Gastro

Question 1

Primary biliary cholangitis features

Answer 1

AMA +ve
Jaundice
Female
IgM

Question 2

Abx of choice for relapsing c diff infection

Answer 2

Fidaxomicin

Question 3

When to give abx in ascites

Answer 3

If protein content of ascitic tap <15g/L

Ciprofloxacin

Question 4

Crypt abscesses, no inflammation beyond submucosa

Answer 4

Ulcerative colitis

Question 5

Calculate units of alcohol

Answer 5

(Volume in mls x ABV) / 1000

Question 6

Melanosis coli causes

Answer 6

Laxative abuse

Question 7

Remission maintenance drugs in Crohns

Answer 7

Azathioprine or mercaptopurine

Question 8

Clotting picture of liver disease

Answer 8

All clotting factors low except factor 8, which is supra normal

Question 9

Hepatitis and hepatocellular carcinoma

Answer 9

Hep B - most common worldwide

Hep C - most common in UK

Question 10

Long term side effect of PPIs

Answer 10

Increased risk of osteoporosis

Question 11

Rules prior to urea breath test for h. Pylori

Answer 11

no antibiotics in past 4 weeks

no antisecretory drugs (e.g. PPI) in past 2 weeks

Question 12

Management of bleeding varices

Answer 12

Antibiotics and terlipressin

Followed by OGD

Question 13

Ulcerative colitis management

Answer 13

If localised, rectal aminosalicylate
If extended, IV steroids and sometimes IV aminosalicylate

Severe: > 6 bloody stools per day + evidence of systemic upset

Question 14

Immunisation hep B serology

Answer 14

Only HbSag is used in vaccines, so only anti-HbS is present

Question 15

Side effects of sulphasalazine drugs

Answer 15

Sulphasalazine; lung fibrosis, oligoSpermia, megaloblastic anaemia

Mesalazine: agranulocytosis, pancreatitis

Question 16

Alcohol screening questionnaires

Answer 16

AUDIT
CAGE
FAST

Question 17

Tx for acute upper GI bleed, non variceal

Answer 17

IV prothrombin complex concentrate