Gastroenterology and Surgery Flashcards

A young woman has right iliac fossa pain, anorexia, and a positive Rovsing's sign. What is the most likely diagnosis?

Answer: Acute appendicitis

Migratory RIF pain with anorexia and Rovsing's sign is classic for acute appendicitis.

Which type of inflammatory bowel disease characteristically shows transmural inflammation with skip lesions?

Answer: Crohn's disease

Crohn's disease causes transmural, discontinuous (skip) lesions anywhere from mouth to anus.

A patient with long-standing GORD has columnar metaplasia on oesophageal biopsy. What is this condition?

Answer: Barrett's oesophagus

Barrett's oesophagus is columnar metaplasia of the distal oesophagus and a precursor to adenocarcinoma.

Which organism is most strongly associated with peptic ulcer disease and gastric MALT lymphoma?

Answer: Helicobacter pylori

H. pylori infection underlies most peptic ulcers and is causally linked to gastric MALT lymphoma.

A 60-year-old presents with altered bowel habit, iron-deficiency anaemia, and weight loss. What is the most important diagnosis to exclude?

Answer: Colorectal carcinoma

Change in bowel habit with iron-deficiency anaemia in an older adult mandates exclusion of colorectal cancer.

Which finding on erect chest X-ray indicates a perforated viscus?

Answer: Free air under the diaphragm

Pneumoperitoneum seen as free subdiaphragmatic air indicates perforation of a hollow viscus.

What is the most appropriate initial management of a small bowel obstruction with no signs of strangulation?

Answer: Nasogastric decompression, IV fluids, and nil by mouth

Uncomplicated SBO is managed conservatively with 'drip and suck' before considering surgery.