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MRCP Part 1 > Gastro > Flashcards

Gastro Flashcards

1
Q

monoclonal antibody which targets C. difficile toxin B

A

Bezlotoxumab

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2
Q

plummer vinson syndrome

A

triad of iron deficiency anaemia, dysphagia due to esophageal webs, and atrophic glossitis

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3
Q

babies born to mothers who are chronically infected with hepatitis B or to mothers who’ve had acute hepatitis B during pregnancy should receive?

A

a complete course of vaccination + hepatitis B immunoglobulin

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4
Q

what do coeliacs need to receive every 5 years?

A

pneumococcal vaccine due to functional hyposplenism

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5
Q

what must be checked before starting before offering azathioprine or mercaptopurine

A

assess thiopurine methyltransferase (TPMT) activity

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6
Q

most useful marker of haemochromatosis

A

transferrin saturation

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7
Q

colorectal cancer tumour marker

A

CEA

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8
Q

diagnosis of Zollinger-Ellison syndrome (ZES)

A

fasting gastrin levels: the single best screen test

The secretin stimulation test

a positive result characterised by a marked increase in serum gastrin levels.

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9
Q

What is the most appropriate tool to screen for malnutrition?

A

The Malnutrition Universal Screening Tool (MUST)

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10
Q

histology finding Gastric adenocarcinoma

A

signet cells

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11
Q

histology finding Barret’s

A

Columnar metaplasia –> adenoca

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12
Q

King’s College Hospital criteria for liver transplantation (paracetamol liver failure)

A

Arterial pH < 7.3, 24 hours after ingestion

or all of the following:
prothrombin time > 100 seconds
creatinine > 300 µmol/l
grade III or IV encephalopathy

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13
Q

how does aspirin work?

A

Aspirin works by blocking the action of both cyclooxygenase-1 and 2. Cyclooxygenase is responsible for prostaglandin, prostacyclin and thromboxane synthesis.

The blocking of thromboxane A2 formation in platelets reduces the ability of platelets to aggregate

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14
Q

how to investigated for liver fibrosis in patients with NAFLD?

A

enhanced liver fibrosis (ELF) testing (blood test)

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15
Q

which vitamin deficiency causes angular cheilits?

A

vitamin B2 - riboflavin

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16
Q

types of surgical resection in colon disease

A

total proctocolectomy with ilea pouch annal anastomosis - entire colon out

low anterior resection - resect part of rectum and colon

Hartmann’s procedure - proctosigmoidectomy

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17
Q

management in PBC

A

ursodeoxycholic acid slows disease progression

cholestyramine helps pruritis

fat soluble vitamin supplementation

liver transplant if bili > 100

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18
Q

most common organism causing SBP?

A

E.Coli

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19
Q

first line test for diagnosis of small bowel overgrowth syndrome

A

Hydrogen breath

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20
Q

breath tests

A

hydrogen - SIBO
urea - h.pylori

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21
Q

Diarrhoea + biospy shows pigment laden macrophages

A

Melanosis coli due to laxative abuse

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22
Q

Spontaneous bacterial peritonitis - treatment:

A

intravenous cefotaxime

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23
Q

HLA antigens are encoded for by genes on which chromosome?

