3. GI

Question 1

Why does jaundice affect the clotting system?

Answer 1

Without bile there is a lack of ability to absorb fat soluble vitamins such as Vitamin K

Question 2

What are the different types of jaundice?

Answer 2

Pre hepatic- haemolysis (increased bilirubin/impaired transport)

Hepatic- parenchymal discharge (Defective uptake of bilirubin)

Post hepatic- obstructive (defective transport of bilirubin by bilary ducts)

Question 3

What are the liver function tests?

Answer 3

Aspirate amino transferase (AAT)- suggests liver damage

Gamma glutamyl transferase- non speicifc liver damage

Bilirubin- conjugated vs uncojugated

Alkaline phosphatase- elevated with obstruction or liver infiltration

Albumin- liver function

Prothrombin time- Degree of liver dysfucntion

Question 4

How is gastric cancer established?

Answer 4

Chronic gastritis (inflammation)
Intestinal metaplasia
Dysplasia
Cancer

Question 5

What skin condition is associated with coeliac disease?

Answer 5

Dermatitis herpetiiformis

Question 6

What skin disease is associated with IBD?

Answer 6

Erythema nodosum

Question 7

Discuss the various hormones that control the GI tract?

Answer 7

Gastric cells –> GaStrin (acts on parietal cells)

CCK

Motilin

Secretin?

Question 8

How does bowel look on a scan when it is obstructed?>

Answer 8

Dilated central loops of bowel

Question 9

What are the various disacharides?

Answer 9

Lactose- glucose and galactose
Sucrose- glucose and fructose
Maltose- glucose and glucose

Question 10

What is Murphy’s triad?

Answer 10

Lower right quadrant pain, N+V and fever

Question 11

Oesophageal carcinoma treatment?

Answer 11

Typically oesophagectomy +/- chemo due to late presentations

Question 12

Liver cirrhosis

Answer 12

End stage chronic liver disease, response to liver to chronic injury

Normal tissue replaced by fibrous tissue

Question 13

What are the nine quadrants of the abdomen?

Answer 13

R hypochondrium epigastrium L hypochondrium
R lumbar umbilical L lumbar
R iliac fossa Hypogastrium L iliac fossa

Question 14

What are the muscles of the core?

Answer 14

Rectus abdominus- abdominal muscle

Transverse abdominal- deep and traverse

Internal oblique- middle layer, hands in back of pockets

External oblique- hands in front of pockets- superficial

Question 15

What are the different types of hepatitis?

Answer 15

Hepatitis A- IgM, common infectious in children

Hep B- more serious may lead to cacner of end stage disease

Hep C- also serious

Hep D-

Hep E- self limiting, no long term effects

Question 16

Differentials for hepatic encephalopathy?

Answer 16

Infection
Hypoglycemia
Intra cranial bleed

Question 17

How do you treat alcoholic hepatitis?

Answer 17

Aregnicelone (steroid, gets them over 30 days)
Thiamine
High nutritional feeds

Question 18

Describe the pathological process of GORD leading to oesophageal cancer?

Answer 18

Ulceration
Stricture
Glandular metaplasia (barrett’s oesophagus)
Carcinoma

Question 19

What is whipples procedure

Answer 19

A pancreaticoduodenectomy, pancreatoduodenectomy, Whipple procedure, or Kausch-Whipple procedure is a major surgical operation most often performed to remove cancerous tumours off the head of the pancreas

Question 20

What is mcburney’s point?

Answer 20

one-third of the distance from the anterior superior iliac spine to the umbilicus

Question 21

What is the most common anatomical lie of the appendix?

Answer 21

retroceocal

Question 22

What are the three specific aspects of the large colon?

Answer 22

teniae coli, haustra, and epiploic appendages

Question 23

Describe the process of fat digestion?

Answer 23

Triglycerols
(bile salts and phospholipids)
Smaller fatty droplets
(lipase)
Very small subunits
(micelles)
Allow the molecules to cross into the intestine

Question 24

What do the gastric pits produce?

Answer 24

Hydrochloric acid, intrinsic factor, mucous