Gastro Buzzwords

Question 1

What is the triad symptoms for Budd-Chiari syndrome?

Answer 1

Sudden onset abdominal pain, ascites, and tender hepatomegaly

Question 1

What 3 abdominal masses may be present in pancreatic cancer?

Answer 1

hepatomegaly (metastases)
gallbladder (Courvoisier’s law)
epigastric mass (primary)

Question 2

What findings on an LFT indicate alcohol hepatitis?

Answer 2

The AST/ALT ratio in alcoholic hepatitis is 2:1

Question 3

What is the triad of symptoms for ascending cholangitis?

Answer 3

Charcot’s cholangitis triad: fever, jaundice and right upper quadrant pain

Question 4

What is the treatment of choice for biliary colic?

Answer 4

An elective laparoscopic cholecystectomy

Question 5

What are the symptoms indicative of common bile duct gallstones after a cholecystectomy?

Answer 5

Gallstones may be present in the CBD causing ongoing jaundice and pain after cholecystectomy

Question 6

What is the M rule for Primary biliary cholangitis?

Answer 6

IgM
anti-Mitochondrial antibodies, M2 subtype
Middle aged females

Question 7

What is the first line management for primary biliary cholangitis?

Answer 7

Ursodeoxycholic acid

Question 8

What does raised ALP alone indicate?

Answer 8

Raised ALP in the presence of normal LFT’s should raise suspicion of malignancy. Particularly bone cancer/ metastases

Question 9

What symptoms are a strong sign of liver failure?

Answer 9

Fetor hepaticus, sweet and fecal breath, is a sign of liver failure

Question 10

What does a ‘double duct’ on imaging indicate?

Answer 10

Pancreatic cancer

Question 11

How does hepatitis A present?

Answer 11

Hepatitis A presents with flu-like symptoms, RUQ pain, tender hepatomegaly and deranged LFTs

Question 12

What is indicative of primary sclerosing cholangitis?

Answer 12

Ulcerative colitis + cholestatis (e.g. jaundice, raised ALP)

Question 12

cholestasis: causative drug?

Answer 12

Co-amoxiclav

Question 13

triad of encephalopathy, jaundice and coagulopathy

Answer 13

Liver failure

Question 14

Ascites: a high SAAG gradient (> 11g/L) indicates portal hypertension

Answer 14

Liver Cirrhosis

Question 15

Deterioration in patient with hepatitis B - ?

Answer 15

hepatocellular carcinoma

Question 16

Liver failure following cardiac arrest

Answer 16

think ischaemic hepatitis

Question 17

Why do patients with coeliac disease require regular immunisations?

Answer 17

Functional hyposplenism.

Question 18

pancreatitis severity

Answer 18

Hypocalcaemia is an indication of severe pancreatitis

Question 19

chronic pancreatitis to help aid digestion of food

Answer 19

Replacement of pancreatic enzymes (e.g. Creon) is part of the management of patients

Question 20

Jaundice following abdominal pain and pruritus during pregnancy

Answer 20

acute fatty liver of pregnancy

Question 21

first-line to maintain remission in patients with Crohn’s

Answer 21

Azathioprine or mercaptopurine

Question 22

management of severe alcoholic hepatitis

Answer 22

Corticosteroids

Question 23

test of exocrine function in chronic pancreatitis

Answer 23

Faecal elastase

Question 24

Gastric MALT lymphoma

Answer 24

eradicate H. pylori

Question 25

Acute respiratory distress syndrome

Answer 25

Acute respiratory distress syndrome is a recognised complication of acute pancreatitis

Question 26

Sister Mary Joseph nodule

Answer 26

sign of metastasis to periumbilical lymph nodes, classically from gastric cancer primary

Question 27

Which of the following should be assessed before commencing azathioprine?

Answer 27

TPMT activity should be assessed before offering azathioprine or mercaptopurine therapy in Crohn’s disease

Question 28

management of Crohn’s patients who develop a perianal fistula

Answer 28

Oral metronidazole

Question 29

Loperamide

Answer 29

Loperamide is first-line for treatment of diarrhoea in IBS

Question 30

most common complication of ERCP

Answer 30

Acute pancreatitis

Question 31

Alcohol hepatitis

Answer 31

The AST/ALT ratio in alcoholic hepatitis is 2:1

Question 32

signet ring cells

Answer 32

Gastric adenocarcinoma

Question 33

A too high INR

Answer 33

Patient is at risk of bleeding

Question 34

A too low INR

Answer 34

Patient is at risk of blood clot formation