Gastro Key facts

Question 1

Primary sclerosis cholagnitits is associated with what lower GI condition

Answer 1

UC

Question 2

primary sclerosing cholangitis is associated with what ANCA

Answer 2

P-ANCA

Question 3

what is the criteria for urgent 2WW referral for upper GI cancer query

Answer 3

all patients with dysphagia
all patients with upper abdo mass consistent with stomach cancer
patients aged 55+ with weight loss AND any of the following (upper abdo pain, reflux, dyspepsia)

Question 4

what is the most common organism found on ascitic fluid culture

Answer 4

E Coli

Question 5

what is the main diagnostic for haemachromatosis

Answer 5

serum ferritin

Question 6

what is Wilsons disease

Answer 6

excessive build up of copper in the body

Question 7

in Wilsons disease what are the rings called in the cornea

Answer 7

kayser-fleischer rings

Question 8

what are the two main organs that are affected by alpha-1-antitrypsin deficiency

Answer 8

Liver cirrhosis after 50 years old

Bronchiectasis and emphysema in the lungs after 30 years old

Question 9

what can liver cirrhosis lead to over time

Answer 9

hepatocellualr carcinoma

Question 10

what is primary binary cirrhosis and what does it lead to

Answer 10

immune system attacks small bile ducts
causes obstruction to outflow of bile
back pressure leads to fibrosis, cirrhosis and liver failure

Question 11

what does a build up of the following cause ]
bile acids
bilirubin
cholesterol

Answer 11

itcing
jaundice
xanthelasma

Question 12

which autoantibodies are specific to primary biliary cirrhosis

Answer 12

Anti-mitochondrial antibodies is the most specific to PBC and forms part of the diagnostic criteria
Anti-nuclear antibodies are present in about 35% of patients

Question 13

what are the following tumour markers for
alpha-fetoprotein
CA19-9

Answer 13

Alpha-fetoprotein is a tumour marker for hepatocellular carcinoma.
CA19-9 is a tumour marker for cholangiocarcinoma

Question 14

barretts oesophagus is considered premalagiant condition and is a risk factor for the development of which cancer

Answer 14

adenocarcinoma of the oesophagus

Question 15

how does Wilsons disease usually present

Answer 15

10-25 year olds, present with either liver disease or neurological disease

Question 16

what are the early symptoms of haemochromatosis

Answer 16

fatigue
ED
arthralgia (often in the hands)

also can cirrhosis, joint pain, pancreatic insufficiency and HF

Question 17

If someone presents with bleeding gums and a poor diet what does this make you think of

Answer 17

vitamin C deficiency- Scurvy

Question 18

in gallstone ileus what does plain abdo film usually show

Answer 18

small bowel obstruction & air in the biliary tree

Question 19

what 3 things can E coli cause

Answer 19

diarrhoea illness
UTI
neonatal meningitis

Question 20

long term PPI use causes which electrical abnormality

Answer 20

low magnesium

Question 21

how do you treat PBC

Answer 21

ursodeoxycholic acid

Question 22

spontaneous bacterial peritonitis; what is the most common organism in ascitic fluid

Answer 22

E coli

Question 23

what scan is performed to look at cirrhosis

Answer 23

transient elastography aka Fibroscan

can also do liver biopsy

Question 24

what is used to treat vatical bleed

what is used for prophylaxis

Answer 24

treat with terlipressin

prophylaxis is propranolol

Question 25

what condition should you always think about if someone presents with pain that is out of proportion to clinical findings, and occurs. after a meal with intermittent and severe pain

Answer 25

ischaemic colitis

Question 26

how many weeks. before endoscopy do you need to stop PPI

Answer 26

2 weeks

Question 27

what is Budd- Chiari syndrome

Answer 27

hepatic vein thrombosis triad of: sudden onset abdo pain, ascites, tender hepatomegaly

Question 28

how do you calculate alcohol units

Answer 28

% x volume / 1000

Question 29

what cancer is associated with GORD or Barretts

Answer 29

oesophageal adenocarcinoma

Question 30

in C diff infection what antibiotic should you prescribe

Answer 30

IV metronidazole or oral vancomycin

Question 31

how is Wilsons disease treated

Answer 31

pencillamine

Question 32

in coeliac patients how long do they have to be eating gluten for in order to test them

Answer 32

6 weeks

Question 33

what is achalasia and how do they usually present

Answer 33

muscles of LOS fail to relax | pt will have trouble with solids and liquids and starts intermittently and regurg food

Question 34

``` what are the following cancer marks for AFP CA19-9 CEA CA125 ```

Answer 34

AFP is HCC CA19-9 is pancreatic cancer CEA is bowel Ca Ca125 for ovarian cancer

Question 35

match the description with the organism 1. bloody diarrhoea & abscess, swinging fever, RUQ pain 2. travellers diarrhoea 3. bloody diarhhoea that is from ingesting uncooked meat and may lead to Gillian barre syndrome 4. rice water stools from contaminated water and shellfish 5. water diarrhoea from soft cheese, processed meat and pate a. listeria b. ecoli c. entamoeba d. campylobacter e. vibrio cholera

Answer 35

1C 2B 3D 4E 5A

Question 36

positive AMA is associated with what condition

Answer 36

PBC

Question 37

in eradication of H pylori, which two antibiotics should not be given together (it is either or)

Answer 37

metronidazole or clarithromycin

Question 38

what is the histological feature of chrons | what is the histological feature of UC

Answer 38

granulomas in areas of transmural inflammation | UC: mucosal inflammation, ulceration and crypt damage

Question 39

what are the 3 main inherited causes of liver failure

Answer 39

Wilsons alpha 1 antitrypsin haemochromatosis

Question 40

in alcohol excess what is seen in LFT

Answer 40

raised GGT | microcytic anaemia

Question 41

name the 2 reasons for a TIPS procedure

Answer 41

secondary prophylaxis of oesophageal varies | treatment of refractory ascites

Question 42

what is librium also known as

Answer 42

chlordiazapoxide

Question 43

what does PSC predispose a patient to

Answer 43

cholangiocarcinoma and HCC

Question 44

what criteria is used for liver transplant

Answer 44

kings college hospital criteria | - note that one is a PH less than 7.3 24 hours after ingestion of paracetamol

Question 45

a patient with ascites secondary to liver cirrhosis should be given what treatment first line

Answer 45

aldosterone antagonist such as spironolactone

Question 46

which vitamin is tetragenic at high doses

Answer 46

vitamin A

Question 47

for hepatic encephalopathy what is given for secondary prevention

Answer 47

lactulose and rifaximin

Question 48

what is the triad for mesenteric ischemia

Answer 48

CVD raised lactate soft but tender abdomen