Study Guide - Gastroenterology & Hepatology Lecture MRCP 1 - 123Doc Education

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A study guide for the Gastroenterology & Hepatology MRCP 1 course. These are slideshows only. The demonstration with video presentation and explanation that goes along with these slides, as well as free example exam questions and the paid full e-lecture can be viewed at https://www.123doc.com/electures/gastroenterology-hepatology/

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Study Guide - Gastroenterology & Hepatology Lecture MRCP 1 - 123Doc Education

  1. 1. Gastroenterology & hepatology lecture MRCP Part 1 Dr Siew C Ng Specialist Registrar in Gastroenterology
  2. 2. Need to know Topics! • Gastric physiology • Helicobacter pylori & peptic ulcer disease • Barrett’s oesophagus • Coeliac disease • Achalasia • Crohn’s disease & ulcerative colitis • Colorectal carcinoma • Irritable bowel syndrome • Viral hepatitis • Primary biliary cirrhosis • Primary sclerosing cholangitis • Acute pancreatitis • Ascites • Variceal bleed • Carcinoid syndrome
  3. 3. Gastric Physiology
  4. 4. Control of gastric acid secretion Antral cell Enterochomaffin Like cell Parietal call Histamine Gastrin B H+ K+ Gastrin B
  5. 5. The Following result in an increase in gastric acid secretion expect: A. Intraluminal amino acid B. Parasympathetic vagal innervation C. Secretin D. Gastrin E. Histamine
  6. 6. Proton Pump Inhibitor Inhibit Gastric parietal call H+ K+ ATPase  Antagonise stimulants of gastric secretion  T ½ life one hour  Irreversible enzyme inhibition  Reduce acidity by 90% over 24 hour  Absorbed in small intestine  Inhibits oxidative metabolism of warfarin and phenytoin, enhancing their activity
  7. 7. Barrett’s oesophagus
  8. 8. Barrett’s oesophagus • Squamous oesophagus mucosa intestinal columnar epithelium • 10 -20 % of GORD cases • Barrett’s oesophageal adenocarcinoma (0.4% p.a) • Endoscopic surveillance 12-18 monthly with quadratic biopsies every 1 cm length • Severe dysplasia and young surgery • New Prague C & M criteria to assist in surveillance

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