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Dysphagia Investigation — UKMLA MCQ

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HardGastroenterologyDysphagia InvestigationUKMLAMRCGP AKTPARAMRCP Part 1PSA

A 64-year-old has unexplained 7-kg weight loss over 3 months, new persistent upper abdominal pain radiating to the back and no jaundice. Examination shows no palpable mass. What urgent primary-care investigation should be considered for pancreatic cancer?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Urgent direct-access CT, or ultrasound when CT is unavailable

B is correct. NICE advises urgent direct-access CT, or urgent direct-access ultrasound if CT is unavailable, in people aged 60 or over with weight loss plus back pain, abdominal pain, diarrhoea, nausea, vomiting, constipation or new-onset diabetes. A is too slow. C ignores a qualifying non-jaundice pathway; jaundice at age 40 or over instead triggers suspected-cancer referral. D is a colorectal triage test and E does not adequately assess the pancreas.

Reference: NICE NG12: suspected cancer recommendations by site: https://www.nice.org.uk/guidance/ng12/chapter/Recommendations-organised-by-site-of-cancer GMC: PA registration assessment content map: https://www.gmc-uk.org/education/standards-guidance-and-curricula/standards-and-outcomes/pa-and-aa-prequalification-education-framework/pa-registration-assessment-content-map