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Clinical Exam

References

 

Gastroenterology and Hepatology

Gi Symptoms: heartburn | chest pain | dysphagia | persistent vomiting | dyspepsia. |
oesophageal dysmotility, infections and reflux | chronic abdominal pain |peptic ulcer | Helicobacter Pylori| acute and chronic gastrointestinal bleeding | Coeliac disease | gastric ca | oesophageal ca | pancreatic ca | colorectal ca |Anal Ca | Inflammatory bowel disease | ulcerative colitis | Crohn's disease | Irritable bowel syndrome and functional bowel disease |Acute and chronic pancreatitis| Diarrhoea, GI infection and AIDS | Acute and chronic liver disease| CLD complications cirrhosis: ascites, encephalopathy, portal hypertension/varices. | viral hepatitis | Immunological liver disease | Haemochromatosis. | diagnostic tests endoscopy, colonoscopy, hepatobiliary imaging | Principles of nutrition.

 

  • Assessment, investigation and management of heartburn, chest pain, dysphagia, persistent vomiting, dyspepsia

    exam question

    2004 paper two question 31 Pharmacological managemetn of abdominal pain, nausea and vomiting in woman with bowel obstruction secondary to malignancy

    2004 paper two question 63 Self-expanding metal stent placement provides immediate relief for dysphagia secondary to oesophageal CA

     

    References

    9 years of recurrent dysphagia
    The LancetVolume 369, Issue 957526 May 2007-1 June 2007Page 1814
    Krishna P Basavaraju, C Roger Hunt and Navneet K Ahluwalia


    Diagnosis and management of oesophageal dysmotility, infections and reflux.

    Exam Questions

    2003 paper one question 6 Histology of Barretts Oesophagus

2004 paper two question 26 Antibiotics and oesophageal ulceration

2004 paper two question 63 Self-expanding metal stent placement provides immediate relief for dysphagia secondary to oesophageal CA

References

Gastro-oesophageal reflux disease • REVIEW ARTICLE
The Lancet, Volume 367, Issue 9528, 24 June 2006-30 June 2006, Pages 2086-2100
Paul Moayyedi and Nicholas J Talley

  • Acute and chronic abdominal pain.
  • Diagnosis and management of peptic ulcer: diagnostic features, including detection of Helicobacter Pylori; current regimens for eradication of Helicobacter Pylori; the use of H2 blockers and proton pump inhibitors.
  • Investigation and management of acute and chronic gastrointestinal bleeding.

exam questions

2002 paper two question 90 Differential diagnosis for upper GI bleeding

References

NEJM Prevention and treatment of major blood loss Mannucci and levi 356;22 May 31 2007; 2301-11

UK guidelines on the management of varicealhaemorrhage in cirrhotic patients
R Jalan and P C Hayes
Gut 2000;46;1-15

Non-variceal upper gastrointestinal haemorrhage:Guidelines
KR Palmer
Gut 2002;51;1-6

  • Coeliac disease; varied presentation in children and adults; role of diagnostic tests, including biopsy and serum antibodies; long-term treatment and potential complications.
  • Presentation, investigation, diagnosis and management of gastrointestinal malignancy, including gastric,.

Exam questions

2003 paper two question 39 Gasroenteropancreatic neuroendocrine tumours diagnosis and management

References

Gastrointestinal stromal tumour
The LancetVolume 369, Issue 957419 May 2007-25 May 2007Pages 1731-1741
Brian P Rubin, Michael C Heinrich and Christopher L Corless

oesophageal CA,

Exam Questions

2003 paper two question 80 Use of EUS in staging oesophageal Cancer Repeat Question 2004 paper two question 87

References:

Esophageal Cancer PC Enzinger and RJ Mayer NEJM 2003;349:2241-52

 

 

pancreatic CA and

 

colorectal cancer

Exam Questions

2003 paper one question 28 use of CAE in colorectal cancer management repeat question 2002 paper one question 53

2004 paper one question 43 Polyp type and risk of developing colorectal cancer q repeated 2003 paper one question 62

2003 paper two question 18Hereditary non-polyposis colon cancer (HNPCC or Lynch syndrome) - associated malignancies cancer

2004 paper two question 40 Investigating change in bowel habit

References

Anal Cancer

Exam Questions

2003 paper two question 85 Management of Anal Cancer

References

 

