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MRCP > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

Which bacteria causes vomiting and diarrhea after eating rice?

A

Bacillus cereus

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2
Q

Which poisoning is associated with eating tuna?

A

Scombroid poisoning

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3
Q

What is the treatment of alcoholic hepatitis?

A

Prednisolone

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4
Q

What is the PPV of FOB?

A

5-15%

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5
Q

What are the pathological features of liver cirrhosis?

A

Excess collagen and extracellular matrix deposition in periportal and pericentral zones

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6
Q

What do chief cells in the stomach secrete?

A

enzymes such as pepsin and gastric lipase

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7
Q

Which cells secrete gastric acid?

A

Parietal cells

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8
Q

What is the most common organism in pyogenic liver abscesses in adults?

A

E. coli

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9
Q

What is the most common organism in pyogenic liver abscesses in children?

A

Staph aureus

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10
Q

What causes multiple duodenal ulcers?

A

Zollinger-Ellinson syndrome

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11
Q

Which anti-retroviral causes pancreatitis?

A

Didanosine

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12
Q

What causes arthralgia and chondrocalcinosis?

A

Haemochromatosis

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13
Q

What causes 95% of duodenal ulcers?

A

H. Pylori

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14
Q

What condition causes PAS granules to be seen on jejunal biopsy?

A

Whipple’s disease

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15
Q

Where do VIPomas arise from?

A

The pancreas

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16
Q

What are the most common type of antibodies seen in pernicious anaemia?

A

Gastric parietal cell Abs

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17
Q

Which hormone increases HCO3 secretion in the GI tract?

A

Secretin

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18
Q

Which liver disease is amenorrhoea associated with?

A

Autoimmune hepatitis

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19
Q

What is the primary management of autoimmune hepatitis?

A

Steroids

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20
Q

Name the 6 types of drug that tend to cause cholestasis

A

COCP, antibiotics (flucloxacillin, co-amoxiclav, erythromycin), steroids, chlorpromazine, sulphonylureas, fibrates

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21
Q

Which 3 drugs cause liver cirrhosis

A

Methotrexate, methyldopa, amiodarone

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22
Q

What is the best initial investigation of Budd Chiari syndrome

A

Ultrasound with dopplers

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23
Q

What is the most common site affected in UC

A

The rectum

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24
Q

What is the most likely sign on imaging of pancreatic cancer

A

Common bile and pancreatic duct dilation (double duct sign)

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25
Q

What test is recommended for H. pylori post-eradication therapy

A

Urea breath test

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26
Q

What is the main risk factor for anal cancer

A

HPV16 and HPV18

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27
Q

What benign condition caused by a defect in the cMOAT protein causes conjugated hyperbilirubinaemia

A

Dubin-Johnson syndrome

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28
Q

What is the most common organism in SBP

A

E. coli

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29
Q

What neutrophil count on ascitic tap suggests SBP

A

Neutrophils >250

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30
Q

Where is CCK secreted

A

I cells in upper small intestines

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31
Q

Where is secretin secreted

A

S cells in upper small intestine

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32
Q

What do A cells produce in the pancreas

A

Glucagon

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33
Q

What secretory tumour causes hypokalaemia, acidosis, low HCl and diarrhoea

A

VIPoma

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34
Q

What cell changes occur in Barrett’s oesophagus

A

Squamous to columnar

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35
Q

Which cancer is most likely to occur in the lower third of the oesophagus

A

Oesophageal adenocarcinoma

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36
Q

What is the treatment of Achalasia

A

Heller cardiomyotomy

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37
Q

Which arteries supply the greater curvature of the stomach

A

Right and left gastroepiploic

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38
Q

What blood results are typical in alcoholic hepatitis

A

AST > ALT, raised IgA

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39
Q

What immune markers are raised in type 1 autoimmune hepatitis

A

ANA, smooth muscle Abs, IgG

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40
Q

What percentage of HCV go on to develop chronic infection

A

80-85%

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41
Q

What are the side effects of interferon alpha

A

Flu, depression, leukopenia, low platelets

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42
Q

Which antivirals are used to treat HBV

A

Entecavir, tenofovir

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43
Q

Which vasculitis is commonly associated with HCV infection

A

Cryoglobulinaemia

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44
Q

What pattern does alcohol/biliary disease show on liver biopsy

A

Micronodular

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45
Q

What is the treatment for hepatorenal syndrome

A

Terlipressin, volume expansion with 20% albumin, ABx, TIPSS

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46
Q

What condition in liver disease causes SOB on standing or being upright

A

Hepatopulmonary syndrome

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47
Q

Which condition causes blistering skin lesion a on the back of hands due to deficiency of hepatic UROD

