Gastroenterology

Question 1

Most common cause of small bowel obstruction:

Answer 1

Adhesions (usually previous surgery)

Question 2

Symptoms of small bowel obstruction:

Answer 2

• Severe, cramping, intermittent abdominal pain
• Vomiting
• Abdominal distention and tenderness
• Increased bowel sounds

Question 3

Management of small bowel obstruction:

Answer 3

• Fluid resuscitation
• Bowel decompression using NG tube
• Analgesia

Question 4

Conservative management is successful is _____ of cases of small bowel obstruction.

Answer 4

65-80%

Question 5

Define primary biliary cholangitis

Answer 5

A chronic disease of the intrahepatic bile ducts where progressive bile duct damage and loss occurs due to chronic portal tract inflammation.

Question 6

Define primary biliary chirrhosis

Answer 6

Fibrosis develops as a consequence of the damage from primary biliary cholangitis and as well as the secondary effects of toxic bile acids retained in the liver results in cirrhosis.

Question 7

Classic presentation of primary biliary cirrhosis:

Answer 7

• > 45
• Female
• Itch
• Fatigue
• Dry eyes and mouth
• Smooth-edged, non-tender hepatomegaly
• Weight-loss
• Jaundice
• Xanthelasmas (hyperlipidaemia)

Question 8

Classic presentation of primary biliary cirrhosis:

Answer 8

• > 45
• Female
• Itch
• Fatigue
• Dry eyes and mouth
• Smooth-edged, non-tender hepatomegaly
• Weight-loss
• Jaundice
• Xanthelasmas (hyperlipidaemia)

Question 9

What investigations support a diagnosis of primary biliary cirrhosis?

Answer 9

• ALP = raised
• gamma-GT = raised
• Bilirubin = raised
• ALT = raised
• Serum albumin = lowered
• Antimicrobial antibodies = positive
• ANA = positive

Question 10

What is the first-line treatment for primary biliary cholangitis? What is it?

Answer 10

Ursodeoxycholic acid, bile acid analogue