Name: Amy Watret

Theme: Upper GI

OPTION LIST

A	Achalasia	I	GORD
B	Adenocarcinoma	J	Haemorrhagic Gastritis
C	Barrett’s Oesophagus	K	Mallory-Weiss tear
D	Bulbar Palsy	L	MALT
E	Duodenal Ulcer	M	Pyloric Stenosis
F	Gastric Ulcer	N	Zollinger-Ellison Syndrome
G	Gastroenteritis (Salmonella)	O
H	Gastroenteritis (Staph. Aureus)	P

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

1. A 35-year-old man presents with a long history of epigastric burning pain, made worse at night and when drinking hot liquids. Recently he has had difficulty swallowing solids. Endoscopy shows lower oesophageal erosions and strictures and pH demonstrates acidity.

2. A 20-year-old student gives an 8 hour history of very frequent vomiting and epigastric cramping. O/E she is pale and shivering. There is no lower abdominal pain, diarrhoea or dysentery.

3. A 30-year-old woman presents with haematemesis. She has recurrent peptic ulceration and is taking omeprazole. Despite this, she has persistently high serum gastrin levels. Endoscopy shows a large 3cm actively bleeding ulcer in the duodenum.

4. A 50-year-old women presents with chest pain associated with regurgitation of solids and liquids equally, both occurring after swallowing. Diagnosis is confirmed by a characteristic ‘beak like’ tapering of the lower oesophagus on barium swallow and manometry shows failure of relaxation of the LOS.

5. A 65-year-old woman presents with a 3 month history of anorexia, weight loss and epigastric pain. Blood tests reveal an iron deficiency anaemia. Endoscopy shows a thickened rigid gastric wall known as ‘leather bottle stomach’ indicating infiltration into all layers of the gastric wall. Numerous signet ring cells on biopsy diffusely infiltrate the mucosa.

ANSWERS

1. I

2. H

3. N

4. A

5. B