Gastroenteritis

Question 1

Diarrhoea - electrolytes

Answer 1

Secretory diarrhea if osmotic gap <50, pH >6.0
Osmotic diarrhea if osmotic gap >125 pH <5.5
Calculated osmotic gap = Measured osmolality – 2x(Na+K)

Question 2

Hormones that inhibits food intake:

Answer 2

Gut:
1) Peptide YY 2) Oxyntomodulin 3) Pancreatic polypeptide 4) Cholecystokinin 5) Glucagon-like peptide 1

Adipose tissue:

1) Insulin
2) Leptin

Question 3

Indications for fecal microbiota transplant in Cdiff

Answer 3

Treatment failure of 2 courses of therapy(must include atleast 10days oral Vanc)
2 or more episodes of symptomatic Cdiff infection requiring hospitalisation
Severe or fulminant infection not responding with 48 hrs of maximal therapy

Question 4

Coeliac disease genetics

Answer 4

HLA DQ2/DQ8. 10% chance if 1st degree relatives
Gluten intolerance
Dermatitis herpetiformis in 15% -scalp, shoulder, buttocks, knees

Question 5

Diagnosis of coeliac

Answer 5

Ttg, IgA

Biopsy -villous blunting, intraepithelial lymphocytes

Question 6

Complications of Coeliac

Answer 6

Anemia, malasorption, osteoporosis, LYMPHOMA

Question 7

AI conditions associated with coeliac

Answer 7

Type 1DM, Auto immune thyroid disease, Addisons, Sjogrens, polyarthritis, lupus, sarcoid, AIH

Question 8

Characteristic endoscopic finding in laxative abuse

Answer 8

Melanosis coli