A

chromosome 6

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24
Q

dysentery (bloody diarrhoea) after a long incubation period

A

Amoebiasis

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25
when to give prophylactic abx for SBP risk
Oral ciprofloxacin. In patients with advanced cirrhosis and low ascitic fluid protein (<15 g/L), there is an increased risk of developing spontaneous bacterial peritonitis (SBP).
26
Budd chiari causes
polycythaemia rubra vera thrombophilia: activated protein C resistance, antithrombin III deficiency, protein C & S deficiencies pregnancy combined oral contraceptive pill: accounts for around 20% of cases
27
Budd chiari symptoms/ signs
abdominal pain: sudden onset, severe ascites → abdominal distension tender hepatomegaly
28
H. pylori eradication:
PPI + amoxicillin + clarithromycin or PPI + metronidazole + clarithromycin
29
Most common cause of HCC
Worldwide - chronic hep B Europe- chronic hep c
30
Tumour market for HCC
' AFP
31
Mx.hepatocellular cancer
End stage liver disease =Conservative Management early disease: surgical resection liver transplantation radiofrequency ablation transarterial chemoembolisation sorafenib: a multikinase inhibitor options
32
A recurrent episode of C. difficile within 12 weeks of symptom resolution
should be treated with oral fidaxomicin
33
Coeliac disease is linked to which HLA type
HLA-DQ2
34
Cystic fibrosis diet
High calorie and high fat with pancreatic enzyme supplementation for every meal.
35
the gold standard for diagnosing Bile acid malabsorption
The SeHCAT (Selenium-75-labelled homocholic acid taurine) test the patient ingests a capsule containing the radiolabelled bile acid analogue SeHCAT. After 7 days, whole-body gamma camera imaging is performed to assess the retention of SeHCAT. A low retention rate indicates bile acid malabsorption.
36
Best way to diagnose chronic Pancreatitis
CT
37
marker of severity in acute pancreatitis.
crp
38
Oesophageal/Gastric Cancer - assessing mural invasion
Endoscopic ultrasound (EUS) is better than CT or MRI
39
when to start anti depressants for IBS and which type?
NICE recommend considering psychological interventions after 12 months. Tricyclic antidepressants (eg. amytriptylline) should be used in preference to selective serotonin reuptake inhibitors
40
what test for h.pylori erradication?
Urea breath test
41
Stauffer syndrome
a paraneoplastic disorder associated with renal cell cancer typically presents as cholestasis/hepatosplenomegaly it is thought to be secondary to increased levels of IL-6
42
when should statins be discontinued?
Treatment with statins should be discontinued if serum transaminase concentrations rise to and persist at 3 times the upper limit of the reference range.
43
The combination of deranged LFTs combined with secondary amenorrhoea in a young female strongly suggest
autoimmune hepatitis
44
common factors indicating severe pancreatitis include:
age > 55 years hypocalcaemia hyperglycaemia hypoxia neutrophilia elevated LDH and AST
45
when to vaccinate before elective splenectomy
at least 2 weeks before elective splenectomy
46
treatment early keloids
intra-lesional steroids e.g. triamcinolone
47
preferred diagnostic test for chronic pancreatitis
CT pancreas is - looking for pancreatic calcification
48
ifrst line investigation for suspected cholangitis
USS
49
antibody associated with miller fisher syndrome
anti-GQ1b antibody
50
Nitric oxide effects
vasodilation + inhibits platelet aggregation
51
following a gastric bypass what supplements are needed
All gastric bypass operations bypass the duodenum. iron and calcium Nearly all menstruating women will therefore require iron supplementation.
52
investigations of choice in primary sclerosing cholangitis
ERCP/MRCP
53
PPI + non-bloody diarrhoea disease and diagnosis
microscopic colitis colonoscopy and biopsy
54
FAP disease gene
autosomal dominant mutation in a tumour suppressor gene called adenomatous polyposis coli gene (APC), located on chromosome 5.
55
small bowel bacterial overgrowth syndrome. What is the treatment of choice?
rifaximin
56
Coeliac disease - the first-line test
tissue transglutaminase antibodies
57
sickle cell disease treatment of future attacks
1. penicillin until age 5 2. long term hydroxycarbamide to reduce the incidence of complications and acute crises
58
The most common cause of biliary disease in patients with HIV is
sclerosing cholangitis due to infections such as CMV, Cryptosporidium and Microsporidia
58
most common cause of travellers' diarrhoea
E. coli
59
Campylobacter infection management
self-limiting immunocompromised / severe then treatment: clarithromycin
60
Liver failure following cardiac arrest think
ischaemic hepatitis
61
which marker is a more specific marker of pancreatitis
Raised lipase
62
Lung cancer dermatological manifestation
Erythema gyratum repens - 'wood-grain' pattern and figurate erythema
63
best first line management for NAFLD
Weight loss
64
Primary sclerosing cholangitis is more associated with which IBD disease?
UC
65
aortic stenosis and angiodysplasia resulting in chronic gastrointestinal blood loss
angiodysplasia
66
ith respect to the coagulopathy associated with liver disease, which clotting factor is characteristically increased?
factor 8
67
The most common type of inherited colorectal cancer:
Hereditary non-polyposis colorectal carcinoma (HNPCC) Lynch syndrome
68
management of eosinophilic oesophagitis
Dietary modification and topical steroids
69
Urea breath test accuracy
no antibiotics in past 4 weeks, no antisecretory drugs (e.g. PPI) in past 2 weeks
70
common complication post TIPS procedure?
exacerbation of hepatic encephalopathy - now more toxins are entering blood
71
Crypt abscesses
ulcerative colitis
72
'Kantor's string sign'
strictures Crohns
73
prophylaxis of oesophageal bleeding
A non-cardioselective B-blocker (NSBB) eg. propranolol
74
hepatorenal syndrome management
1. liver transplant 2. vasopressin analogues, for example terlipressin - causing vasoconstriction of the splanchnic circulation 3. volume expansion with 20% albumin 4. transjugular intrahepatic portosystemic shunt
75
multiple white plaques or pseudomembranes on the gastrointestinal mucosa
Pseudomembranous colitis multiple white plaques - overgrowth of the bacterium Clostridium difficile following antibiotic use.
76
anti-retroviral drugs most characteristically associated with pancreatitis?
Didanosine, a nucleoside reverse transcriptase inhibitor (NRTI),
77
h.pylori and link to oesophageal cancer
h.pylori is protective against oesophageal ca
78
acute alcohol hepatitis mx.
steroids
79
King's College Hospital criteria for liver transplantation (paracetamol liver failure)
Arterial pH < 7.3, 24 hours after ingestion or all of the following: prothrombin time > 100 seconds creatinine > 300 µmol/l grade III or IV encephalopathy
80
encephalopathy grades
Grade I: Irritability Grade II: Confusion, inappropriate behaviour Grade III: Incoherent, restless Grade IV: Coma

MRCP Part 1 (21 decks)

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