.

Question 17

Why is ‘black tarry stool’ considered a red flag in patients with upper GI symptoms?

Answer 17

It indicates the presence of digested blood, suggesting a potential GI bleed.

Question 18

What red flag symptom involves the physical sensation of swallowing?

Answer 18

The feeling of food sticking in the throat.

Question 19

Which types of antacid salts provide a rapid onset but have a short duration of action?

Answer 19

Sodium and potassium salts.

Question 20

How do magnesium and aluminium salts differ from sodium salts in the treatment of dyspepsia?

Answer 20

They dissolve more slowly but provide a longer duration of action.

Question 21

Which antacid salt is characterised by both a fast onset and a long duration of action?

Answer 21

Calcium.

Question 22

When is the optimal time for a patient to take antacids and alginates for maximum effect?

Answer 22

After food and before bed.

Question 23

Regarding formulation, why might a patient prefer liquid antacids over tablets during an acute episode?

Answer 23

Liquid formulations act the quickest.

Question 24

Which common alginate brand is specifically noted as safe for use during pregnancy?

Answer 24

Gaviscon.

Question 25

In Gaviscon, what is the specific role of sodium alginate?

Answer 25

It reacts with acid to form a low-density gel (raft) that blocks stomach contents from entering the oesophagus.

Question 26

How does calcium carbonate contribute to the efficacy of Gaviscon?

Answer 26

It reduces acid pH and releases calcium ions that strengthen the alginate gel raft.

Question 27

What is the function of sodium bicarbonate in the Gaviscon 'raft' mechanism?

Answer 27

It reacts with acid to produce $CO_{2}$, which makes the alginate raft float on top of the stomach acid.

Question 28

Mechanism of Action: Proton Pump Inhibitors (PPIs)

Answer 28

They irreversibly inhibit Proton ($H^{+}$) pumps in parietal cells to reduce gastric acid secretion.

Question 29

Which two PPIs are available Over-The-Counter (OTC) in the UK?

Answer 29

Esomeprazole and Omeprazole.

Question 30

What is the minimum age requirement for purchasing OTC Proton Pump Inhibitors?

Answer 30

18 years old.

Question 31

What is the maximum licenced duration for the continuous use of OTC PPIs?

Answer 31

14 days.

Question 32

Why should patients be advised that PPIs are not for immediate symptom relief?

Answer 32

They are slow-acting and typically take 1–2 days to have a full effect.

Question 33

What lifestyle modification is recommended for patients experiencing nocturnal (night-time) reflux?

Answer 33

Raising the head of the bed by adding more pillows.

Question 34

How is a diagnosis of peptic ulcer disease definitively confirmed?

Answer 34

Via endoscopy.

Question 35

What are the three major complications associated with peptic ulcer disease?

Answer 35

Haemorrhage, perforation, and gastric outlet obstruction.

Question 36

Describe the typical timing and nature of pain associated with stomach ulcers.

Answer 36

A burning pain that often occurs between meals or at night when the stomach is empty.

Question 37

Why might a patient with a chronic stomach ulcer experience fatigue?

Answer 37

It can be secondary to anaemia caused by chronic internal bleeding.

Question 38

To avoid aggravating an ulcer, how long before bed should a patient ideally eat their evening meal?

Answer 38

3–4 hours before bed.

Question 39

What is the 'gold standard' advice for patients who must take NSAIDs but are at risk of ulcers?

Answer 39

Ensure the NSAIDs are taken with food.

Question 40

Term: Nausea

Answer 40

Definition: A sensation of discomfort or unease in the stomach that often precedes vomiting.

Question 41

Term: Vomiting

Answer 41

Definition: The forceful expulsion of gastric contents.

Question 42

Where in the brain is the 'vomiting centre' located?

Answer 42

The medulla oblongata.

Question 43

What is the function of the Chemoreceptor Trigger Zone (CTZ)?

Answer 43

It detects toxins or drugs in the blood and sends signals to the GI tract to induce vomiting.

Question 44

Which inner ear infection is a common cause of nausea and dizziness?

Answer 44

Labyrinthitis.

Question 45

What dietary advice involving specific herbs is recommended to alleviate nausea?

Answer 45

Drinking ginger or peppermint tea or eating foods containing ginger.

Question 46

Approximately what percentage of women are affected by nausea and vomiting in early pregnancy?

Answer 46

Greater than $50\% $.

Question 47

By which week of gestation does pregnancy-related nausea and vomiting usually resolve?

Answer 47

16–20 weeks.

Question 48

List two risk factors for severe nausea and vomiting in pregnancy ($Hyperemesis \text{ Gravidarum}$).

Answer 48

Increased placental mass (e.g., multiple pregnancy) and obesity.

Question 49

What simple morning dietary intervention is suggested for pregnancy-related nausea?

Answer 49

Eating plain biscuits or crackers in the morning.

Question 50

Why are cold meals often better tolerated than hot meals in smell-related pregnancy nausea?

Answer 50

Cold meals generally produce fewer odours that trigger symptoms.

Question 51

Which specific acupressure point is suggested for managing nausea?

Answer 51

The P6 point on the ventral aspect of the wrist.

Question 52

In children, what age and duration threshold for vomiting constitutes a Red Flag?

Answer 52

Vomiting in children under 1 year old that lasts more than 24 hours.

Question 53

Why is 'early morning vomiting' a specific Red Flag in women of childbearing age?

Answer 53

It is a primary indicator of pregnancy that requires confirmation.

Question 54

Which red flag symptom for N&V is particularly concerning during pregnancy due to the risk of malnutrition or dehydration?

Answer 54

Unexplained loss in body weight.

Question 55

What is the recommended dietary pattern for someone suffering from nausea to avoid overloading the stomach?

Answer 55

Eat smaller, more frequent meals.