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1
Q

what nerve supplies the rectum

A

inferior rectal nerve

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2
Q

inferior rectal nerve origin

A

S4

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3
Q

treatment of H pylori

A

PPI and 2 antibacterials - omeprazole, clarithromycin and amoxicillin/metronidazole

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4
Q

how to identify H pylori

A

stool antigen test or urea breath test

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5
Q

difference between gastric and duodenal ulcers

A

duodenal ulcer is relieved by food or antacids but provide minimal relief for gastric ulcer pain

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6
Q

treatment for acute hepatitis

A

supportive

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7
Q

treatment for chronic hepatitis

A

interferon alpha or antiviral tenofovir

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8
Q

what is hep C

A

a heamatological RNA virus that is acute but usually becomes chronic

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9
Q

how to test for hep C

A

PCR

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10
Q

is there a vaccine for hep C

A

no

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11
Q

what is hep B

A

a heamotological virus with a vaccine that is acute but 20% become chronic

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12
Q

what does HBsAG mean

A

previous infection, acute or chronic

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13
Q

what does antiHBsAg mean

A

clinical recovery and immunity

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14
Q

what does HBeAg mean

A

highly infectious

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15
Q

what does IgM antiHBc mean

A

acute infection

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16
Q

what does IgG antiHBc mean

A

chronic infection

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17
Q

what does hep E come from

A

contaminated or undercooked food - spread via the faecal oral route

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18
Q

is there a vaccine for hep E

A

no

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19
Q

hep D when does it arise

A

only with hep B

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20
Q

staphylococcus aureus found

A

cooked meats and cream products

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21
Q

bacillus cereus found

A

reheated rice

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22
Q

costridiium perfringens found

A

reheated meat dishes or cooked meats

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23
Q

otheres causes of bacteria gastroenteritis

A

campylobacter, Ecoli, salmonella, shigella

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24
Q

what can Ecoli 0157 cause

A

haemolytic uraemic syndrome

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25
Q

viral causes of gastroenteritis

A

rotavirus, norovirus, adenoviruses

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26
Q

parasitic causes of gastroenteritis

A

cryptosporidium, entamoeba histolytica, giardia intestinalis, schistosoma

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27
Q

what gives a birds beak appearance

A

achalasia

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28
Q

how to diagnose achalasia

A

barium swallow

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29
Q

treatment of achalasia

A

hellers cardiomyotomy or balloon dilation

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30
Q

treatment of oesophageal varices

A

resuscitation, IV terlipressin, banding, sengstaken blakermore tube

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31
Q

prophylaxis of oesophageal varices

A

Beta blockers, EGD and banding, TIPSS

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32
Q

cobblestone mucosa

A

crohns

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33
Q

recurrent oral stomatitis

A

crohns

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34
Q

deep fissuring ulceration of mucosa

A

crohns

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35
Q

treatments of crohns

A

steriods, liquid diet, immunosupressants, surgery

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36
Q

Barretts oesophagus/ pre cancer

A

replacement of normal stratified squamous epithelium by simple columnar epithelium with goblet cells

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37
Q

murphys sign

A

asking the patient to take in and hold a deep breath while palpating the right subcostal area if the pain occurs on inspiration when the gall bladder comes in contact with the examiner’s hand then the Murphys sign is positive

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38
Q

what does murphys sign indicate

A

acute cholecystitis

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39
Q

dukes A

A

the cancer is in the inner lining of the bowel or slightly into the muscle layer

40
Q

dukes B

A

the cancer has grown through the muscle layer of the bowel

41
Q

dukes C

A

the cancer has spread to at least 1 lymph node close to the bowel

42
Q

dukes D

A

the cancer has spread to another part of the body such as the liver, lungs or bones

43
Q

treatment of ascites

A

spironolactone

44
Q

SE of spironolactone

A

gynaecomastia and hyperkalaemia - risk of arrhythmias

45
Q

thumb printing at the splenic flexure

A

ischaemic colitis

46
Q

difference between haemorrhoids and rectal prolapse

A

rectal prolapse involves an entire segment of the bowel and hemorrhoids only involves the inner layer of the bowel near the anal opening

