Practice targeted AMC-style multiple-choice questions on endoscopy.
A 63-year-old man presents to his GP with a 6-month history of intermittent postprandial fullness and mild dysphagia, particularly with solid foods. He reports occasional regurgitation but denies significant heartburn or chest pain. His vital signs are stable, and physical examination is unremarkable. Recent blood tests show mild iron deficiency anaemia. The provided image is from a CT scan of the chest and upper abdomen performed as part of his investigation. Considering the clinical presentation and the significant anatomical finding demonstrated in the image, what is the most appropriate next step in the management of this patient?
A 75-year-old presents with a 4-month history of increasing dysphagia to solids, occasional regurgitation, and chronic cough, particularly at night. He denies significant weight loss or chest pain. Past medical history includes type 2 diabetes and hypertension. Medications are metformin and perindopril. Physical examination is unremarkable. A chest X-ray is performed as part of the initial assessment. Considering the clinical presentation and the radiographic findings, which of the following investigations is most appropriate at this stage?
A 68-year-old man presents with a 3-month history of progressive dysphagia, early satiety, and unintentional weight loss of 8 kg. He has a background of well-controlled hypertension. Physical examination reveals mild epigastric tenderness. Initial blood tests show a normocytic anaemia. An urgent upper endoscopy identified a large, ulcerated mass in the gastric body, and biopsies were taken. A staging CT scan of the abdomen and pelvis was subsequently performed. Considering the clinical presentation and the findings demonstrated in the provided imaging, which of the following statements best reflects the likely prognosis and primary management strategy for this patient?
A 65-year-old male with recently diagnosed gastric mixed adenoneuroendocrine carcinoma presents with unintentional weight loss. Endoscopy confirmed the diagnosis. Staging imaging is provided. His ECOG performance status is 1. Based on the clinical context and the findings demonstrated, what is the primary goal of initial management for this patient?
A 63-year-old man presents to his GP with a 6-month history of intermittent postprandial fullness and mild dysphagia, particularly with solid foods. He reports occasional regurgitation but denies significant heartburn or chest pain. His vital signs are stable, and physical examination is unremarkable. Recent blood tests show mild iron deficiency anaemia. The provided image is from a CT scan of the chest and upper abdomen performed as part of his investigation. Considering the clinical presentation and the significant anatomical finding demonstrated in the image, what is the most appropriate next step in the management of this patient?
An 82-year-old patient presents with a 6-month history of chronic cough, intermittent dyspnea, and occasional regurgitation, particularly when lying flat. They deny significant chest pain or weight loss. Past medical history includes well-controlled hypertension and mild asthma managed with salbutamol PRN. On examination, vital signs are stable, and lung sounds are clear with no wheeze. An outpatient chest X-ray was performed as part of the workup for the cough and dyspnea. Considering the radiographic findings in conjunction with the clinical history, which of the following investigations is most appropriate at this stage?
A 48-year-old man with multiple cutaneous hemangiomas presents with crampy abdominal pain and guaiac-positive stools. The provided image was obtained. What is the MOST appropriate initial diagnostic test to identify the source of bleeding?
A 65-year-old male with recently diagnosed gastric mixed adenoneuroendocrine carcinoma presents with unintentional weight loss. Endoscopy confirmed the diagnosis. Staging imaging is provided. His ECOG performance status is 1. Considering the extent of disease demonstrated, which of the following represents the most appropriate initial therapeutic approach?