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gastro Flashcards

1
Q

History of recurrent peptic ulcers, and gastro-oesophageal reflux disease, raised serum gastrin? Diagnostic hormone?

A

Zollinger-Ellison syndrome (ZES)
Secretin

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2
Q

Metabolic ketoacidosis with normal or low glucose?

A

Alcohol XS

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3
Q

Hep B positive pregnant woman?

A

Give newborn vaccine and immunoglobulin

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4
Q

The majority of gastrinomas are found where?

A

First part of the duodenum

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5
Q

High SAAG (serum albumin-ascites albumin) indicates what?

A

Portal vein thrombosis

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6
Q

Diarrhoea - biospy shows pigment laden macrophages?

A

Laxative abuse

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7
Q

Drugs causing dyspepsia?

A

NSAIDs, bisphosphonates, steroids, nitrates, CCBs, aminophylline

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8
Q

In life-threatening C. difficile infection treatment is?

A

Oral vanc and IV met

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9
Q

Secretion of below hormones?
Gastrin, CCK, secretin, VIP, somatostatin?

A

Gastrin - G cells
CCK - I cells in upper small intestine
Secretin - S cells in upper small intestine
VIP - small intestine, pancreas
Somatostatin - D cells in pancreas and stomach

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10
Q

A 29-year-old woman who is 30 weeks pregnant is admitted to the Emergency Department with central abdominal pain, raised amylase?

A

Gallstone induced pancreatitis

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11
Q

With respect to the coagulopathy associated with liver disease, which clotting factor is characteristically increased?

A

Factor 8

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12
Q

Which drug is associated with drug induced cholestasis?

A

OCP

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13
Q

Deep inflammatory infiltrate from the mucosa to the muscularis propria and numerous granulomata?

A

Crohn’s - UC would involve only mucosal layer

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14
Q

8 months of watery diarrhoea, using ramipril and omeprazole in middle aged man, nil else. Cause?

A

Microscopic colitis - PPI use

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15
Q

Liver disease in HIV pt?

A

Sclerosing cholangitis

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16
Q

Investigation of choice for pancreatic cancer?

A

High res CT

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17
Q

Diarrhoea following ileocaecal resection to treat terminal ileal Crohns disease?

A

Oral cholestyramine

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18
Q

An isolated rise in bilirubin in response to physiological stress is typical of?

A

Gilbert’s syndrome

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19
Q

What is the most appropriate course of action to avoid refeeding syndrome?

A

50% of energy and protein for first 2 days

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20
Q

Which medication does NICE recommend that we avoid in patients with IBS?

A

Lactulose

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21
Q

A diagnosis of ulcerative colitis is suspected. Which part of the bowel is most likely to be affected?

A

Rectum

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22
Q

Most common organism in SBP?

A

E Coli

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23
Q

Hallmark disturbance in refeeding syndrome?

A

Hypophosphotemia

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24
Q

It is decided that a patient is put on a prophylactic medication to reduce the risk of variceal bleeding.

Which medication would be most appropriate?

A

Propranolol

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25
Q

A 72-year-old female is admitted with diarrhoea to the acute medical unit. A sigmoidoscopy is performed which shows multiple white plaques adhered to the gastrointestinal mucosa. What is the most likely diagnosis?

A

Pseudomembranous colitis

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26
Q

Angiodysplasia association?

A

Aortic stenosis

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27
Q

Risk of refeeding syndrome?

A

Torsades

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28
Q

Liver failure following cardiac arrest?

A

Ischaemic hepatitis

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29
Q

Which hormones increase secretion of pancreatic fluid?

A

VIP, CCK, secretin

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30
Q

Function of gastrin?

A

Gastrin increases HCL production and gastrointestinal motility

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31
Q

What must be done before testing for coeliac disease?

A

Eat gluten for 6 weeks prior

32
Q

Triad of abdominal pain, hepatomegaly and ascites?

A

Budd Chiari

33
Q

Management of eosinophilic oesophagitis?

A

Steroids and dietary modification

34
Q

ALT is typically elevated e.g. 500 u/l, abdo pain, vomiting - 34 weeks pregnant?

A

Acute fatty liver of pregnancy

35
Q

Gold standard for diagnosing bile acid malabsorption syndrome?

36
Q

Most common complication of ERCP?

A

Acute pancreatitis

37
Q

Diarrhoea, weight, arthralgia, lymphadenopathy, ophthalmoplegia?

