Gastroenterology

Question 1

variceal bleed prophylaxis

Answer 1

propranolol
endoscopic variceal band ligation

Question 2

variceal bleed Mx

Answer 2

ABC
correct clotting: FFP, vit K
Terlipressin
Prophylactic IV Abx
Endoscopic variceal band ligation
TIPPS if above fail

Question 3

C Diff Mx

Answer 3

1st - PO Vanc or Fidaxomicin
2nd - PO Vanc + IV Metronidazole

Question 4

Primary biliary cholangitis Features

Answer 4

IgM
anti-Mitochondrial Abs
Middle aged female

Question 5

alcoholic hepatits Mx

Answer 5

Prednisolone

Question 6

coeliac disease Ix

Answer 6

gold standard - jejunal biopsy
positive anti-TTG Abs, anti-endomysial abs

Question 7

irritable bowel syndrome features (3)

Answer 7

Abdominal pain
Bloating
Change bowel habits

Question 8

Liver failure clotting profile

Answer 8

all clotting factors are low apart from Factor VIII

Question 9

haemophillia A clotting profile

Answer 9

low factor VIII

Question 10

haemophillia B clotting profile

Answer 10

low factor IX

Question 11

Von willebrand disease clotting profile

Answer 11

low VWF

Question 12

H Pylori Ix

Answer 12

Carbon 13 urea breath test

Question 13

Mesalazine (aminosalicylates) SE

Answer 13

agranulocytosis (check FBC) - sore throat, fever

Question 14

hepatocellular Ca screening in which patients?

Answer 14

liver cirrhosis + Hep B/ C/ Haemochromatosis
MEN with alcoholic liver cirrhosis

Question 15

ulcerative colitis mild/moderate
Features
Management

Answer 15

Features - <4-6 loose stool (variable blood)
Mx - 1st - rectal aminosalicylate (+oral aminosalicylate if extensive)
2nd - oral steroids if above not successful

Question 16

ulcerative colitis severe
features
management

Answer 16

Features - >6 bloody stools + systemic upset
Mx - IV steroid (IV ciclosporin if steroid contraindicated)

Question 17

pancreatic Ca Ix

Answer 17

high res CT

Question 18

spontaneous bacterial peritonitis prophylaxis

Answer 18

if protein <15 - oral ciprofloxacin
if protein >15 - nil Abx required

Question 19

isoniazid SE

Answer 19

Vit B6 def (peripheral neuropathy)

Question 20

primary biliary cholangitis antibodies

Answer 20

Anti mitochondrial antibody

Question 21

primary biliary cholangitis management

Answer 21

ursodeoxycholic acid
cholestyramine for pruritis

Question 22

crohns maintenance management

Answer 22

azathioprine/ mercaptopurine
TPMT (thiopurine methyltransferase) needs to be checked prior to starting azathioprine due to bone marrow suppression

Question 23

crohns acute management

Answer 23

1st - glucocorticoids
2nd - 5-ASA (mesalazine)
3rd - azathioprine/ methotrexate/ mercaptopurine
4th - infliximab

Question 24

bile acid malabsorption Mx

Answer 24

cholestyramine

Question 25

C Diff risk factors

Answer 25

PPI, Clindamycin, broadspec abx

Question 26

Oesophageal Ca Adenocarcinoma risk factors

Answer 26

GORD, Barretts, smoking

Question 27

Referal for OGD

Answer 27

dysphagia

upper abdominal mass consistent with stomach cancer

Patients aged >= 55 years who’ve got weight loss, AND any of the following:
upper abdominal pain
reflux
dyspepsia