A

Porphyria Cutanea Tarda

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48
Q

What condition shows onion skin pattern on liver biopsy

A

PSC

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49
Q

What blood result suggests haemochromatosis

A

Transferrin sats >45%

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50
Q

What does haemochromatosis show on liver biopsy

A

Perl’s stain

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51
Q

How is Wilson’s disease diagnosed

A

24 hour urinary copper excretion

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52
Q

What two conditions cause ALT > 10,000

A

Paracetamol overdose, ischaemic hepatitis

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53
Q

What condition causes low HCO3 on secretin stimulation test

A

Chronic pancreatitis

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54
Q

Which blood panel is used to assess fibrosis in an asymptomatic finding of NAFLD

A

ELF (hyaluronic acid + procollagen III + tissue inhibition of metalloproteinase 1)

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55
Q

Which monoclonal antibody can be used to prevent recurrence of C.diff

A

Bezlotuxumab

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56
Q

What test is used to assess small bowel bacterial overgrowth syndrome

A

Hydrogen breath test

57
Q

What is the treatment of bile acid malabsorption after ileal resection

A

Cholestyramine

58
Q

What causes Howel-Jolly bodies in coeliac disease

A

Hyposplenism

59
Q

Which condition might present after a holiday to Thailand with coliforms on jejunal biopsy

A

Tropical sprue

60
Q

What test is used to detect bile acid malabsorption

A

14C glycolate test

61
Q

What test is diagnostic for Whipple’s disease

A

PAS staining

62
Q

What are the common symptoms of carcinoid syndrome

A

Flushing, hypotension, right heart valvular stenosis, pellagra

63
Q

What is cowden’s syndrome

A

Multiple hamartomatous polyps in GIT

64
Q

Which condition causes hamartomatous polyps in GI tract and pigmented lesions on lips

A

Peutz-Jeghers syndrome

65
Q

What is seen on GI biopsy in laxative abuse

A

Pigment-laden macrophages

66
Q

Why does hypocalcaemia occur in pancreatitis

A

Saponification of fats

67
Q

What is the increased risk of developing HCC in PBC patients

A

20-fold increase

68
Q

What is the earliest symptom of carcinoid syndrome

A

Facial flushing

69
Q

What is the diagnostic test for pancreatic cancer

A

High-resolution CT

70
Q

What BMI is cutoff for referral to bariatric surgery if patient has risk factors

A

BMI > 35

71
Q

Where does mesenteric ischaemia typically affect

A

Small bowel

72
Q

What is the treatment of C.diff that doesn’t respond to oral vancomycin

A

Oral fidaxomicin

73
Q

What criteria determines moderate c.diff

A

Raised WCC <15, 3-5 loose stools per day

74
Q

What criteria determines life-threatening c.diff

A

Hypotension, partial/complete ileus, toxic megacolon, CT evidence of severe disease

75
Q

What is the action of VIP

A

Stimulates secretion by pancreas and intestines, inhibits acid secretion

76
Q

What is the treatment of recurrent c.diff within 12 weeks

A

Oral fidaxomicin

77
Q

Which aminosalicylate drug has the highest risk of causing pancreatitis

A

Mesalazine

78
Q

Which aminosalicylate is associated with oligospermia

A

Sulphasalazine

79
Q

What is the management of eosinophilic oesophagitis

A

Dietary modification and topical steroids (e.g. fluticasone)

80
Q

Which clotting factor is paradoxically increased in coagulopathy of liver disease

A

Factor VIII

81
Q

Which laxative should not be given in IBS

A

Lactulose

82
Q

What eye condition is a rare complication of acute pancreatitis

A

Ischaemic (Purtscher) retinopathy

83
Q

What is included in the child-Pugh classification for liver cirrhosis

A

Bilirubin, albumin, PT, encephalopathy, ascites

84
Q

What is used to calculate the MELD score to predict survival in liver cirrhosis patients

A

Creatinine, bilirubin, INR

85
Q

Which condition is associated with aortic stenosis and predisposes to bleeding in the GI tract

A

Angiodysplasia

86
Q

What is the most common cause of biliary disease in HIV

A

PSC due to infections such as CMV, cryptosporidium, microsporidia

87
Q

What are the risk factors for squamous cell oesophageal cancer

A

Alcohol, smoking, achalasia, Plummer Vinson

88
Q

What are the risk factors for oesophageal adenocarcinoma

A

Alcohol, smoking, Barrett’s oesophagus

89
Q

A retrocardiac air-fluid level is sometimes seen in which GI condition

A

Achalasia

90
Q

Which drug can be used to reverse the bleeding effect of dabigatran

A

Idarucizumab

91
Q

Which features of haemochromatosis are reversible with treatment

A

Cardiomyopathy, skin pigmentation

92
Q

What test can be used to diagnose Gilbert’s syndrome

A

Nicotinic acid test

93
Q

What are the causes of villous atrophy

A

Coeliac, tropical sprue, Whipple’s, lymphoma, hypogammaglobulinaemia

94
Q

Which brush border enzyme results in the formation of glucose and galactose

A

Lactase

95
Q

Which brush border enzyme results in the formation of glucose and fructose

A

Sucrase

96
Q

Which brush border enzyme results in the formation of glucose and glucose

A

Maltase

97
Q

What percentage of patients with Peutz-Jeghers syndrome will die from a related cancer by the age of 60

