GIT and Nutrition (Block 3) - Guts and glory

The Gastrointestinal tract and Nutrition (GIT) block... I almost died in this block. Not so much from the content, rather the encephalitis I had. As a result of me being in ICU for a few days I missed quite a bit of the block and I still managed to pass, so it's not such a bad block!

The GIT block is divided into seven weeks. It's quite a long block. I have mixed feelings about the block, for obvious reasons, but I'm sure you'll enjoy it. Although it might be difficult to stomach near the end.

The first week is the bread and butter of paediatrics in the clinical years. Malnutrition. In this week you'll learn that the terms marasmus and kwashiorkor is not used, because it is now seen as a spectrum of disorders, rather than separate entities. The preferred term is protein energy malnutrition. As random as it may seem, this week also deals with lactation. Food for thought (was that pun in bad taste...?).

Week two is all about gastro-oesophageal reflux disease (GORD). It will be repeated (get it?) again in surgery in your clinical years. It's super important. It also covers upper GI bleeds, which is devastating. I've seen a couple of patients succumb to this. The treatment of peptic ulcers will be covered as well. Try to embed the eradication therapy of Helicobacter pylori (the culprit that causes peptic ulcer disease) well. Surgeons love asking it, especially on ward rounds. The pharmacology is pretty much the same stuff from PCMS.

Week three is quite a mouth full. It covers a lot of important topics in very little time. Inflammatory bowel disease (Crohn's disease and Ulcerative colitis), disorders of the pancreas and obesity and its effects on the liver. The important thing here is to know the differences, both clinically and pathologically, between Crohn's and Ulcerative colitis. Both for MCQ and SACS papers. This is probably the week with the most content. It's a tough one.

So week four isn't great, either. Here infections of the GIT are discussed. It has a huge amount of pharmacology in the course pack. Don't panic. Have a general approach to the mechanisms of action, but don't get too bogged down in the detail. I found it simply too much. Read through it a couple of times and be able to recognise it in MCQs. Personally, I don't think this is a great way to study pharmacology, but anyway... The lectures were really useful in this week, so know them well.

The fifth week deals with cancers. GIT malignancies are devastating. In an elderly patient with anaemia, you MUST rule out malignancy first and foremost. Remember that for clinical practice. The course pack is great. Recognise the importance of certain genetic disorders and their propensity to cause neoplastic change in the gut. The course pack also covers oesophageal cancer. What a terrible disease. It has a dismal prognosis. The molecular basis of neoplastic change is discussed. They love asking this as well, so know it! The lectures are pretty meh...

Ahhh the liver. The organ that endures a lot of abuse from students. This is what weeks six and seven cover. It's quite difficult and, again, a lot of information to cram. So try to have the first five weeks covered by the weekend before this starts. It will just make your life easier. Week six handles alcohol and the liver. You'll find out that binge drinking is perhaps more detrimental to the liver than chronic alcohol abuse. (I'm pretty sure PubCrawl counts.) It also gives information about the hepatitidies. Remember, Hep A = Acute, Hep B and C are chronic. Hep C = Cirrhosis. Unfortunately only Hep A and B have vaccines. Hep C is often a co morbidity with HIV infection.

Week seven is a mean week. Seriously, you'll see. It's so much information, and it's all covered in the last week. I have no idea why it's done this way. Jaundice is the main topic and it's important to understand the differences between pre-, intra- and posthepatic jaundice and the causes thereof. Also remember the specific biochemical differences. Oh, porphyria is also covered here. It's in the course pack and it is a serious amount of detail. I tried really hard to study it all, but don't waste time. Get a general idea of what it is and some key differences. Don't aim to become an expert in porphyria just yet.

As always, I hope this helps. All the best!