Gastro

Question 1

What is the most appropriate advice to give a man with regards to alcohol intake?

Answer 1

No more than 14 units of alcohol per week. If you do drink as much as 14 units per week, it is best to spread this evenly over 3 days or more

Question 2

What is the 1st management for mild-moderate flare of distal ulcerative colitis?

Answer 2

topical (rectal) aminosalicylates

Question 3

what is the VBG of a patient vomiting/ aspirating?

Answer 3

Hypochloraemic metabolic alkalosis (loss of H+ ions)

Question 4

What is the iron study of haemochromatosis?

Answer 4

↑ Transferrin saturation, ↑ serum ferritin, ↓ total iron binding capacity

Question 5

What are 2 cancers most assocated with HNPCC (lynch syndrome)?

Answer 5

• colon
• Endometrial

Question 6

Following an urgent referral for endoscopy, what is the next most important action to take before the procedure?

Answer 6

Advise him to stop taking omeprazole 2 weeks before endoscopy

Question 7

In pernicious anaemia, which long-term complication is this patient at an increased risk of developing?

Answer 7

Gastric carcinoma

Question 8

If a patient with ulcerative colitis has had a severe relapse or >=2 exacerbations in the past year, what should they be given to maintain remission?

Answer 8

Oral azathioprine or oral mercaptopurine

Question 9

If acute cholecystitis can’t be diagnosed with an ultrasound, use a …

Answer 9

technetium-labelled HIDA scan

Question 10

What cancer is coeliac disease associated with?

Answer 10

T cell lymphoma

Question 11

What is mangement of high-grade dysplasia of barrett’s oesophagus?

Answer 11

Offer endoscopic intervention

Question 12

If you have a suspected upper GI bleed, what investigation must be done?

Answer 12

Upper gastrointestinal tract endoscopy within 24 hours

Question 13

What electrolyte disturbances are seen in refeeding syndrome?

Answer 13

hypophosphataemia, hypokalaemia and hypomagnesaemia

Question 14

VBG of vomiting?

Answer 14

Metabolic alkalosis with hypokalaemia

Question 15

VBG if diarrhoea?

Answer 15

Metabolic acidosis with hypokalaemia

Question 16

What has to be monitored with haemochromatosis?

Answer 16

Ferritin and transferrin saturation

Question 17

When do you do a Laparotomy and surgical exploration for a bleeding ulcer?

Answer 17

Surgery is indicated in patients with ongoing acute bleeding despite repeated endoscopic therapy

Question 18

What is management of an exacerbation of alcohol-related liver cirrhosis?

Answer 18

IV thiamine (prevent Wernicke’s encephalopathy) and 0.9% saline

Question 19

What part of the bowel is affected by in coealic?

Answer 19

Jejunum and duodenum

Question 20

How often and what test is used to test for DM in chronic pancreatitis patients?

Answer 20

HBA1C every 6 months

Question 21

What are signs of bowel perforation?

Answer 21

severe abdominal pain, guarding, and rigidity
Vomiting

Question 22

What is the first line invetigation for bowel perforation?

Answer 22

erect chest x-ray - detect free air under the diaphragm (pneumoperitoneum)

Question 23

What autoantibody is positive in primary sclerosing cholangitis?

Answer 23

p-ANCA