Gastrointestinal pathology :)

A middle-aged man with longstanding Barrett’s esophagus is referred for specialist review after he reports increasing dysphagia over the last 4 months. He has noted that it initially only affected solids but now struggles with liquids as well. What is the next most important investigation to aid diagnosis?

What is the first line maintenance treatment for Ulcerative Collitis?

What do parietal cells produce?

An elderly man with a history of alcohol abuse goes to ED with hematemesis for 1 day. He has no abdominal or chest pain. His eyes are reddened and he admits to drinking heavily the night before he vomited several times. What may be the reason for this?

A 20-year-old man presents to the ED with fever and severe right lower quadrant (RLQ) pain for 1 day. Prior to this episode, he reports 2 months of crampy abdominal pain, generalized malaise, a 5kg weight loss, and occasional bloody diarrhoea. On physical exam, the patient appears uncomfortable and has a tender mass is in the RLQ. An abdominal CT scan demonstrates normal appendix and inflammation of the distal ileum and several areas of the colon without rectal involvement.Which of the following is the most likely diagnosis?

An older woman arrives at ED complaining of abdominal pain. She states that the pain began as a vague aching but has migrated to the left side of her abdomen. She had a fever over the past 3 days and just not feeling like herself. She also complains of being more constipated than usual. Your abdominal exam reveals normal bowel sounds, mild distension, and tenderness over the left lower quadrant. What is most likely the reason for this

What is the blood supply to the superior rectum?

A elderly man attends your clinic with a three-month history of weight loss ofapproximately 9 kg despite a normal appetite. A full blood count reveals that his hemoglobin is 9.0 g/dL (previous hemoglobin was 13.5 g/dL one year ago) and the MCV is 71 fL.

The abdominal examination is unremarkable and per rectum exam is unremarkable. The patient states that he has normal bowel habits and has been feeling quite tired lately. What is the most appropriate management?

A middle aged woman has a four-month history of diarrhoeaand bloating. Associated symptoms include lethargy and weight loss.

Full blood count reveals:
hemoglobin of 9.3 d/gL (13.8 to 17.2)
MCV 70 fL. (77-95)

What other investigation allow proper patient diagnosis?

You see an elderly man with an acute episode of hematemesis, who was admitted the night before and is awaiting an upper GI endoscopy. You are asked on the ward round about the common causes of upper GI bleeding. From the list below, which of the following is the most common cause of upper GI bleeding?

You see a middle aged woman with Crohn’s disease. Due to a severe attack of Crohn’s which failed to respond to medical therapy, she had a small bowel resection. Your registrar tells you that she is at risk of developing vitamin B12 deficiency as a result of her surgery. Which part of the bowel is responsible for the absorption of vitamin B12?

You see a middle aged man who was admitted for an elective upper GI endoscopydue to longstanding GORD which has failed to improve on antacids and PPIs. Your registrar suspects that this patient may have Barrett’s oesophagus and asks you to define what this is:

Which of the following is the most common cause of duodenal ulcers?

A middle-aged lorry driver presents to the GP with chest pain that usually occurs after having a meal. He has no major past medical history and he takes ibuprofen regularly. He is otherwise fit and healthy. What is the most important next step in management?

You see a middle aged lorry driver, who presents to you with a three-month history of heartburn after meals which has not been settling with antacids and PPIs. You suspect that the patient has a hiatus hernia. The most appropriate investigation for diagnosing a hiatus hernia is:

A middle-aged woman is referred for upper gastrointestinal (GI) endoscopy following a four-month history of epigastric pain despite treatment with antacids and proton pump inhibitors (PPIs). The results demonstrate a duodenal ulcer coupled with a positive campylobacter-like organism (CLO) test. The patient has no past medical history and has no known drug allergies. What is the most appropriate treatment?

You see a middle aged man with a three-month history of epigastric dullabdominal pain. The pain is worse in the mornings and is better after meals. There is no history of weight loss and the patient’s bowel habits are normal. His abdomen is soft and experiences moderate discomfort on palpation of the epigastric region. What is the most likely diagnosis?

