Gastroenterology

Question 1

investigating primary sclerosing cholangitis

Answer 1

ERCP/MRCP

Question 2

marker of hepatocellular carcinoma

Answer 2

alpha-fetoprotein

Question 3

causes of dysphagia (10)

Answer 3

pharyngeal pouch
oesophageal cancer
oesophagitis
achalasia
oesophageal candidiasis
myasthenia gravis
systemic sclerosis
globus hystericus
stroke
parkinsons
MS

Question 4

presentation of wilson’s

Answer 4

kids - liver failure
young adults - behavioural and mood changes
also renal tubular acidosis
parkinsonism
speech changes

Question 5

diagnosis of wilsons

Answer 5

low serum copper
high 24hr urinary copper
high copper on liver biopsy

Question 6

management of wilson’s

Answer 6

penicillamine - chelates copper

Question 7

hereditary nonpolyposis colorectal cancer (HNPCC)
what is it
pathological features
associated cancers

Answer 7

autosomal dominant condition
most common form of inherited colon cancer.
poorly differentiated and highly aggressive without adenomatous polyposis
endometrial and pancreatic cancer

Question 8

Weight loss diagnostic of malnutrition

Answer 8

Unintentional weight loss greater than 10% within the last 3-6 months is diagnostic of malnutrition

Question 9

Patients with GORD being considered for fundoplication surgery require what investigations?

Answer 9

oesophageal pH and manometry studies

Question 10

Ix for coeliac

Answer 10

IgA and IgA tTG antibody testing

Question 11

Features of Peutz-Jeghers Syndrome (6)

Answer 11

Autosomal dominant
hamartomatous polyps in GI tract (mainly small bowel)
pigmented lesions on lips, oral mucosa, face, palms and soles
intestinal obstruction e.g. intussusception
gastrointestinal bleeding
increased risk of GI malignancy