Gastro

Question 1

What is the x-ray finding for duodenal atrasia?

Answer 1

Double bubble sign

Question 2

What are the tests for suspected coeliac disease?

Answer 2

IgA and anti-tTG

Question 3

What is the treatment for elevated ammonia?

Answer 3

Stop oral intake
Dextrose infusion
Sodium benzoate infusion

Question 4

What is Meckel’s diverticulum?

Answer 4

Remnant of vitelloibtestinal duct, often containing ectopic Gastro or pancreatic tissue

Question 5

What is the investigation of choice for ? Meckel’s diverticulum?

Answer 5

Technetium-99m scan.
Diverticulum becomes present same time as stomach due to both having gastric mucosa

Question 6

RUQ pain, fever and jaundice in 3 year old suggests what?

Answer 6

Choledochal cyst

Question 7

What are the causes for conjugated hyperbilirubinaemia?

Answer 7

Biliary atrasia
Alpha-1-antitrypsin deficiency
Cystic fibrosis
TPN

Question 8

Liver failure symptoms and psych/neuro changes should make you think what?

Answer 8

Wilson’s disease

Question 9

What are the investigations for Wilson’s disease?

Answer 9

Urinary copper (high)
Serum ceruloplasmin (low)
INRs for liver function
Liver biopsy is good standard

Question 10

What is treatment for Wilson’s disease?

Answer 10

Penicillamine -copper chelating agent-life long

Question 11

What is name of autosomal recessive condition characterised by unconjugated hyperbilirubinaemia?

Answer 11

Gilbert syndrome

Question 12

When suspecting coeliac disease what is the most appropriate initial investigation?

Answer 12

Serum IgA anti-tTG
AND serum total IgA.
If IgA is low consider other antibodies

Question 13

What are the treatments for Crohn’s disease?

Answer 13

Polymeric diet (modulen) to induce remission
Thiopurines (azothioprine/ 6-mercaptopurine ) to maintain remission
Influximab 1st line if extensive ulcer or perinatal disease
Prednisolone for acute flares