Day 7

Question 1

Side effects of PPIs

Answer 1

Hyponataemia, hypomagnasaemia

Osteoporosis-> increased risk of fractures

Microscopic colitis

Increased risk of C. diff infections

Question 2

Symptoms of duodenal ulcers

Answer 2

Cause pain when hungry, relieved by eating

Question 3

Why do patients with coeliac require additional vaccines

Answer 3

Functional hyposplenism

Question 4

Management of dysplasia on biopsy in barrett’s

Answer 4

Endoscopic intervention

Question 5

First-line investigation for acute mesenteric ischaemi

Answer 5

Lactate

Question 6

Jaundice following abdominal pain and pruritis during pregnancy

Answer 6

Acute fatty liver of pregnancy

Question 7

Best management for NAFLD

Answer 7

Weight loss

Question 8

Scoring system for severity of liver cirrhosis

Answer 8

Child-pugh
> bilirubin
> albumin
> prothrombin time, prolonged by (s)
> encephalopathy
> ascites

Question 9

Management of severe alcoholic hepatitis

Answer 9

Glucocorticoids

Pentoxyphylline

Question 10

+ve anti-HBc IgG
-ve anti-HBc IgM
-ve anti-HBc
+ve HBsAG

Answer 10

Chronic HBV

Question 11

Sister mary-joseph node

Answer 11

metastatic umbilical lesion

Question 12

Virchow’s node

Answer 12

enlarged left supraclavicular lymph node

Question 13

Peadbody’s sign

Answer 13

calf muscle spasm occuring on elevation and foot extnesion of affected leg in DVT

Question 14

Bouchard’s node

Answer 14

Sign of OA- bony outgrowth PIP

Question 15

Heberden’s node

Answer 15

Sign of OA and bony outgrowth of DIP

Question 16

Pathophysiology of hepatorenal syndrome

Answer 16

> vasoactive mediators cause splanchnic vasodilation which in turn reduces the systemic vascular resistance.
This results in ‘underfilling’ of the kidneys. This is sensed by the juxtaglomerular apparatus >activates the renin-angiotensin-aldosterone system, causing renal vasoconstriction which is not enough to counterbalance the effects of the splanchnic vasodilation.

Question 17

Iron deficiency anaemia vs anaemia of chronic disease

Answer 17

TIBC is high in IDA, and low/normal in anaemia of chronic disease

Question 18

Investigation for toxic megacolon

Answer 18

AXR

Question 19

Most common cause of hepatocellular carcinoma

Answer 19

Hep B worldwide

Hep C Europe

Question 20

PBC rule

Answer 20

the ‘M’ rule
> IgM
> anti-Mitochondrial antibodies, M2 subtype
> Middle aged females

Question 21

Action before appendicectomy

Answer 21

prophylactic IV antibiotics

Question 22

Management of severe flare of UC

Answer 22

Hospital with IV corticosteroids

Question 23

What is plummer-vinson syndrome

Answer 23

dysphagia, glossitis, iron-deficiency anaemia

iron deficiency anaemia