Gastroenterology

Question 1

What are the causes of cirrhosis?

Answer 1

Viral - hepatitis 
Alcohol 
Metabolic - NASH, Haemochromatosis, alpha 1 antitrypsin
Autoimmune - PBC, PSC, AH
Medications - isoniazid, methotrexate

Question 2

What are the signs of alcohol misuse?

Answer 2

Cachexia
Tremor 
Dupuytrens contracture 
Cerebellar Syndrome 
Peripheral neuropathy

Question 3

What are the consequences of portal hypertension?

Answer 3

Ascities
Oesophageal varicies
Splenomegaly
Thrombocytopenia

Question 4

What are the consequences of liver dysfunction?

Answer 4

Coagulopathy
Encephalopathy
Jaundice
Hypoalbuminaemia

Question 5

What are the grades of hepatic encephalopathy?

Answer 5

1. reversal of sleep wake cycle
2. Lethargy/disorientation
3. Confusion/somnolence
4. Coma

Question 6

What are the signs of decompensated liver failure?

Answer 6

Spontaneous bacterial peritonitis 
Oesophageal variceal bleeding 
Hepatorenal Syndrome
Hepatopulmonary Syndrome  
Ascities 
Hepatic encephalopathy

Question 7

What is faecal calprotectin?

Answer 7

Product of neutrophil degranulation.

Question 8

What are the cut offs for faecal calprotectin?

Answer 8

<50

>250

Question 9

What are the causes of non cirrhotic portal hypertension?

Answer 9

Prehepatic
- portal/splenic vein thrombosis
Intrahepatic
- presinusoidal - schistosomiasis, PBC, Sarcoidosis, idiopathic, congenital hepatic fibrosis
- sinusoidal - gauchers, viral hepatitis, Q fever, Drugs (amiodarone and methotrexate)
-postsinusoidal - sarcoidosis, radiation injury, MAC, alcoholic liver disease
Posthepatic
- IVC obstruction (Buds Chiari)
- cardiac failure

Question 10

Asca positivity is likely to indicate which type of IBD?

Answer 10

Crohns

Question 11

Anca positivity is likely to indicate which type of IBD?

Answer 11

UC

Question 12

What are the extra intestinal manifestations of IBD which are independent to colitis activity?

Answer 12

Type 2 small joint Arthropathy
Pyoderma gangrenosum
Primary sclerosing cholangitis