Gastroenterology

Question 1

Transmission routes of hepatitis

Answer 1

Hep A and E: faecal-oral route, MSM sexually
Hep C and B: co infection IVDU, sexually
Hep D alongside hep B

Question 2

What hepatitis does not cause chronic infection

Answer 2

Hepatitis A

Question 3

Budd chiari syndrome

Answer 3

A hepatic outflow tract obstruction classically presenting with abdo pain, ascites, hepatomegaly.

Question 4

Wilson’s disease inheritance and presentations

Answer 4

Autosomal recessive mutation in Wilson gene leading to copper accumulation (kayser fleischer rings). Causes neurological, hepatic and psychiatric problems .

Question 5

Duodenal ulcers related artery in bleeding

Answer 5

Gastroduodenal

Question 6

Mallory Weiss tear

Answer 6

Small volumes of blood usually caused by repetitive vomiting

Question 7

Diverticular disease FBC

Answer 7

Polymorphonuclear leukocytosis

Question 8

Ulcerative colitis associations

Answer 8

Primary sclerosis cholangitis, axial spondyloarthritis.

Question 9

Gastroenteritis caused by contaminated shellfish

Answer 9

Norovirus

Question 10

Which strand of E. coli causes HUS due to shiva toxin?

Answer 10

0157

Question 11

Travelers diarrhoea, common spread by raw meat, unpasteurised milk, BBQs

Answer 11

Campylobacter jejuni

Question 12

Salmonella causss and symptoms

Answer 12

Caused by raw food (eggs), very watery diarrhoea

Question 13

Very quick (within 5h) abdo cramps and quick resolutions due to rice

Answer 13

Bacillus cereus

Question 14

Yersinia enterocolitica presentation

Answer 14

Mostly kids with lymphadenopathy and GI Sx.

Question 15

Giardia lamblia gastroenteritis cause and treatment

Answer 15

Fecal oral transmission often contaminated food or water. Metronidazole.

Question 16

Predominant vomiting with rapid onset, milk products and hand made foods

Answer 16

Staph aureus

Question 17

Common cause of duodenal and gastric ulcers

Answer 17

Duodenal: H pylori almost always
Gastric: h pylori and NSAIDs.

Question 18

Common deficiency seen in Crohns

Answer 18

B12 (due to frequent involvement of terminal ilium

Question 19

Causes of macrocytic anaemia

Answer 19

folate deficiency (absorbed in duodenum/jejunum)
B12 deficiency (absorbed in terminal ilium)
Alcohol
Reticulocytosis
Liver disease
Hypothyroid

Question 20

Where is crohns usually present

Answer 20

Ilium (causing b12 deficiency)

Question 21

Differentiating crohns from UC

Answer 21

Crohns:
Weight loss more prominent
Upper GI Sx like ulcers, abdo mass palpable, non bloody diarrhoea

Question 22

Stones risk in patients with IBS

Answer 22

Crohns are more at risk of oxalate renal stones

Gall stones due to reduced bile acid reabsorption

Question 23

Which IBD has more risk of cancer

Answer 23

UC more risk of colorectal cancer.

Question 24

Antibodies in Coeliacs and associated gene

Answer 24

Anti ttg and anti -EMA.p (endomyseal). HLA DQ2 or DQ8

Question 25

Sx of chronic pancreatitis

Answer 25

Epigastric pain radiating to back, steatorrhoea, malnutrition, diabetes mellitus

Question 26

Main causes of acute pancreatitis

Answer 26

Idiopathic, (10), gallstones (40), ethanol (35,

), mumps, steroids, hypercalcaemia

Question 27

Investigations in acute pancreatitis

Answer 27

Lipase or amylase >3x upper limit of normal, LFTs,

(If high ALT consider gallstone disease), calcium (hypercalcaemia is a cause)

Question 28

Symptoms of RA

Answer 28

Bilateral distal joint pain usually hands and wrist, improves with exercise and morning stiffness.

Question 29

Prediabetes HBA1C levels

Answer 29

5.7 - 6.4

Question 30

Murphy’s sign

Answer 30

Pain on deep inspiration with hand on right subcostal area

Question 31

Commonly affected areas in ischaemic colitis

Answer 31

1. Splenic flexure
2. Sigmoid colon

Both highly vascularised

Question 32

Associations with far embolisms

Answer 32

Pelvic/femur fracture, pancreatitis, bone marrow transplant, liposuction.