GI

Question 1

typical patient with sigmoid volvulus

Answer 1

elderly
constipated
abdominal pain

Question 2

coffee bean AXR

Answer 2

sigmoid volvulus

loop of distended bowel

Question 3

paralytic ileus presentation

Answer 3

adynamic bowel (lack of normal peristalsis)
can cause constipation, painful abdominal distension and absent bowel sounds

Question 4

Colorectal carcinoma presentation

Answer 4

acutely as bowel obstruction, with symptoms of constipation and abdominal pain
red flags: weight loss, night sweats

Question 5

Intussusception

Answer 5

part of the intestine slides into an adjacent part of the intestine

Question 6

intussusception presentation

Answer 6

nonspecific abdominal pain that comes and goes, change in bowel habit and decreased/absent bowel sounds
children <5

Question 7

Hirschsprung disease

Answer 7

presents with childhood

nerve cells in the bowel cause problem with peristalsis

Question 8

achalasia

Answer 8

degenerative loss of ganglia from auerbach’s plexus
dysphagia to solids and liquids
sometimes accompanied by regurgitation

Question 9

globus hystericus cause

Answer 9

anxiety

Question 10

mechanism of cirrhosis

Answer 10

degeneration and necrosis of hepatocytes, and replacement of liver parenchyma by fibrotic tissues and regenerative nodules, and loss of liver function

Question 11

peginterferon

Answer 11

viral hepatitis

Question 12

azathioprine

Answer 12

autoimmune hepatitis

Question 13

Ursodeoxycholic acid

Answer 13

Primary biliary cholangitis

Question 14

mechanism of PSC

Answer 14

autoimmune destruction of both the intra and extra hepatic bile ducts

Question 15

mechanism of PBC

Answer 15

Autoimmune destruction of intra-hepatic bile ducts only

Question 16

gallstone ileus

Answer 16

form of small bowel obstruction caused by gallstone in the small intestine
gallstone enters bowel via cholecysto-enteric fistula

Question 17

Acute cholecystitis presentation

Answer 17

RUQ pain- radiate to right shoulder
positive murphys sign
fever
nausea 
tachycardia

Question 18

primary sclerosing cholangitis presentation

Answer 18

jaundice
chronic RUQ pain
pruritus
fatigue
heptomegaly

Question 19

raised serum amylase

Answer 19

acute pancreatitis

Question 20

Appendicitis presentation

Answer 20

central pain radiating to RIF
mild pyrexia, tachycardia
rebound tenderness
vomited

Question 21

treatment for appendicitis

Answer 21

appendectomy
analgesia
antibiotics

Question 22

wilson’s disease

Answer 22

rare autosomal recessive condition in which the patient cannot eliminate copper effectively

Question 23

presentation of wilson’s disease

Answer 23

can lead to chronic hepatitis and eventually cirrhosis
neurological problems
psychiatric problem

Question 24

indication of severity for acute pancreatitis

Answer 24

PaO2 <8
Age >55
Neutrophilia 
Calcium <2
renal function >16
enzymes
Albumin < 32
Sugar >10

Question 25

what blood marker classically rises with an upper GI bleed

Answer 25

Urea

Question 26

plain Xray reveals dilated loop of bowel and thumb printing

Answer 26

UC

Question 27

history of dysphagia and regurgitation of undigested solids + liquids along with the distal narrowing seen on the barium swallow

Answer 27

achalasia

Question 28

most common cause of acute appendicitis

Answer 28

obstruction of the appendix with dried compacted faeces termed a faceolith

Question 29

barrett's oesophagus is a type of which pathological process

Answer 29

metaplasia

Question 30

what is the most sensitive test for coeliac disease

Answer 30

serum anti-tTG antibodies

Question 31

RUQ pain, jaundice and fever

Answer 31

acute cholangitis

Question 32

managing variceal bleeding

Answer 32

terlipressin- stop after definitive haemostasis has been achieved prophylactive antibiotic therapy

Question 33

presentation of small bowel disease

Answer 33

diarrhoea abdominal pain and discomfort weight loss iron, B12 and folate def

Question 34

feature of C.diff that makes is hard to destroy

Answer 34

spore formation

Question 35

which LFT reflects the synthetic function of the liver

Answer 35

albumin

Question 36

causes of upper GI bleeding

Answer 36

oesophageal varicies MW tear Peptic ulcers cancer of stomach or duodenum

Question 37

MW tear

Answer 37

mucosal tear at the oesophagastric junction | can be due to bulimia

Question 38

presentation of MW tear

Answer 38

dizziness hypotension vomiting blood

Question 39

presentation of PBC

Answer 39

``` middle aged women fatigue pruritus abdo pain jaundice in end-stage ```

Question 40

LFT in PBC

Answer 40

raised ALP

Question 41

blood supply of duodenum

Answer 41

proximal- gastroduodenal artery (including superior pancreaticoduodenal) distal- SMA and inferior pancreaticoduodenal artery

Question 42

granulation tissue with layer of necrotic debris

Answer 42

peptic ulcer

Question 43

presentation of gallstones

Answer 43

severe epigastric pain vomiting occurs after eating

Question 44

how to confirm gallstones

Answer 44

US

Question 45

treatment of sigmoid volvus

Answer 45

insertion of flatus tube

Question 46

management of GORD

Answer 46

first line- antacids | second line- PPI

Question 47

life style measure associated with colorectal cancer

Answer 47

red and processed meat

Question 48

most common location of ischaemic colitis

Answer 48

splenic flexure

Question 49

ischaemic colitis on XRAY

Answer 49

thrumbprinting

Question 50

pernicious anaemia cause

Answer 50

antibodies that target either intrinsic factor or gastric parietal cells