Murtagh's Triads
Fatigue + weight loss + diarrhoea
Severe abdominal pain + vomiting + radiation to shoulder tip
Blood in stool + abdominal discomfort + change in bowel habit
Anxiety and prostration + intense central abdomen pain + profuse vomiting +/- bloody diarrhoea
Sudden severe abdominal pain + anxious, still, 'grey', sweaty + deceptive improvement
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For investigations, consider the indications for ordering the test and the key findings for common or critical conditions.
In addition to managing the key diagnoses related to each of the presenting problems above, here are some examples of key management issues to think about.
  • Antiemetics edit
  • Bariatric surgery referrals edit
  • Bowel cancer screening edit
  • FODMAPs edit
  • Hepatitis C edit
  • Laxatives edit
  • Low residue diet edit
  • Prescribing in liver failure edit
  • Stoma care edit
For each diagnosis that arises from your differentials, you can then consider the key signs, investigations and management. This list is by no means exhaustive, but here are a few assorted diagnoses to consider.
  • Acute appendicitis edit
  • Acute cholangitis edit
  • Acute intermittent porphyria edit
  • Acute intussusception edit
  • Acute pancreatitis edit
  • Anal fissure edit
  • Biliary colic edit
  • Carcinoid syndrome edit
  • Cholecystitis edit
  • Cholelithiasis edit
  • Cholestasis of pregnancy edit
  • Chronic pancreatitis edit
  • Cirrhosis edit
  • Coeliac disease edit
  • Colon cancer edit
  • Constipation edit
  • Crohn disease edit
  • Diverticulitis edit
  • Diverticulosis edit
  • Faecal impaction edit
  • Gastric / Duodenal ulcer edit
  • Gastroenteritis edit
  • Giardiasis edit
  • Haemochromatosis edit
  • Haemorrhoids edit
  • Hepatitis A edit
  • Hepatitis B edit
  • Hepatitis C edit
  • Hiatus hernia edit
  • Inguinal hernia edit
  • Intestinal malformations edit
  • Irritable bowel syndrome edit
  • Large bowel obstruction edit
  • Meckel diverticulum edit
  • Mesenteric adenitis edit
  • Mesenteric arterial occlusion edit
  • Pancreatic cancer edit
  • Perforated peptic ulcer edit
  • Perianal abscess edit
  • Porphyria edit
  • Pyloric stenosis edit
  • Ruptured Abdominal Aortic Aneurysm edit
  • Ruptured oesophagus edit
  • Scurvy edit
  • Small bowel obstruction edit
  • Stomach cancer edit
  • Ulcerative colitis edit
  • Worms edit
Foundation topics like anatomy, physiology and embryology are not the main focus of GP fellowship exams. The following are examples of topics that may be useful for quizzing any medical students you are supervising:
  • GIT anatomy edit
  • Layers of the GIT edit
  • Liver anatomy edit
  • Liver metabolism edit
Medical students may be more focused on learning basic definitions, aetiology and pathophysiology of specific diagnoses, but registrars need to focus more on clinical problem solving. For each common presenting problem, consider what would be the red flag features, the most common differentials, as well as the most dangerous and most often missed (see Murtagh for more information on this model). For each diagnosis that arises from your differentials, you can then consider the key signs, investigations and management.
Medicine is nebulous with many conditions that arise infrequently in General Practice. These topics are not the main focus of college exams but nonetheless might occasionally appear - just as they can appear in your consultation room on a Friday afternoon. Other topics are so controversial that they are very difficult to examine. Here are some examples of topics that should not be the main focus of your study.
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