MRCP Part 1 Exam Preparation: A Comprehensive Guide

Pass your MRCP Part 1 exam with confidence with our comprehensive revision resource. Our materials are fully aligned with the Royal College of Physicians curriculum, providing you with the closest revision experience possible to the exam. Revise with quality questions and detailed explanations.

Sample Question

A 39-year-old sailor has had repeated visits to his GP for heartburn and dyspepsia. He had been an irregular visitor and his treatments had been discontinuous in the past. This time, after an acute episode of dyspepsia and abdominal pain, he underwent an upper GI endoscopy which showed Barret’s esophagus. Histopathology showed very low-grade dysplasia. What is the best next line of management?

1. Endoscopic ablation therapy
2. A trial of PPI therapy
3. Endoscopic mucosal resection
4. Lower esophageal resection
5. Only observation

Key Learning Points

Barret’s oesophagus is treated with PPI as first line therapy. The initial therapy for this condition is PPI-based. Usually, once-daily dosing of PPI is preferred. Observation only is not a preferred strategy. Barret’s oesophagus is a premalignant condition. Hence, quick intervention is needed. The three remaining therapies are used in the NICE pathways in patients with moderate to severe grade dysplasia. Also, if there is inadequate response to PPI therapy, then these modalities of treatment may be tried. They are also used for recurrent disease.