A 44-year-old obese female is noted to have gallstones during an abdominal ultrasound, which was requested due to repeated urinary tract infections. Apart from the repeated UTIs she is otherwise well.
What is the most appropriate management of the gallstones?
Correct Answer D: Asymptomatic gallstones are common and do not require treatment.
Which of the following conditions is least associated with Helicobacter pylori?
Correct Answer C:
Helicobacter pylori: Helicobacter pylori is a Gram negative bacteria associated with a variety of gastrointestinal problems, principally peptic ulcer disease.
Associations:
The role of H pylori in Gastro-oesophageal reflux disease (GORD) is unclear - there is currently no role in GORD for the eradication of H pylori.
Management - eradication may be achieved with a 7 day course of:
A 54-year-old man who is known to have gastric cancer is reviewed in clinic. He asks you about a rash he has developed.
Which of the following skin disorders is most associated with gastric cancer?
Correct Answer E:
Skin disorders associated with malignancy: Paraneoplastic syndromes associated with internal malignancies:
Each one of the following is associated with pancreatic cancer, except:
Pancreatic cancer:
Features:
Management:
A 36-year-old man presents with dyspepsia. No alarm symptoms are present. This is his first episode and he has no significant medical history of note. A test-and-treat strategy is agreed upon.
What is the most appropriate investigation to test for Helicobacter pylori?
Correct Answer E: The urea breath test is highly sensitive, specific and non-invasive. There is no indication for an endoscopy. Stool antigen, rather than culture, is an alternative.
Helicobacter pylori: tests:
Urea breath test:
Rapid urease test (e.g. CLO test):
Serum antibody:
Culture of gastric biopsy:
Gastric biopsy:
Stool antigen test:
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