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The Gastroenterology Training Handbook
For Specialist Registrars
HOME
OESOPHAGUS
•Gastro Oesophageal Reflux Disease
•Oesophageal Cancer
•Oesophageal Dysmotility
•Benign Oesophageal Lesions
•Miscellaneous
•Dysphagia
STOMACH
•Obesity Surgery
•Clinical Presentations of Gastric Conditions
•Gastric Cancer
•Gastric Polyps and Masses
•Peptic Ulcer Disease
•Gastritis and Gastropathy
•Miscellaneous
SMALL BOWEL
•Coeliac Disease
•Small Bowel Infections
•Small Bowel Masses
•Miscellaneous
COLON
•Colorectal and Anal Cancer
•Diagnostic Pathways for Colonic Disease
•Colonic Vascular Disorders
•Anal Diseases
•Various Colitides
•Colonic Motility Disorders
•Miscellaneous
•Colonic Infection
LIVER
•Alcohol
•Liver Failure
•Miscellaneous
•Ascites
•Bilirubin Metabolism
•Vascular Problems
•Clinical Presentations
•Liver Masses
•Hepatitis B
•Hepatitis C
•Autoimmune Conditions
•Metabolic Conditions
•Treatments
•Various Viruses
•Hepatopulmonary Disorders
•Liver Imaging
BILIARY
•Gallstone Disease
•Biliary Cancers
•Biliary Parasites
•Miscellaneous
NUTRITION
•Nutrition Therapy
•Minerals
•Proteins, Fats and Sugars
•Vitamins
•Clinical Conditions and Nutrition
PANCREAS
•Pancreatitis
•Pancreatic Masses and Cysts
•Pancreatic Cancers
•Other
IBD
•Epidemiology
•IBD Diagnosis
•Extra Intestinal Manifestations
•Surgery
•Treatment
MISCELLANEOUS
•Bleeding
•Rheumatological Disease
•Infection
•Vascular Lesions
•Other
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Rheumatology
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Written by Dr Sebastian Zeki
MCQs for this page
What the Curriculum Says
Knowledge
Recognises the importance of sepsis as a complication
Aware of the differential diagnosis and management of sepsis and its
possible sequelae
Knows the appropriate use of the appropriate antibiotics and their
complications Aware of prevention of nosocomial infection
Skills
Understands the principles and practice of diagnosis and treatment of
sepsis
Behaviours
Prepared to involve and liaise with specialist sepsis support
Also....
Knowledge
Knows the importance of clinical nutrition and its disturbances in
patients with acute and chronic liver disease
Appreciates indications for enteral or parenteral support and
understanding of limitations of these interventions
Skills
Shows ability to make careful nutritional assessment
Behaviours
Can liaise with nutritional support team where appropriate
Also...
Knowledge
Understands prognostic scoring systems including Child - Pugh
MELD UKELD Maddrey and disease-specific scoring systems where
they exist
Skills
Builds the use of accredited quantitative scoring systems into routine
clinical liver practice clinical colleagues and junior staff
Behaviours
Shows consistent application of evidence-based in the
evaluation of liver disease and the determination of prognosis
Rheumatology
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Rheumatological
manifestations of
liver disease
Viral hepatitis
Hep B (25% have
rheumatological
problems)
1) Poly-arthritis (in pre-icteric 25% of patients get these) treat with NSAID's
2) PAN (fever/arthritis/cardiac/abdominal pain): Diagnose:Angiography
-Treatment
Plasma-phoresis and steroids
3)
Membranous
GN
-Cryoglobulinaemia (hep B virus severe rash/arthritis/renal and RF/low C4)
Hep C
1) Non-erosive poly-arthritis (mono or oligo)
System PAN like vasculitis
3)Membranous GN
4) Mixed cryoglobulinaemia
5)Antibody production
6)
Porphyria
cutanea tarda
7) Sjogren's (5-19%)
Auto-immune hepatitis
Similar to SLE (fever/rash/arthritis/young women/ANA positive)
But ...(DS DNA negative
No oral ulcers
Nephrosis
CVS)
Primary biliary cirrhosis
CF auto-immune association
PBC arthritis (similar to RA)
Haemochromatosis
60% get arthritis
Also ...
osteomalacia/
HPOA/osteoarthritis
Second and third MCP
Hips
Knees
Wrists
Get erosive disease
May be PC in 40% of haemochromatosis
Phlebotomy does not alter prognosis
Written by Dr Sebastian Zeki