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Q1: Definition & classification (2 min)
- Define dyspepsia and the four cardinal Rome IV symptoms.
- What are the diagnostic criteria for functional dyspepsia (onset, duration, normal OGD)?
- Describe the two Rome IV subtypes (PDS vs EPS) — distinguishing features, frequency thresholds, and the underlying mechanisms of each.
- Why is the term "non-ulcer dyspepsia" now obsolete?
Q2: Pathophysiology (2 min)
- FD is a disorder of gut-brain interaction — explain the bidirectional axis.
- Describe the four converging mechanisms: impaired gastric accommodation, delayed gastric emptying, visceral hypersensitivity, duodenal low-grade inflammation.
- How does each mechanism map onto a subtype? (accommodation/emptying → PDS; hypersensitivity → EPS)
- What is the role of H. pylori? Of post-infectious dyspepsia?
Q3: Investigation strategy (2 min)
- How would you risk-stratify a patient with new dyspepsia?
- Recite the alarm features that mandate urgent OGD.
- In a patient under 55 without alarm features, what non-invasive strategy is used?
- Which H. pylori tests are appropriate for diagnosis, and which for confirming eradication? Why is serology unsuitable for confirmation?
Q4: Management ladder (3 min)
- Walk through the stepwise management, naming drugs with dose, route, timing, rationale and monitoring.
- What is the role of H. pylori eradication? What regimens? What is the relative benefit?
- Metoclopramide vs domperidone — max durations and principal toxicities.
- What is acotiamide and in which regions is it approved?
- When and how do you use a TCA in FD?
Q5: Complications, prognosis & pitfalls (2 min)
- FD carries no mortality — what ARE the complications? (quality of life, misdiagnosis, iatrogenic harm)
- What predicts good vs poor outcome?
- What is the cardinal diagnostic pitfall, and how do you avoid it?
- Why should you avoid repeated endoscopy?