Gastrointestinal

Question 1

what are the investigations for achalasia?

Answer 1

• barium swallow = bird beak appearance

- oesophageal manometry

Question 2

what is the management for achalasia?

Answer 2

• balloon dilatation

- Heller’s cardiomyotomy

Question 3

which oesophageal cancer presents in the lower 3rd of the oesophagus?

Answer 3

adenocarcinoma

Question 4

which oesophageal cancer presents in the upper 2/3rds of the oesophagus?

Answer 4

squamous cell carcinoma

Question 5

which oesophageal cancer is most associated with GORD + Barrett’s

Answer 5

adenocarcinoma

Question 6

what is the first line investigation for suspected oesophageal carcinoma?

Answer 6

upper GI endoscopy

Question 7

what cancer is associated with coeliacs disease

Answer 7

MALT (T cell lymphoma)

Question 8

what is the management of a flare up of ulcerative colitis?

Answer 8

mild/mod = rectal or oral mesalasine 
severe = IV steroids

Question 9

what is the management of a flare up of crohn’s?

Answer 9

steroids

Question 10

what is the maintenance management of ulcerative colitis?

Answer 10

mild/moderate = oral or rectal mesalasine 
severe = oral azathioprine

Question 11

what is the maintenance management of crohns?

Answer 11

1st line = azathioprine

2nd line = methotrexate

Question 12

what three causes of gastroenteritis cause bloody diarrhoea?

Answer 12

salmonella, shigella, campylobacter (sometimes)

Question 13

which causes of gastroenteritis have an incubation period of 1-6hrs?

Answer 13

staphylococcus aureus and bacillus cereus

Question 14

which causes of gastroenteritis have an incubation period of 12-48hrs?

Answer 14

ecoli and salmonella

Question 15

which causes of gastroenteritis have an incubation period of 48-72hrs?

Answer 15

shigella and campylobacter

Question 16

how does campylobacter present?

Answer 16

flu like prodrome followed by crampy abdo pain, fever and diarrhoea

Question 17

which cause of gastroenteritis is associated with lactose intolerance?

Answer 17

giardiasis

Question 18

how does giardiasis present?

Answer 18

• bloating, abdo pain, flatulence, non-bloody diarrhoea, steatorrhea, lactose intolerance

Question 19

what is the investigation for giardiasis?

Answer 19

stool microscopy or stool antigen detection assay

Question 20

what is the management of giardiasis?

Answer 20

metronidazole

Question 21

How do you differentiate between type 1 and type 2 autoimmune hepatitis?

Answer 21

type 1 = IgG raised

type 2 = IgG raised and IgA low (plus only really in kids)

Question 22

what drug is used to treat bile acid malabsorption?

Answer 22

cholestyramine

Question 23

what is the triad of electrolyte findings seen in refeeding syndrome?

Answer 23

hypophosphatemia, hypokalaemia, hypo magnesia

Question 24

double duct sign

Answer 24

pancreatic cancer

Question 25

sweet and fecal breath

Answer 25

liver failure