Gastroenterology is considered as a favorite, delicate and functionally complex Superspeciality branch. With advances in the field of medicine, especially gastroenterology and with growing competition, during the past two decades, we have come to realize that it is a highly sought Superspeciality branch.
GIT disorders are acute as well as chronic conditions and cause considerable discomfort and much disability. The disability caused is physical, emotional and socioeconomic.
There is a lot of Demand for DM Gastroenterologists and many NEET DM Aspirants opt for it. This means greater competition and greater preparation.
What a DMGastroenterologist should know to prepare forNEET DMGastroenterology
ü Know the basics of the normal histology, physiology, and biochemistry of the GIT system. (Anatomy of GIT, Physiology of GIT Secretions, Biochemical components of different secretions)
ü Know the process and alterations leading to pathological conditions producing a set of clinical lesions and signs and symptoms of some of the GIT Diseases. (Example of Barretts Esophagus )
ü Have a sound knowledge and clear concept of common terminology related to GIT Lesions like GAVE, GIST Tumours, ZES, Schatzkis ring, Esophageal Webs,
ü Able to arrive at diagnosis from history of a clinical Scenario given. These types of questions are frequently asked.
ü Able to Diagnose a clinical scenario , and treatment options of such
ü Have sufficient understanding of the common benign and malignant tumors of the GIT. Molecular mechanisms, genetic mutations, pathological subtypes, treatment modalities.
ü Have sufficient cognizable knowledge of the pharmacology of drugs used as well as their doses and side effects of these drugs.
By the end of the Preparation for NEET DM student should be able to know about
· Anatomy of GIT
· Physiology of GIT
· Explain the mechanism of the PATHOGENESIS of both common and rare disorders like Gastric ulcer, FAP, HNPCC, VIPomas, Phaeochromocytoma, ZES, and Carcinoids.
· Explain the synthesis, secretion of GIT Secretions
· Latest concept of GUT -associated lymphoid tissue (GALT) , apud System , GIST Tumours
· Mechanism of immune-mediated Gut Damage and its consequences.
· Know the etiology, pathogenesis, and clinical features of some common inflammatory, infectious, preneoplastic and neoplastic skin diseases with emphasis on the correlation between histopathologic changes and the clinical manifestations.
· Identify, on visual aid material, by image based questions the clinical and microscopic features of such skin diseases.
· Know the rationale of treatment based on these histopathologist and corresponding clinical conditions.
· Know about the normal gut flora as well as diseases likely to be produced by these in immune deficiency.
· Know the common microbiologic agents causing GIT infections and explain the pathogenesis of commonly involved microbes and viruses affecting the GUT.
· Know the various types of systemic and topical pharmacologic agents used in treating skin disorders.
· Know about the various types of drugs used for GIT conditions and explain the effects and side effects of these agents.
· Use of different Investigations and tools for examination of GIT lesions.
Example of What a NEET DM Aspirant should at least know about Oncogenesis pertaining to GIT
· Know mechanism of dysplasia and conversion to carcinoma-in-situ.
· Know differences in carcinoma-in-situ and invasive carcinoma.
· Know the importance of techniques used for the early detection of carcinoma of the different parts of GIT by screening methods.
· Know about the clinical features as well as the gross and histological differentiating features of benign and malignant tumors.
· Know about the nomenclature used in neoplasia, and give the classification according to histogenesis and behavior.
· Know about the exact mechanisms by which malignant tumors spread through the body.
· Know about the role of oncogenes as well as cancer-suppressor genes.
· Know about the the hereditary and childhood cancers as well as acquired and hereditary preneoplastic conditions.
· Know about the different types of laboratory diagnosis of tumors with emphasis on early diagnosis of cancers with techniques like exfoliative cytology, Tumour Markers, use of investigative techniques.
· Know about the grading and staging of cancers.
· Know about warning signs of cancer in each organ system, like dysphagia and weight loss in cancer of the esophagus, hoarseness of voice in laryngeal carcinoma, jaundice, and ascites in stomach cancer.
· Know about the mode of inheritance of genetic disorders (autosomal dominant & recessive disorders and sex-linked disorders) related to GIT.
Hot Topics for 2021 2022 for DM Gastroenterology
· Acute gastritis
· Alcoholic cirrhosis
· Alcoholic fatty liver disease and alcoholic hepatitis
· Alcoholic liver disease
· Antacids, sucralfate (a surface-acting agent), H2-receptor blockers
· Antireflux surgery (Nissen fundoplication)
· Azotemia and electrolyte disturbances
· Barium swallow and upper gastrointestinal (GI) series test
· Barrett’s esophagus.
· Barrett’s esophagus (premalignant epithelial changes associated with chronic reflux).
· Blood in the stool
· Chronic gastritis
· Cimetidine, ranitidine
· Elevated serum carcinoembryonic antigen (CEA) level
· Endoscopic retrograde cholangiopancreatography (ERCP)
· Endoscopy with biopsy
· Esophageal dysmotility and gastric emptying disorders
· Esophageal neoplasms
· Gastric lymphoma
· Hematemesis, melena, and abdominal pain.
· Hepatotenal syndrome
· Lye ingestion
· Neoplasms of the esophagus and stomach
· Pancreatic carcinoma
· Pancreatic digestive enzymes
· Pancreatic stimulation tests
· Peptic ulcers in the stomach or proximal duodenum.
· Reflux esophagitis
· Serum gastrin measurements a
· Serum ƴ-glutamyltransferase, AST, ALT, and AP levels are elevated in fatty liver disease.
· Signs and symptoms include weight loss, anorexia, fatigue, epigastric pain, early satiety, and vomiting.
· Small bowel obstruction
· Surgery and radiotherapy
· Wright’s or methylene blue staining of stool