Gastro Fun Quiz!!

A 29 year old women presents with fatigue, abdominal bloating and pain and loose stools for the past 3 months. She has also been suffering with recurrent aphthous ulcers in her mouth. She opens her bowels between 2 and 4 times per day, and describes these stools as type 5/6, greasy and difficult to flush. She has no past medical history and her only family history of note is that her brother has Type 1 Diabetes. What investigation would most likely lead to a diagnosis?

A 74 year old lady is brought in by ambulance from her care home after vomiting “black fluid” several times after lunch. She has not vomited since being in hospital. She cannot give a more detailed description of the quality of quantity of what she vomited, but said that it smelled awful. She denies any pain, syncope, palpitations or loss of consciousness. She has not opened her bowels for 24 hours and passed a normal stool at that time. On examination she is haemodynamically stable but does has mild epigastric tenderness. PR reveals an empty rectum with no melaena. Blood tests are sent. What scoring system would be useful in predicting this patient’s risk of having an upper GI bleed?

A 64 year old lady is booked in to have an endoscopy to investigate reflux symptoms. During the procedure the endoscopist notices that the lower portion of her oesophagus, near the sphincter, has an abnormal appearance. Biospies are taken, and the results show a histological change to columnar epithelium. What term is used to describe this process?

A 24 year old lady presents to her GP with irregular bowel movements and crampy abdominal pain. She normally opens her bowels between 1 and 3 times per day, and this can vary from normal to loose. Occasionally she has mucus in her stools, but denies any PR bleeding. She tends to get generalised crampy pain in her abdomen prior to opening her bowels, which tends to relieve the pain. These symptoms have not changed in the last year. She denies any weight loss or anorexia. She only drinks limited alcohol on special occasions and does not smoke. She is worried as her uncle was recently diagnosed with Crohns disease and she is worried that she may have the condition. She has no other family history. Abdominal and PR examination are normal. Routine blood tests come back normal. What would be the most appropriate investigation for reassuring this patient?

A 34 year old woman presents to her GP with epigastric discomfort and reflux symptoms. Her GP sends her for a urea breath test, which is positive. As well as antibiotics, what other medication should be prescribed as part of the treatment for her newly diagnosed infection.

A 43 year old known alcoholic presents to A&E with haematemesis. It started 1 hour ago, and since then he says he has been vomiting about a cupful of fresh red blood every 30 minutes. What is the most likely cause of this bleeding?

A 34 year old man with known Ulcerative Colitis presents with a flare. He is opening his bowels with blood and mucus 8-10 times a day for the last 3 days. He is dehydrated and lethargic on examination. His observations are as follows: BP 115/67 HR 105 Temp 37.8C RR 18 Sats 98% on room air What is the most appropriate first line treatment for his flare up?