You see an elderly man who comes to ED with epigastric pain. The pain started 3 days ago and today his stools color has changed to a ‘tarry-black’ color. Associated symptoms include nausea and lethargy.
The patient is alert and orientated with a pulse rate of 99 and blood pressure of 98/69, respiratory rateof 18, oxygen saturations of 98 per cent on room air and temperature of 37.2°C.
The abdomen is soft with marked tenderness in the epigastric region and bowel sounds are present. The rectum is empty, on PR examination, with some traces of melaena. The patient has been started on high flow oxygen and has been given some oral analgesia. The most appropriate next step in managing this patient is:

As you palpate the right upper quadrant (RUQ) of a middle aged woman’s abdomen, you notice that she stops her inspiration for a brief moment. The patient states that over the last 2 days she gets pain in her RUQ that radiates to her back shortly after eating.

Her vitals are temperature 38°C, heart rate (HR) 95, blood pressure (BP)130/75, respiratory rate (RR) 16. What is the initial diagnostic modality of choice for this disorder?

A middle-aged woman at ED complains of pain in her RUQ that is steady but gets worse with eating over the past 2 days. The pain also radiates to the right side of her mid-back. No vomiting. Her only medication is an oral contraceptive.
Her BP is 140/75 mm Hg, HRis 80 beats per minute, temperature is 37°C, and RR is 16 breaths perminute. Laboratory tests are within normal limits. What is the most likely diagnosis?

A 50-year-old man presents to the ED complaining of abrupt onset of epigastric pain that radiates to his back. He describes the pain as constant and associated with nausea and vomiting. The pain improves mildly if he leans forward. He has a 20-pack-year smoking history and consumes a 6-pack of beer daily for more than 5 years. His BP is 150/80 mm Hg, HR is 98 beats per minute, temperature is 37.8°C, and his RR is 18 breaths perminute. He is tender to palpation in the epigastric area. His WBC count is normal and lipase 520 U/L (0-160 U/L). What is the most likely diagnosis?

A 55-year-old man presents to the ED complaining of mild diffuse abdominal pain. The pain began upon waking up and is associated with some nausea. He denies fever, vomiting, diarrhoea, and rectal bleeding. His BP is 143/71 mm Hg, HR is 87 beats per minute, temperature is 36°C, and RR is 16 breaths per minute. His abdomen is tense but only mildly tender. You order baseline labs. His chest radiograph is seen below. Which of the following is the most likely diagnosis?

A 33-year-old man presents to the ED complaining of lower abdominal pain. He states that last night he ate pizza with pepperoni for dinner, went to sleep, and awoke several hours later with a vague, periumbilical pain. The pain has been constant since its onset and has migrated to his lower abdomen more on the right than left. Since eating the pizza he has no appetite. He is nauseated and vomited twice in the ED. His BP is 125/70 mm Hg, HR is88 beats per minute, temperature is 38°C, and his RR is 16 breaths perminute. On exam, his RLQ is tender to palpation.What is the most likely diagnosis?

Patient presents with painless jaundice and palpable RUQ mass. Which of the following is the most likely diagnosis

A 71-year-old obese man is brought to the ED complaining of constant left middle quadrant abdominal pain with radiation into his back. His past medical history is significant for hypertension, peripheral vascular disease, and kidney stones. He smokes a pack of cigarettes daily. His BP is 145/80 mm Hg, HR is 90 beats per minute, temperature is 37.2°C, and RR is 16 breaths per minute. Abdominal exam shows a pulsatile abdominal mass. An abdominal radiograph reveals normal loops of bowel. Which of the following is the most likely diagnosis?

A 78-year-old woman is brought to the ED by EMS complaining of vomiting and abdominal pain that began during the night. EMS reports that her BP is 90/50 mm Hg, HR is 110 beats per minute, temperature is 38°C, and RR is 18 breaths per minute. After giving her a 500 mL bolus of normal saline, her BP is 115/70 mm Hg. During the exam, you notice that her face and chest appear jaundiced. What is the most likely diagnosis?

What is NOT true regarding GI anatomy?

Which is NOT a major lymph structures involved with abdominal drainage?

Which of these does NOT directly come off of the celiac trunk?

Which comes first in the development of a carcinoma?

What is not a sign of dyspepsia?

Which of the following is not a way to diagnose Celiac's disease?

Which are symptoms of diverticulitis?

How can you investigate for diverticulitis?

What is not an investigation for Crohn's Disease?

Which is not a way to investigate for ulcerative colitis?

What is the condition that describes a type of pain related to the gallbladder that occurs when a gallstone temporarily obstructs the cystic duct and the gallbladder contracts?

What is not true regarding cholangitis?

What is NOT true regarding pseudocyst?

How does ischemic bowel NOT present?