GASTROENTEROLOGY

Question 1

Spontaneous bacterial peritonitis:

Answer 1

E.COLI IS THE CAUSE

Question 2

hep B serology

Answer 2

previous immunisation: anti-HBs positive, all others negative
previous hepatitis B (> 6 months ago), not a carrier: anti-HBc positive, HBsAg negative
previous hepatitis B, now a carrier: anti-HBc positive, HBsAg positive

Question 3

primary biliary cholangitis

Answer 3

1. more common in women
2. Anti mitochondrial antibodies are hallmark for PBC

Question 4

primary sclerosis cholangitis

Answer 4

1 inflammation and fibrosis of intra and extra-hepatic bile ducts.
2.associations:ulcerative colitis: 4% of patients with UC have PSC, 80% of patients with PSC have UC
Crohn’s (much less common association than UC)
HIV
3.ERCP/MRCP are the investigations of choice

Question 5

whipple’s dz

Answer 5

1rare multi-system disorder caused by Tropheryma whippelii infection. It is more common in those who are HLA-B27 positive and in middle-aged men.
2jejunal biopsy shows deposition of macrophages containing Periodic acid-Schiff (PAS) granules