EFA for Endo and Gastro

Question 1

Enlarged lymph nodes and abdo pain + management

Answer 1

Mesenteric adenitis - after viral infection, enlarged lymph nodes in mesentery.
No treatment.

Question 2

Gastric vs duodenal ulcer

Answer 2

Gastric ulcer - worse by eating, people lose weight
Dudodenal ulcer - better after eating

Question 3

Haemmorhoids symptoms + inv + grading + mx

Answer 3

Painless rectal bleeding due to engorgement of haemorrhoidal cushions in the anus from staining/pressure.

Classification:
Grade 1 - no prolapse
Grade 2 - spontaneous reduction after defecation
Grade 3 - manually reducible
Grade 4 - not reducible

Invs - DRE, found at 3, 7 and 11 o’clock.

Management:
Soften stool - Fibre + fluids, laxatives, topical steroids, analgesics
Medical - rubber band ligation, sclerotherapy
Surgical - excision haemorrhoidectomy, stapled haemorrhoidectomy, haemorrhoid artery ligation operation (HALO)

Question 4

Which enzymes are raised in PSC and other biliary diseases

Answer 4

Gamma GT - released when there is damage to bile ducts
ALP - also raised

Question 5

Differentiate between acute cholecystitis and acute cholangitis and acute pancreatitis

Answer 5

Amylase would be way higher in acute pancreatitis

Acute cholangitis you’d be jaundiced with sepsis

Acute cholecystitis - slight raise in ALP and amylase

Question 6

What’s the range for pre-diabetes

Answer 6

42-48mmol

You’d be less likely to fasting glucose, because high glucose levels would be post-prandial

We don’t do as much fasting glucose levels as it doesn’t catch people who

Question 7

Graves antibody

Answer 7

Anti-TSH receptor antibody

Question 8

Primary hyperparathyroidism

Answer 8

Hypercalcemia
Hypophosphatemia (increased excretion)

Question 9

Name a drug that contributes to hyperkalemia

Answer 9

ARBs such as losaratan

Question 10

Do you continue with an ACEi in CKD

Answer 10

Yes

Question 11

What do you do with ACEi in AKI

Answer 11

Stop - because it causes vasodilation in the

Question 12

DKA management

Answer 12

Fluids - normal saline due to profound dehydration and risk of CV collapse

IV insulin

Question 13

Dysphagia in oesophageal cancer - management

Answer 13

Oesophageal stent

Question 14

When would you do an ascitic tap?

Answer 14

On any patient who comes in with ascites

Question 15

What is haemochromatosis?

Answer 15

Hereditary excessive iron absorption and accumulation due to the HFE gene

Question 16

What symptoms are caused by haemochromatosis?

Answer 16

Arthritis
T2DM (watch out in question stems - you might get a pt with normal BMI and T2DM)
Infertility
Liver disease