Gastro

Question 1

13C urea breath test rules

Answer 1

No Abx within 4 weeks, no acid lowering Rx within 2 weeks

Question 2

Leading cause of C Diff

Answer 2

2nd and 3rd gen cepholsporins - cefuroxime, ceftriaxone

Question 3

Other causes of C diff

Answer 3

Cipro, co-amox - lower relative risk than cephs

Question 4

Oesophageal Ca RFs (8)

Answer 4

Smoking 
Alcohol
GORD
Barretts oesophagus 
achalasia
Plummer Vinson syndrome
Squamous cell Ca - nitrosamine rich diets
Rare - coeliac, scleroderma

Question 5

UC factors increasing risk of Ca

Answer 5

Disease >10 years 
Patients with pancolitis
Onset <15
Unremitting disease
Poor Rx compliance

Question 6

IBD low risk -> five year colonoscopy surveillance

Answer 6

Extensive colitis with no active endoscopic/histological inflammation
L sided colitis
Crohns <50% bowel

Question 7

IBD intermediate risk -> 3 yearly colonoscopy

Answer 7

Extensive colitis with mild active endoscopy/histological inflammation
Post inflammatory polyps
Family history of colorectal cancer in a first degree relative aged 50 or over

Question 8

IBD high risk -> yearly colonoscopy

Answer 8

Extensive colitis with moderate/severe active endoscopic/histological inflammation
Stricture in past 5 years
Dysplasia in last 5 years declining surgery
PSC/transplant for PSC
FHx colorectal CA in family member <50

Question 9

Maltase function

Answer 9

Cleaves disaccharide maltose to glucose + glucose

Question 10

Sucrase function

Answer 10

Cleaves sucrose to Fructose and glucose

Question 11

Lactase function

Answer 11

CLeaves disaccharide lactose to glucose + galactose

Question 12

Amylase function

Answer 12

Breaks down starch into sugar

Question 13

Wilsons genetics

Answer 13

Autosomal Recessive

Defect in the ATP7B gene located on chromosome 13

Question 14

Liver Biopsy Contraindications (8)

Answer 14

INR >1.4
Plts <60
Anaemia
Extrahepatic bilary obstruction
Hyatid cyst
Haemangioma
Uncooperative pt
Ascites