Gastro

Question 1

Risk Factors for bowel ischaemia

Answer 1

Increasing age
AF - particularly mesenteric ischaemia
Emboli - endocarditis, malignancy
Cardiovascular disease RF - smoking, HTN, diabetes
Cocaine - ischaemic colitis seen in young patients following cocaine use

Question 2

inheritance of haemochromatosis

Answer 2

Autosomal recessive

Question 3

Drug used to treat variceal haemorrhage

Answer 3

Terlipressin

Question 4

Inducing remission in Chron’s Management

Answer 4

Corticosteroids

Question 5

Inducing remission in UC in mild to moderate disease

Answer 5

1st line = aminosalicylate (mesalazine) can be rectal or oral
2nd line = corticosteroids

Question 6

Inducing remission in UC severe disease

Answer 6

1st line = IV corticosteroids
2nd line = IV ciclosporin

Question 7

Maintaining remission in UC

Answer 7

Aminosalicylates
Azathoprine
Mercaptopurine

Question 8

Maintaining remission in Chrons

Answer 8

1st line = azathioprine or mercaptopurine
Alternatives = methotrexate, infliximab, adalimumab

Question 9

Investigation findings in Wilsons disease

Answer 9

Reduced serum caeruloplasmin
Reduced total serum copper
Increased 24 hour urinary copper excretion
Confirmed by ATP7B gene mutation

Question 10

Management of wilsons disease

Answer 10

Penicillamine - chelating agent
Trientine hydrochloride

Question 11

antibodies in autoimmune hepatitis

Answer 11

Antinuclear antibodies, anti-smooth muscle antibodies, raised IgG

Question 12

Area most likely to be affected in ischaemic colitis

Answer 12

Splenic flexure

Question 13

Score used in upper GI bleeds after endoscopy

Answer 13

Rockall score

Question 14

Treatment for life-threatening C. Diff

Answer 14

Oral vancomycin and IV metronidazole

Question 15

1st line treatment for C. Diff

Answer 15

Oral vancomycin for 10 days

Question 16

Chrons histology

Answer 16

Inflammation in all layers from mucosa to serosa
increased goblet cells
granulomas

Question 17

UC histology

Answer 17

No inflammation past the submucosa - inflammatory cell infiltrate in the lamina propria
Neutrophils migrate through the walls of glands to form crypt abscesses
Depletion of goblet cells

Question 18

Primary biliary cholangitis antibodies

Answer 18

IgM
Anti-mitochondrial, M2 subtype

Question 19

Primary biliary cholangitis management

Answer 19

1st line = ursodeoxycholic acid
Pruritis = cholestyramine
Fat soluble vitamin supplementation
Liver transplantation

Question 20

Tumour marker for cholangiocarcinoma

Answer 20

CA19-9

Question 21

Most common causative organism in ascending cholangitis

Answer 21

E coli

Question 22

Acute pancreatitis complications

Answer 22

Peripancreatic fluid collections
Pseudocysts
Pancreatic necrosis
Pancreatic abscess
Haemorrhage
ARDS

Question 23

Precipitants for hepatic encephalopathy

Answer 23

Spontaneous bacterial peritonitis
Constipation
Post TIPS
Renal failure
Hypokalaemia
Drugs - diuretics, sedatives
GI bleed
Increased dietary protein

Question 24

Features of hepatic encephalopathy

Answer 24

Confusion
Asterix
Constructional apraxia

Question 25

Most common artery to be involved in acute mesenteric ischaemia

Answer 25

Superior mesenteric artery