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Upper gastrointestinal malignancy — MCCQE Part 1 MCQ

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HardWeight LossUpper gastrointestinal malignancyMCCQE Part 1

A 50-year-old man presents with burning epigastric discomfort and early satiety. He has unintentionally lost 6 kg and has iron deficiency anaemia. He uses no NSAIDs and has no previous endoscopy. What is the most appropriate investigation?

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Correct answer: A — Upper gastrointestinal endoscopy

Dyspepsia with alarm features such as weight loss and iron deficiency anaemia requires endoscopic evaluation for malignancy or ulcer disease. A urea breath test may be useful for H. pylori but is insufficient when alarm features exist. Long empiric PPI therapy risks delaying diagnosis. Ultrasound does not evaluate the gastric mucosa.

Reference: Canadian Association of Gastroenterology dyspepsia guidance