A

50%

98
Q

What triad of symptoms is associated with Plummer-Vinson Syndrome

A

Dysphagia, glossitis, IDA

99
Q

Which lipid disorders predispose a risk of acute pancreatitis

A

Hypertriglyceridaemia, Hyperchylomicronaemia

100
Q

What is the MOA of azathioprine

A

Metabolised to mecaptopurine - a purine analogue that inhibits purine synthesis

101
Q

What is the treatment of AIP

A

Haematin (haem arginate) + IV glucose

102
Q

Which hepatitis is associated with transmission via blood transfusion prior to 1991

A

Hepatitis C

103
Q

What is the management of Barrett’s oesophagus with high grade dysplasia

A

Endoscopic mucosal ablation

104
Q

Which IBD has crypt abscesses

A

Ulcerative colitis

105
Q

Which vitamin deficiency can carcinoid syndrome cause

A

Pellagra (niacin - B3)

106
Q

What are the indications for FOB testing

A

> = 50 with unexplained abdo pain/weight loss

< 60 with CIBH or IDA

> = 60 with anaemia in absence of iron deficiency

107
Q

Which subtype of AMA is specific for PBC

A

M2 subtype AMA

108
Q

What causes inclusion bodies on colonic histology

A

CMV infection

109
Q

What is the most suitable emergency diagnostic test for mesenteric ischaemia

A

Contrast CT angiography

110
Q

What are the causes of chronic pancreatitis

A

Alcohol abuse, CF, haemochromatosis and PSC

111
Q

What are the most effective agents in maintaining Crohn’s disease long term

A

Thiopurines (azathioprine and 6-mercaptopurine)

112
Q

Which type of colitis is associated with coeliac disease

A

Collagenous colitis

113
Q

Which colitis presents with chronic watery diarrhoea and looks normal on colonoscopy

A

Collagenous colitis

114
Q

When should liver transplant be considered in cirrhosis + HCC

A

Cirrhosis and single small HCC (<5cm) or up to three lesions (<3cm)

115
Q

When should hepatic resection be considered in HCC

A

Primary HCC in a non-cirrhotic liver

116
Q

What is the management of acute fatty liver disease of pregnancy

A

Aggressive correction of hypoglycaemia and coagulopathy followed by expeditious delivery

117
Q

What can be used to induce remission in severe colitis not responding to steroids after 72 hours

A

IV cyclosporin

118
Q

What is the initial treatment for gastroparesis

A

Domperidone

119
Q

Which disease is associated with Kantor’s string sign

A

Small bowel Crohn’s disease

120
Q

What cause of ascites does a SAAG gradient >11g/L indicate

A

Transudate (portal HTN)

121
Q

What is the vertical transmission rate of HCV

A

6%

122
Q

What % of acute HCV leads to chronic infection

A

85%

123
Q

What is first line treatment for HCV infection

A

Direct-acting antivirals (sofosbuvir, ledipasvir, ombitasvir etc)

124
Q

What is the status of HBsAb in chronic disease

A

Negative

125
Q

When should patients at risk of HNPCC be screened with colonoscopy

A

2-yearly between 20-40 years, then annually

126
Q

Which deficiency is most common after a gastrectomy

A

Iron deficiency (absent acidic environment means Fe3+ can’t be reduced to the more absorbable Fe2+)

127
Q

What is the the most common extra-intestinal feature in Crohn’s and UC

A

Arthritis

128
Q

What criteria is used to determine severe colitis

A

Truelove-Witts

129
Q

How often should patients with intermediate risk UC be screened for colorectal ca

A

3 yearly colonoscopy

130
Q

How often should a patient with UC and PSC be screened for colorectal ca

A

Yearly (high risk)

131
Q

Which type of lymphoma is most associated with coeliac disease

A

Enteropathy associated T-cell lymphoma

132
Q

What should be considered in a young adult presenting with intermittent melaena despite normal OGD/colonoscopy

A

Meckel’s diverticulum

133
Q

What are the causes of hamartomatous polyps in the GI tract

A

Cowden syndrome
Peutz-Jeghers syndrome
NF1
MEN2
Familial juvenile polyposis

134
Q

What are the causes of adenomatous polyposis in the GI tract

A

HNPCC
FAP

135
Q

What test is used to diagnose Meckel’s diverticulum

A

Tc-99m pertechnetate

136
Q

What INR is transplant indicated according to King’s College criteria

A

> 6.5

OR

> 3.5 along with: age <11 or >40, bili >300, drug toxicity, >7 days to develop coma

137
Q

What is the treatment of pyoderma gangrenosum around a stoma site that does not respond to steroids

A

Anti-TNF drugs e.g. infliximab

138
Q

Which type of patients tend to develop acalculous cholecystitis

A

ICU patients, extensive burns patients

MRCP (16 decks)

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