A

Whipple’s disease

38
Q

Severe alcoholic hepatitis rx?

A

Prednisolone

39
Q

Abx implicated in cholestasis?

A

Fluclox, erythromycin, co amox

40
Q

Indicator of pancreatitis severity?

A

Hypocalcemia

41
Q

Positive anti-HBc IgG, negative anti-HBc IgM and negative anti-HBc in the presence of HBsAg implies?

A

Chronic HBV infection

42
Q

Appropriate first line test for diagnosis of small bowel overgrowth syndrome?

A

Hydrogen breath test

43
Q

Jejunal biopsy findings in Whipple’s?

A

Macrophages containing Periodic acid-Schiff (PAS) granules

44
Q

Best first line management for NAFLD?

A

Weight loss

45
Q

After diagnosing NAFLD which test should be done?

A

Liver fibrosis testing

46
Q

A recurrent episode of C. difficile within 12 weeks of symptom resolution should be treated with?

A

Oral fidaxomicin

47
Q

Testing for carcinoid syndrome?

A

urinary 5-HIAA

48
Q

What would confirm a diagnosis of spontaneous bacterial peritonitis (SBP)?

A

Paracentesis - neutrophil count >250

49
Q

A 70-year-old woman presented with difficulty swallowing, chronic cough associated with occasional swellings in the neck? Investigation?

A

Pharyngeal pouch - barium swallow

50
Q

A diagnosis of ischaemic colitis is suspected. Which part of the colon is most likely to be affected?

A

Splenic flexure

51
Q

Perianal itching in children, possibly affecting other family members?

A

Enterobius vermicularis

52
Q

Management of Barrett’s oesophagus?

A

High dose PPI

53
Q

Investigations of choice in primary sclerosing cholangitis?

54
Q

Diarrhoea + hypokalaemia?

A

Villous adenoma

55
Q

Autoimmune hepatitis associated with raised levels of which immunoglob?

56
Q

What stimulates the release of gastrin from G-cells?

A

Luminal peptides

57
Q

Brush border enzymes:
Lactase?
Maltase?
Sucrase?

A

Maltase - glucose and glucose
Sucrase - glucose and fructose
Lactase - glucose and galactose

58
Q

A 19-year-old man is referred to the general medical clinic. For the past six months his family have noted increasing behavioural and speech problems. He himself has noticed that he is more clumsy than normal and reports excessive salivation. His older brother died of liver disease. Given the likely underlying condition what is the most appropriate therapy?

A

Wilson’s disease - penicillamine

59
Q

Hepatorenal syndrome is primarily caused by what?

A

Splanchnic vasodilation

60
Q

How long should pt be abx and PPI free for prior to urea breath test?

A

Urea breath test - no antibiotics in past 4 weeks, no antisecretory drugs (e.g. PPI) in past 2 weeks

61
Q

What is the most appropriate antibiotic therapy to accompany drainage of the abscess?

A

Amox + metro + cipro

62
Q

Which enzyme is mainly responsible for breaking starch down into sugars?

63
Q

Strongest association with H Pylori?

A

Duodenal ulceration

64
Q

Inheritance of Wilson’s disease?

A

Auto recessive

65
Q

Treatment of SBP?

A

IV cefotaxime

66
Q

Causes of villous atrophy (other than coeliacs)?

A

Hypogammaglob, tropical sprue, FMF, Whipple’s, lymphoma

67
Q

Which disorder is commonly associated with PBC?

68
Q

First line rx for hepatorenal syndrome?

A

Terlipressin

69
Q

H Pylori association?

A

Gastric ca but not oesophageal ca

70
Q

Assocation between omep and c diff?

A

Omeprazole increases risk of C diff

71
Q

Can sodium valproate cause pancreatitis?

72
Q

A 65-year-old man with liver cirrhosis of unknown cause is reviewed in clinic. Which factor is most likely to indicate a poor prognosis?

73
Q

What percentage of patients with Peutz-Jeghers syndrome will have died from a related cancer by the age of 60 years?

74
Q

In a mild-moderate flare of distal ulcerative colitis, the first-line treatment?

A

Topical (rectal) aminosalicylates

75
Q

Diagnosing and monitoring the severity of liver cirrhosis?

A

Transient elastography

76
Q

First line in BMI 30-39?

A

Laparoscopic-adjustable gastric banding (LAGB)

mrcp 1 (18 decks)

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