Gastro

Question 1

What is the difference between bleeding and perforated peptic ulcer

Answer 1

• Bleeding: Melena, Evidence of upper GI bleed

- Perf: Peritonitis, Distention, guarding, rigidity

Question 2

Histology Coeliac Screen

Answer 2

• Intraepithelial Lymphocytosis
• Crypt Hyperplasia
• Villous Atrophy

Question 3

Toxic Megacolon Dx

Answer 3

Bowel distention> 6cm Abdo X ray, thumb printing

Question 4

What is Pellagra

Answer 4

Deficiency of B3: diarrhoea, dementia, dermatitis

Question 5

Dx an d Treatment of Bile acid malabsorption

Answer 5

• Dx: SeHCAT

- Cholestryamine

Question 6

Malignant association of Barrett’s Oesophagus

Answer 6

Adenocarcinoma

Question 7

Pancoast Tumour

Answer 7

Malignancy in apex of lung: can cause hoarse voice due to compression of laryngeal nerve

Question 8

Where does Ischaemiac Colitis most commonly occur, Dx on Xray

Answer 8

Splenic Flexure at borders of inferior mesenteric artery (L3)

• thumb printing

Question 9

What do Iron studies show in anaemia of chronic disease and Iron deficiency anaemia

Answer 9

• Chronic: normocytic, reduced total iron binding capacity, raised or normal ferratin
• Iron deficiency: Low ferritin, TIBC raised
• TIBC also raised in pregnancy

Question 10

What does the Child-Pugh score use?

Answer 10

Bili, Albumin, PTT, Encephalopathy, Ascites

Question 11

What is Boerhaave and Plummer-Vinson syndrome

Answer 11

Boerhaave: severe vomiting leads to oesophageal rupture: pain and crepitus in epigastrium

Plummer Vinson: Dysphagia, Iron deficiency anaemia, glossitis

Question 12

What blood picture can pancreatitis cause

Answer 12

Cholestatic

Question 13

Wilson’s disease blood picture:

Answer 13

• Caeruloplasmin decreased
• Serum copper decreased
• Increased urinary excretion copper
• ATP7B

Question 14

Primary sclerosis cholangitis complication

Answer 14

Cholangiocarcinoma

Question 15

Malignant associations of hereditary non polyposis colorectal cancer

Answer 15

1. Colon
2. Endometrial
3. Pancreatic

Question 16

Which Vitamin can be teratogenic in high doses

Answer 16

Vitamin A

Question 17

What hepatic condition is sudden weight loss associated with

Answer 17

NAFLD exacerbation

Question 18

What do blood results show in Haemachromatosis?

Answer 18

• Raised Transferrin Saturation
• Raised Ferratin
• Low TIBC

Question 19

Which electrolyte imbalances is characteristic for refeeding syndrome?

Answer 19

Hypophosphatemia

Hypokalaemia

Hypomagnesia -> Tussauds

Question 20

What is a Dieulafoy lesion?

Answer 20

A single large arteriole in sub mucousa which cause brisk haematemesis

Question 21

Risk of long term PPI use?

Answer 21

Osteoperosis

Question 22

Diagnosis of SBP?

Answer 22

Neutrophil count>250 on ascitic drainage

Question 23

Man with unknown osteoporosis aetiology needs what measuring?

Answer 23

Testosterone, low testosterone = osteoporosis