47
Q

sepsis treatment

A

BUFALO - blood cultures, urine output, fluids, antibiotics, lactate and oxygen

48
Q

signs of wilsons

A

excess copper, kayser Fleischer rings

49
Q

signs of acute pancreatitis

A

grey turners (lumbar redness) and cullens signs (umbilical redness) vomiting and very raised amylase

50
Q

causes of acute pancreatitis

A

GETSMASHED G - gallstones, E- ethanol T -trauma S- steriods M- mumps A - autoimmune pancreatitis S - scoprion stingH - hyperlipidemia, hypothermia, hyperparathyroidism E - endoscopic retrograde cholangiopancreatography D - drugs (azathiprine)

51
Q

virchows node

A

left supracalvicular node - GASTRIC CANCER

52
Q

diffuse stomach cancer

A

signet ring cells on biopsy linitis plastic

53
Q

alphafeto protein

A

hepatocellular carcinoma

54
Q

cork screw oesophagus on barium swallow

A

diffuse oesophageal spasm

55
Q

abdominal pain after sour milk or shellfish

A

campylobacter

56
Q

acute cholangitis

A

charcots triad

57
Q

charcots triad

A

fever, jaundice, abdominal pain

58
Q

short bowel syndrome

59
Q

g cells secrete

60
Q

i cells secrete

61
Q

S cells secrete

62
Q

d cells secrete

A

somatostatin

63
Q

parietal cells secrete

64
Q

zollinger ellison syndrome

A

too much gastric acid causing peptic ulcers

65
Q

complication of IBD

A

toxic megacolon

66
Q

treatment for haemochromatosis

A

phlemotomy, blood letting

67
Q

leukonychia

A

hypoalbuminaemia white nails

68
Q

koilonychias

A

nail spooning and iron deficiency anaemia

69
Q

pre hepatic jaundice

A

gilberts, haemolytic anaemia, newborn and trauma

70
Q

intrahepatic jaundice

A

viral hep, alcoholic hep, autoimmune hep, decompensated cirrhosis, PBC, PSC

71
Q

post hepatic jaundice

A

gall stone, head of pancreas cancer, gall bladder cancer

72
Q

mallory hyaline bodies

A

alcoholic liver disease

73
Q

onion skinning fibrosis, beading of bile ducts

A

primary sclerosing cholangitis

74
Q

Pance +

75
Q

lowest part of the peritoneal cavity when supine

A

hepatorenal recess / morrisons pouch

76
Q

very raised creatinine

A

renal problem

77
Q

muscle of the cheek that moves food during mastication

A

buccinator

78
Q

biliary tract infection treatment

A

ciprofloxacin or gentamicin or a cephalosporin

79
Q

treatment for peritonitis

A

metronidazole and gentamicin

80
Q

primary biliary cirrhosis

81
Q

autoimmune hepatitis

82
Q

hepatocellular carcinoma

A

alpha feto protein

83
Q

diffuse stomach cancers

A

signet rings seen on biopsy

84
Q

coeliac disease

A

anti transglutaminase antibody, anti endomysial antibody

85
Q

uc, psc

86
Q

psc

A

anca, canca

87
Q

pancreatitis

A

raised amylase, lipase, vomiting, pain

88
Q

colicky loin pain radiatig to groin

A

ureteric colic

89
Q

jaundice and constant right upper quadrant pain

A

biliary colic

90
Q

severe epigastric pain radiating to the back associated with vomiting

A

acute pancreatitis

91
Q

periumbilical pain radiating to right iliac fossa

A

acute appendicitis

92
Q

central abdominal pain, expansile pulsatile mass

A

abdominal aortic aneurysm

93
Q

iliac fossa pain, positive pregnancy test

A

ectopic pregnancy

94
Q

middle aged woman presents with pruritus, jaundice, pigmentation, AMA+

95
Q

middle aged man presents with pruritis, jaundice, abdominal pain and increased ALP

96
Q

signs of chronic liver disease

A

clubbing, flapping tremor, depuytrens contracture, palmar erythema, gynaecomastia, spider naevi, splenomegaly, testicular atrophu, ascites encephalopathy

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