Gastroenterology

Question 1

Gold standard investigation for GORD

Answer 1

24 hour pH monitoring

Question 2

Small intestine bowel overgrowth management

Answer 2

1. Low FODMAP diet
2. Antibiotics e.g. metronidazole, cipro, co-amox

Question 3

Hepatic encephalopathy management

Answer 3

1. Lactulose (not absorbed by the gut)
2. Rifaximin (decreases the absorption and production of ammonia)

Question 4

Hepatitis B biggest indicator of disease progression to cirrhosis

Answer 4

HBV DNA titre

Question 5

Management of carcinoid syndrome

Answer 5

Ocreotide

Question 6

Eruptive xanthomas cause

Answer 6

caused by deficiency in lipoprotein lipase

Question 7

Whipples disease

Answer 7

Men aged 30-60 years
Fever, arthralgia, pleuritic chest pain, pericarditis, opthalmoplegia
Abdominal pain, loose stoold

Question 8

Investigations for Whipples disease

Answer 8

Biopsy
Can also use PCR

Question 9

Management of Whipples disease

Answer 9

4-6 months of co-trimoxazole or penicillin

Question 10

Whipples histology

Answer 10

macrophages are positive with PAS

Question 11

Dukes A tumour, colonoscopy surveillance

Answer 11

Annual for 2 years then 3 yearly
Faecult blood for 6 months for 4 years then annually

Question 12

Chronic pancreatitis investigation

Answer 12

Faecal elastase

Question 13

Enteric fever chronic status investigation

Answer 13

Culture of intestinal secretions

Question 14

Wilsons disease bloods

Answer 14

Low serum uric acid
High urinary copper excretion
Low caeruloplasmin

Question 15

Small bowel overgrowth managemetn

Answer 15

Rifaximin