Gastrointestinal examination

Question 1

PBC and cholestasis are associated with … levels of lipids

Answer 1

High (tendon xanthomata)

Question 2

There are 6 causes of Dupytrens contracture, name the drug, the disease and the liver related ones.

Answer 2

CLD
Phenytoin
DM

Question 3

Palmar Erythema has 4 causes, 3 are related to e2 and 1 is not. Name them.

Answer 3

Increased E2 (CLD, Pregnancy, Hyperthyroidism)
RA (unknown MOA)

Question 4

Clubbing has 4 GI causes.

Answer 4

IBD
cirrhosis
Coeliac
Lymphoma

Question 5

Thrombocytopenia and reduced clotting factor synthesis may result from CLD. How might this present.

Answer 5

Bruising

Question 6

IVDU are at increased risk of which Hepatitis’

Answer 6

B and C

Question 7

A beefy red tongue is a sign of …

Answer 7

B12 (B for Beefy) defiency

Question 8

An smooth tongue glossitis

Answer 8

Iron folate deficiency

Question 9

Immunocompromised/suppressed patients may have oral ….

Answer 9

Candidiasis

Question 10

Crohns may present in the mouth with …

Answer 10

Apthous ulcers

Question 11

What is mercaptan

Answer 11

A waste product which accumulates in hepatic failure.

Question 12

What compound is responsible for fetor hepaticus

Answer 12

Mercaptans

Question 13

… in palpable in the left supraclavicular fossa and is a sign of gastric cancer

Answer 13

Virchows node

Question 14

What appears only in the distribution of the SVC. What is their characteristic test

Answer 14

Spider naevi

Fill from centre upon depression

Question 15

What are the ∆∆for gynecomastia (3)

Answer 15

CLD
Teticular failure
Some drugs

Question 16

Name the 6 F’s associated with abdominal distension

Answer 16

Fat
Flatus
Foetus
Food
Fluid
Flipping big masses (Ca)

Question 17

Dilated veins from the umbilicus outwards indicates … and they are named…

Answer 17

Portal hypertension

Caput Medusa

Question 18

What organ in this exam is differentiated from the kidney by its notch

Answer 18

Spleen

Question 19

Can you get above the kidney

Answer 19

yes

Question 20

The … area is more resonant than the … and this help differentiate them.

Answer 20

Kidney

spleen

Question 21

More than … Litres of fluid is present if there is shifting dullness

Answer 21

1.5L

Question 22

What might a liver bruit (+palpable liver edge) suggest. The acronym is … (3)

Answer 22

HAT

HCC
AV malformation
TIPSS

Question 23

Where is erythema nodosum found and what does it look like

Answer 23

Shins

Painful purple raised lesions

Question 24

What is the pathophysiology of erythema nodosum

Answer 24

inflammation of fat cells

Question 25

What GI condition is erythema nodosum found in

Answer 25

IBD

Question 26

What is pyoderma gangrenosum

Answer 26

A necrotic and deep ulcerative condtion

Question 27

What causes pyoderma gangrenosum (2)

Answer 27

IBD | RA

Question 28

What is the mneumonic for remembering hepatomegaly ∆∆

Answer 28

The 2Is, 2 Bs and 2 Cs IIBBCC

Question 29

Hepatomegaly ∆∆: what do the 2Is stand for

Answer 29

infection | infiltration

Question 30

Hepatomegaly ∆∆: what do the 2Bs stand for

Answer 30

Blood related | Biliary

Question 31

Hepatomegaly ∆∆: what do the 2Cs stand for

Answer 31

cancer | congestion

Question 32

Hepatomegaly ∆∆: infective causes (3)

Answer 32

Viral hepatitis EBV Malaria

Question 33

Hepatomegaly ∆∆: infiltration (2)

Answer 33

Sarcoid | Amyloid

Question 34

Hepatomegaly ∆∆: blood related (4)

Answer 34

Lymphoma Leukaemia myeloproliferative Haemolytic anaemias

Question 35

Hepatomegaly ∆∆: Biliary (2)

Answer 35

PBC | PSC

Question 36

Hepatomegaly ∆∆:Cancer (2)

Answer 36

primary HCC | Metastatic deposits

Question 37

Hepatomegaly ∆∆:Congestion (3)

Answer 37

RHF Tricuspid regurgitation Budd-Chiari

Question 38

What is the triad that Budd-chiari usually presents with, due to its occlusion of the hepatic vein

Answer 38

abdominal pain ascites hepatomegaly

Question 39

The 3 Ms of Massive splenomegaly

Answer 39

Malaria Myelofibrosis cMl

Question 40

Causes of splenomegaly that are not massive are ... (2)

Answer 40

IE | RA

Question 41

What can cause splenomegaly but not hepatomegaly.

Answer 41

Portal hypertension

Question 42

Oesophageal varices are a clinical manifesation of ... due to the increased collateral circulation due to blood being redirected to areas of lower pressure.

Answer 42

portal hypertension

Question 43

... and ... are two ocular manifestations of IBD

Answer 43

Episcleritis (red + pain) | Conjuctivitis

Question 44

Amyloidosis is especially common in which IBD

Answer 44

Crohns

Question 45

UC is likely to affect the biliary area by causing

Answer 45

PSC

Question 46

There are 6 causes of Dupytrens contracture, name 3 which arent the drug, liver or disease ones.

Answer 46

Familial trauma Heavy labour