Gastroenterology

Question 1

Which antibiotics are associated with cholestasis?

Answer 1

flucloxacillin, co-amoxiclav, erythromycin

Question 2

Which anti-emetic should be avoided in bowel obstruction?

Answer 2

Metoclopramide

Question 3

What is the preferred laxative in IBS?

Answer 3

Ispaghula husk

Question 4

Which anti-emetic is best in migraines?

Answer 4

Metoclopramide

Question 5

Which haematological malignancy is coeliac disease associated with?

Answer 5

enteropathy-associated T cell lymphoma

Question 6

What is the most common affected site in crohn’s?

Answer 6

The ileum

Question 7

Which clotting factors are low in liver failure?

Answer 7

In liver failure all clotting factors are low, except for factor VIII which is paradoxically supra-normal. This is because factor VIII is synthesised in endothelial cells throughout the body, unlike the other clotting factors which are synthesised purely in hepatic endothelial cells.

Question 8

How do you work out how many units in a bottle of alcohol?

Answer 8

multiply the number of millilitres by the ABV and divide by 1,000.

% alcohol on a bottle = number of units if you drank 1 litre of it.

Question 9

How long before endoscopy do you need to stop a PPI?

Answer 9

2 weeks

Question 10

Which part of the iron studies are most useful for monitoring haemochromatosis?

Answer 10

Ferritin and transferrin saturation

Question 11

Which type of imaging for investigating fistuals in crohn’s disease?

Answer 11

MRI

Question 12

Which medication used in IBD can cause agranulocytosis?

Answer 12

Aminosalicylates are associated with a variety of haematological adverse effects, including agranulocytosis - FBC is a key investigation

Question 13

Which test is used to see whether H.pylori has resolved?

What medications need to be stopped to make this test reliable?

Answer 13

Urea breath test

No antibiotics in the past 4 weeks, no anti-secretory drugs (e.g. PPI) in past 2 weeks

Question 14

Which blood group is associated with an increased risk of developing gastric cancer?

Answer 14

Blood group A

Question 15

What should be given to patients with UGI bleed before endoscopy?

Answer 15

Terlipressin and prophylactic antibiotics

Question 15

Which type of cancer does achalasia increase the risk of ?

Answer 15

Squamous cell carcinoma of the oesophagus

Question 16

What medication is used first line in crohn’s to maintain remission?

Answer 16

Azathioprine

Question 17

What is the ‘double duct’ sign on MRCP suggestive of?

Answer 17

The ‘double duct’ sign on MRCP is when there is dilatation of both the common bile duct and pancreatic duct which is usually indicative of pancreatic cancer (typically the head of the pancreas).

Question 18

Patients with cirrhosis and low ascitic protein concentraiton (<15) should be given which antibiotic as prophylaxis against SBP?

Answer 18

Ciprofloxacin

Question 19

Which diabetes medication is associated with cholestasis?

Answer 19

Gliclazide

Question 20

Which antibodies are tested for to investigate B12 deficiency?

Answer 20

Intrinsic factor antibodies

Question 21

Which anti-emetic is contra-indicated in GI obstruction and shouldn’t be given to children?

Answer 21

Metoclopramide

Question 21

Which patients shouldn’t be given H1 receptor antagonists as anti-emetics? (cyclizine, cinnarizine, promethazine)

Answer 21

Hepatic encephalopathy / prostatic hypertrophy

Question 22

Which anti-emetic should be avoided in diverticulitis, IBD, colitis, megacolon and strictures?

Answer 22

Ondansetron

Question 23

What is achalasia?

Answer 23

Impaired relaxation of the lower oesophageal sphincter

Question 24

Which ulcer is worsened by eating?

Answer 24

Gastric ulcers.

Question 25

What is the most common cause of food poisoning?

Answer 25

Campylobacter

Question 26

What is fulminant hepatic failure?

Answer 26

Encephalopathy + jaundice in < 2 weeks from a previously normal liver

Question 27

What causes pre-hepatic jaundice?

Answer 27

Excess haemolysis (haemolytic anaemia) - there is increased bilirubin entering the liver

Question 28

What causes intra-hepatic jaundice?

Answer 28

Injury of hepatocytes - hepatitis, drugs, cirrhosis

Question 29

In which condition can you see AST> ALT?

Answer 29

Cirrhosis