  • Inflammatory bowel disease, including ulcerative colitis and Crohn's disease; identification of patients with severe acute colitis; the importance of medical/surgical collaborative care.

exam questions

2002 paper two question 29 Medical management to maintain remission

2004 paper two question 8 Treatment of Chron's Disease cf UC

2004 paper two question 73 Chron's flare diagnosis, history and CT scan

References

Inflammatory bowel disease: cause and immunobiology
The LancetVolume 369, Issue 957312 May 2007-18 May 2007Pages 1627-1640
Daniel C Baumgart and Simon R Carding


Inflammatory bowel disease: clinical aspects and established and evolving therapies
The LancetVolume 369, Issue 957312 May 2007-18 May 2007Pages 1641-1657
Daniel C Baumgart and William J Sandborn

  • Irritable bowel syndrome and functional bowel disease: frequency, typical symptoms.
  • Acute and chronic pancreatitis: presentation and management: differential diagnosis of malabsorption syndromes, including breath gas analysis; risk factors; diagnostic methods and pancreatic function.
  • Diarrhoea, GI infection and AIDS.
  • Acute and chronic liver disease: common causes, investigation and management.

Exam Question

2003 paper two question 36 Differentials for hyperbilirubineamia Repeat quesion 2002 paper two question 59

2002 paper two question 73 classic presentation of veno-occlusive liver disease and its differentials

2002 paper two question 81 differentials for ruq pain, vomiting and abnormal liver

2003 paper one question 38 Nonalcoholic fatty liver disease is a common explanation for assymptomatic abnormal liver-test results in western society function tests in pregnancy

2003 paper two question 89 Differentials for acute hepatitis

2004 paper one question 34 Cirrhosis of the liver in genetic alpha-1-antitrypsin deficiency is a result of Intracellular accumulation of alpha-1-antitrypsin

2004 paper two question 24 Differentials for acute hepatitis

2004 paper two question 80 Metabolic syndrome is associated with Non-alcoholic fatty liver disease

References

  • Management of the complications of cirrhosis: ascites, encephalopathy, portal hypertension/varices.

Exam Questions

2002 paper two question 5 predictors of variceal bleeding

2003 paper two question 50 Management of variceal bleeding following acute event has been treated

2004 paper one question 26 management of acute variceal bleeding

References

UK guidelines on the management of variceal haemorrhage in cirrhotic patients
R Jalan and P C Hayes
Gut 2000;46; supplement 31-15

  • Hepatitis: viral hepatitis, prophylaxis and treatment.

Exam Questions

2003 paper one question 19 hepatitis C and risk of progression to cirrhosis question repeated 2004 paper one question 15

2003 paper two question 23 Chronic Hepatitis B, differentials for acute hepatitis

2003 paper two question 41 extra hepatic manifestations of hep c - raynauds/rheum

2004 paper two question 53 Haematological manifestations of Hepatitis C and treatment

2005 paper two question 31 ESRD and haemodialysis general suppression of immune system due to ureamia. If initial attempts at hep b immunisation are inadequate appropriate to Immunise with up to 3 further doses of hepatitis B vaccine

2005 paper two question 35 In immunocompormised host prophylactic anti-viral therapy. is indicated in those at risk of reactivation of hep b

References

  • Immunological liver disease.
  • Haemochromatosis.

Exam Questions

2002 paper two question 28 xray findings in haemachromatosis

2002 paper two question 46 Diagnosis of iron overload syndromes / Haemochromatosis

References

  • Knowledge of appropriate use of endoscopy, colonoscopy, hepatobiliary imaging and other diagnostic tests in gastrointestinal disease.

Exam Questions

2002 paper one question 35 using ultrasound to detect gallstones

2002 paper two question 61 Risks associated with PEG insertion

2003 paper two question 7 Risks associated with ERCP

2003 paper two question 14 An unanswerable question with a CT abdo

References

  • Dietetic and nutrition services: principles of nutrition.

Exam questions

2003 paper one question 3 Site of iron absorption

2004 paper one question 57 In a patient with a distal gastrectomy, Iron is the most likely nutritional deficiencies.

2004 paper one question 59 Megaloblastosis in Transcobalamin I deficiency

2004 paper two question 48 Investigating Iron deficiency anaemia

References