Gastro

Question 1

What is the main histology findings in UC?

Answer 1

Large number of crypt abscess
Goblet cell depletion
Few granulomas

Question 2

What is the main histology findings in Coeliac disease?

Answer 2

Villous atrophy
Crypt hyperplasia
Lamnia propria infiltration with lymphocytes

Question 3

What is the main histology findings in Crohn’s disease?

Answer 3

Goblet cell hyperplasia

Large number of granulmonas

Question 4

Peutz-Jeghers syndrome is an autosomal dominant condition characterised by what findings?

Answer 4

Hamartomatous polyp formation

Pigmented lesions on lips, face, palms and soles.

Question 5

What is SAAG and how do you calculate it?

Answer 5

Serum ascites albumin gradient

Serum albumin - ascitic fluid albumin.

Question 6

What is the cut-off for SAAG indicating portal hypertension?

Answer 6

> 11

Question 7

Expect for cirrhosis, what are the other causes of a raised SAAG?

Answer 7

Acute liver failure
Liver Mets 
Right sided HF 
Constrictive pericarditis 
Budd-Chiari syndrome 
Portal vein thrombosis

Question 8

What are the 3 main clinical features of sponanteous bacterial peritonitis?

Answer 8

1) Fever
2) Abdominal pain
3) Ascites

Question 9

How is sponanteous bacterial peritonitis diagnosed clinically?

Answer 9

Neutrophils in ascitic fluid >250

Question 10

How is sponanteous bacterial peritonitis treated?

Answer 10

IV Cefotaxime

Question 11

What is the most common causative organism for SBP?

Answer 11

E.Coli

Question 12

What are the two different autoantibodies that are produced in Pernicious anaemia?

Answer 12

Intrinsic factor antibodies → bind to intrinsic factor blocking the vitamin B12 binding site

Gastric parietal cell antibodies → reduced acid production and atrophic gastritis. Reduced intrinsic factor production → reduced vitamin B12 absorption

Question 13

What is the treatment for pernicious anaemia?

Answer 13

B12 replacement via IM injections

Question 14

If a patient is deficient in both folate and B12, which do you replace and why?

Answer 14

You must always replace B12 first due to the risk of subacute degeneration of the spinal cord. Giving folate in a patient with B12 deficiency will results in the body using up the remaining B12, making levels even lower.

Question 15

What are the main clinical feature of pernicious anaemia? Divide them between symptoms of anaemia and neurological.

Answer 15

Anaemia: fatigue, pallor, SOB
Neuro: peripheral neuropathy, sub-acute degeneration of the spinal cord
Neuropsychiatric: confusion, memory loss, irritability