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MRCP Part 1 > Gastroenterology Clinical > Flashcards

Gastroenterology Clinical Flashcards

1
Q

Which HLA subtype is associated with autoimmune hepatitis?

A

HLA B8

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2
Q

What antibodies are associated with autoimmune hepatitis?

A

Anti nuclear

Anti smooth muscle

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3
Q

What immunoglobulin is high is autoimmune hepatitis?

A

IgG

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4
Q

What do you see on a liver biopsy of autoimmune hepatitis?

A

Piecemeal necrossi

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5
Q

What are the three subtypes of autoimmune hepatitis?

A

Type 1 - Affects adults and children. Anti nuclear and anti smooth muscle antibodies
Type 2 - Affects children online (LKM1 antibodies)
Type 3 - Adults in middle age. Soluble liver-kidney antigen

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6
Q

What is zollinger ellison syndrome?

A

Excessive production of gastrin usually from a gastrin secreting tumour of the duodenum or pancreas. Around 30% occur as part on MEN 1

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7
Q

What tests do you do if you suspect zollinger ellison syndrome?

A

Fasting gastrin levels (best test)

Secretin stimulation test

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8
Q

What HLA type in associated with coeliac disease?

A

HLA DQ2 (also HLA DQ8 but slightly less common!)

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9
Q

What does somatostatin do?

A

Decreases acid and pepsin secretion, decreases gastrin secretion, decreases pancreatic enzyme secretion, decreases insulin and glucagon secretion

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10
Q

What is the most common type of oesophageal cancer in the UK?

A

Adenocarcinoma

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11
Q

Where is the location of adenocarcinoma oesophageal cancer?

A

Lower third - near the gastrooesophageal junction

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12
Q

Where is the location of squamous cell carcinoma of the oesophagus?

A

Upper two thirds of the ooesophague

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13
Q

What are the risk factors for adenocarcinoma of the oesophagus?

A 
GORD
Barretts oesophagus 
Smoking 
Achalasia 
Obesity
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14
Q

What are the risk factors for squamous cell carcinoma of the oesophagus?

A 
smoking 
alcohol 
achalasia 
plummer vinson syndrome 
diet rich in nitrosamines
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15
Q

What part of the colon is most often affected by ischaemic colitis?

A

Splenic flexure

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16
Q

What do you see on an abdominal X Ray of ischaemia colitis?

A

Thumbprinting oedema

17
Q

What do you see on a duodenal biopsy of coeliac disease?

A

Villous atrophy

Crypt hyperplasia

18
Q

What cells secrete somatostatin?

A

D cells in the pancreas and the stomach

19
Q

What is the test for haemachromatosis?

A

General population: Transferrin saturation (over 55% in men or over 50% in women with haemachromatosis)
Family history: HFE gene

20
Q

What is the inheritence pattern of wilsons disease?

A

Autosomal recessive - gene located on chromosome 13

21
Q

How do you diagnose wilsons disease?

A
  1. Kayser Fleisher rings
  2. Reduced serum caeruloplasmin
  3. Reduced total serum copper
  4. Free serum copper in increased
  5. Increased 24 hour urinary copper excretion
22
Q

What is the treatment for wilsons disease?

A

Penicillamine (chelates copper)

23
Q

What is the best investigation for suspected budd chiari syndrome?

A

Ultrasound with doppler flow studies

24
Q

What is the treatment for eosinophilic oesophagitis?

A

Dietary modifications (eg elemental diet)
Topical steroids
Oesophageal dilatation

25
Q

What does secretin do?

A

Increases the secretion of bicarbonate rich fluid from the pnacreas and hepatic duct cells. decrease gastric acid secretion

26
Q

Where is secretin secreted from?

A

S cells in the upper small intestine

27
Q

What antibodies are seen in autoimmune hepatitis?

A

Anti nuclear and/or anti smooth muscle

28
Q

What bacteria causes whipples disease?

A

Tropheryma wippelii

29
Q

What is the diagnostic investigation for whipple’s disease?

A

Jejunal biopsy shows deposition of macrophages containing PAS grnaules

30
Q

What is the treatment for whipples disease?

A

Oral co trimoxazole for 1 year

31
Q

What antibodies are seen in pernicious anaemia?

A

Intrinsic factor antibodies

Gastric parietal cell antibodies

32
Q

What is the treatment for pernicious anaemia?

A

Vitamin B12 replacement

33
Q

What is peutz jeghers syndrome?

A

An autosomal dominant syndrome characterised by numerous hamartomatous polyps in the GI tract. It is also associated with pigmented freckles on the lips face palms and soles. .

Colon cancer is common in these patients

34
Q

What antibodies are present in primary biliary sclerosis?

A

Anti mitochondrial antibodies

MRCP Part 1 (30 decks)

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