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Gastroenterology > Exam > Flashcards

Exam Flashcards

1
Q

Gastroenteritis- bacteria with short incubation?

A

Staph aureus
Bacillus cereus
Clostridium perfringens

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2
Q

Norovirus- how long after symptoms pass are patients still infective for?

A

48 hours

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3
Q

Risk factors for C diff? (5)

A 
Age
Prolonged hospital stay
PPI use
Recent surgery particularly bowel
Immunosuppression
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4
Q

Motile, flagellated trophozoites in the stool?

A

Giardiasis

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5
Q

Transient episode of diarrhoea followed fever, sweats and rose spot rash?

A

Typhoid fever

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6
Q

C difficile treatment? (2)

A

Non severe- metronidazole

Severe- metronidazole + vancomycin

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7
Q

Investigation of coeliac disease? (3)

A

Unexplained IDA/B12/folate deficiency
Tissue TTG
Jejunal biopsy

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8
Q

Non-pharmacological treatment of IBS? (3)

A

Low FODMAP diet
Peppermint oil
Probiotic yoghurts

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9
Q

Investigations to rule other causes in IBS?

A

TTG
ESR and CRP
Faecal calprotectin

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10
Q

Chronic granulomatous inflammation of interlobular bile ducts

A

Primary biliary cirrhosis

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11
Q

Antibody association in PBC?

A

anti-mitochondrial Ab M2

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12
Q

Treatment of itch in PBC?

A

Cholestyramine, ursodeoxycholic acid

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13
Q

Inflammation, fibrosis and stricture of the extra and intra-hepatic bile ducts

A

Primary sclerosing cholangitis

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14
Q

Classical skin sign of PBC?

A

Xanthelasma of eyelid

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15
Q

Risk factors for peptic ulcer? (3)

A

H. pylori infection
NSAIDs
Smoking

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16
Q

ALARMS in dyspepsia?

A 
Anaemia
Loss of weight
Anorexia
Recent onset and progressive
Malaena
Swallowing difficulty
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17
Q

Management of dyspepsia?

a) ALARMS or older than 55
b) no alarms

A

a) upper GI endoscopy

b) stop exacerbating drugs, encourage lifestyle changes, OTC antacids

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18
Q

What is the indication for H pylori breath testing?

A

Failure of symptoms to respond to conservative management

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19
Q

Treatment of

a) H pylori -ve dyspepsia
b) H pylori +ve dyspepsia

A

a) PPI/H2 blocker for 4 weeks

b) Eradication therapy- PPI + amox + erythro

20
Q

Multiple gastric ulcers, diarrhoea, refractory o treatment?

A

? possible gastrinoma

21
Q

Peptic ulcer disease + gastrinoma….syndrome name?

A

Zollinger Ellison

22
Q

Underlying cause of most gastric MALT?

A

H pylori infection

23
Q

Main risk factor for the development of HCC?

A

Liver cirrhosis secondary to hepatitis, alcohol

24
Q

Screening for HCC in at risk patients? (2)

A

Liver USS and alpha fetoprotein

25
Q

Jaundice is an early feature in ….cancer and a late feature in….

A

Cholangiocarcinoma

HCC

26
Q

Triad of symptoms in HCC?

A

Hepatomegaly + ascites + jaundice

27
Q

Tumours which commonly metastazise to liver? (3)

A

Breast, bronchus, colorectal

28
Q

Young/middle aged woman with acute hepatitis + amenorrhoea?

A

Autoimmune hepatitis

29
Q

Antibodies implicated in autoimmune hepatitis? (4)

A

ANA, anti-smooth muscle, LKM1, soluble liver-kidney antigen

30
Q

Management of autoimmune hepatitis? (3)

A

Steroids to induce and maintain remission
AZT as steroid-sparing agent
Liver transplantation

31
Q

Toxic accumulation of copper in the liver and CNS>

A

Wilson’s disease

32
Q

Pathognomonic sign in Wilson’s disease?

A

Kayser-Fleischer rings

33
Q

Diagnostic tests for Wilson’s disease? (2)

A

High 24hr urinary copper excretion

Low serum copper and ceruloplasmin

34
Q

Management of Wilson’s disease? (3)

A

Avoidance of foods with high copper content
Lifelong penicallamine
Liver transplantation

35
Q

Commonest cause of an acute hepatitis, spread by the faecal-oral route?

A

Hepatitis A

36
Q

Complications of hepatitis B and C? (2)

A

Chronic carrier state in 85% for HCV, 10% for HBV

Hepatocellular carcinoma

37
Q

Hepatitis B serology:

a) Anti-HBS
b) implies high infectivity
c) defines chronic infection

A

a) recovery/vaccinated
b) HBeAg
c) persistence of HBsAg for 6 months

38
Q

Treatment of HCV? (2)

A

Ribavarin + PEGinterferon alpha

39
Q

Spread of HBV and HCV? (3)

A

Sexually, IVDU, blood transfusions

40
Q

In chronic liver disease, symptoms resulting from:

a) reduced synthetic function
b) reduced detox
c) portal hypertension

A

a) ascites, bruising, peripheral oedema (3)
b) jaundice, encephalopathy, amenorrhoea (3)
c) ascites, haematemesis, PR bleeding/melaena (3)

41
Q

Stigmata of chronic liver disease? (8)

A 
Asterixis
Bruising
Dupuytren's contracture
Palmar eyrthema
Jaundice
Spider naevi
Caput medusae
Splenomegaly
42
Q

Accounts for 50% of liver failure in the UK?

A

Paracetamol overdose

43
Q

Definition of liver failure?

A

Severe liver dysfunction leading to jaundice, encephalopathy and coagulopathy

44
Q

Liver failure management of:

a) ascites
b) hepatic encephalopathy
c) cerebral oedema
d) hepatorenal syndrome

A

a) salt and fluid restriction, spironolactone, furosemide, parecentesis, IV albumin
b) lactulose
c) mannitol
d) IV albumin + terlipressin

45
Q

Jaundice + diabetes + arthritis

A

Hereditary haemochromatosis

46
Q

Tests for hereditary haemochromatosis? (2)

A

Increased serum ferritin

HFE genotyping

47
Q

Management of hereditary haemochromatosis?

A

Venesection

Gastroenterology (21 decks)

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