GI

Question 1

What’s the mnemonic for remembering the features of Crohn’s?

Answer 1

Question 2

What’s the mnemonic for remembering the features of UC?

Answer 2

Question 3

What’s the mnemonic for thinking of causes and differentials?

Answer 3

Question 4

In which type of IBD do you see goblet cell depletion?

Answer 4

Question 5

In which IBD do you see a cobblestone appearance and granulomas?

Answer 5

Question 6

What’s the medical term for excess fat in stools?

Answer 6

Steatorrhoea

Question 7

What two antibodies can you test for to investigate coeliac?

Answer 7

Question 8

What two things would you expect to see on an intestinal biopsy in a coeliac?

Answer 8

Question 9

When testing for anti-TTG and anti-EMA antibodies in coeliacs, what else do you need to test for?

Answer 9

Need to test for total IgA (if they’re IgA deficient, this would mask them being coeliac)

Question 10

What does the patient need to do in the 6 weeks prior to antibody testing for coeliac?

Answer 10

The patient needs to carry on eating gluten (otherwise may not be possible to detect the antibodies/inflammation)

Question 11

What genes are associated with coeliac on which chromosome? (BONUS: which chromosome?)

Answer 11

HLA-DQ2 (90%)
HLA-DQ8 (10%)

Chromosome 6

Question 12

What’s the medical term for the passage of fresh blood through the anus?

Answer 12

Haematochezia

Question 13

What’s the medical term for black/dark stools due to GI bleeding?

Answer 13

Melaena

Question 14

Pain from which type of peptic ulcer is generally improved by eating?

Answer 14

Question 15

Which artery is most at risk of erosion due to a duodenal ulcer?

Answer 15

Question 16

Risk factors for developing oesophageal cancer?

Answer 16

Question 17

Give three causes of diarrhoea not related to disease or infection?

Answer 17

• Stress
• Medication
• Toxin ingestion

Question 18

1st and 2nd line treatment for inducing remission in Crohn’s?

Answer 18

Question 19

Management of uncomplicated diverticulitis?

Answer 19

Question 20

First line antibiotic for C. diff infection?

Answer 20

Question 21

Two drugs that can be given for IBS-related constipation?

Answer 21

Senna
Movicol

Question 22

What is a pilonidal sinus?

Answer 22

Abnormal pocket in the skin containing hair and skin debris
(usually at the top of the cleft of the buttocks)

Question 23

What type of drug can be used to decrease stomach acid production? Give an example.

Answer 23

Question 24

What metaplasia occurs in Barrett’s oesophagus?

Answer 24

Question 25

MC cause of bowel obstruction in young children?

Answer 25

Question 26

In which type of bowel obstruction do you get less frequent pain but with longer episodes?

Answer 26

Question 27

How would you investigate mesenteric ischaemia? What about ischaemic colitis?

Answer 27

Mesenteric ischaemia: - CT angiogram abdomen (can show thromboembolic occlusion) Ischaemic colitis: - CT abdomen (rule out other things) - Colonoscopy - Stool culture (rule out infection)

Question 28

Out of mesenteric ischaemia and ischaemic colitis, which one can be treated with a stent?

Answer 28

Mesenteric ischaemia

Question 29

Most common risk factor for chronic pancreatitis?

Answer 29

Excessive alcohol intake

Question 30

Most common site of intussusception?

Answer 30

Ileocolic (ileum invaginates into colon)

Question 31

Most common type of colorectal cancer?

Answer 31

Adenocarcinoma

Question 32

What urea and creatinine blood results would you expect in an upper GI bleed?

Answer 32

- Raised urea - Normal creatinine (Urea is raised as blood is reabsorbed in the GI tract and metabolised by the liver into urea)

Question 33

What drug is used prophylactically to reduce the risk of bleeding in oesophageal varices?

Answer 33

Question 34

Give four things that can be done if a Mallory-Weiss tear doesn't self resolve?

Answer 34

Question 35

Five types of diarrhoea?

Answer 35

Question 36

Main pathogens that cause bloody diarrhoea?

Answer 36

Question 37

2 X-ray findings indicative of a small bowel obstruction?

Answer 37

Question 38

List initial supportive management options for small bowel obstruction?

Answer 38

'Drip and suck' - Make the patient nil-by-mouth (NBM) - Insert a nasogastric tube to decompress the bowel (‘suck’) - Start IV fluids and correct any electrolyte disturbances (‘drip’) - Urinary catheter and fluid balance - Analgesia as required - Suitable anti-emetics

Question 39

What complication of a small bowel obstruction would lead to emergency surgery?

Answer 39

Bowel ischaemia/strangulation

Question 40

Give four tests you could use for H. pylori infection.

Answer 40

Question 41

What drugs are given to treat an H. pylori infection?

Answer 41

Question 42

Pathophysiology of haemorrhoids?

Answer 42

swelling and inflammation of veins in the rectum and anus

Question 43

Difference between external and internal haemorrhoids?

Answer 43

Internal: - painless - can prolapse - covered in mucus External: - form at anal opening - painful - covered in skin

Question 44

Non-surgical treatment for haemorrhoids?

Answer 44

- High fibre diet - Stool softeners - Topical anusol (analgesia) - Topical hydrocortisone

Question 45

Surgical options for haemorrhoids?

Answer 45

- Band ligation - Haemorrhoidectomy - Scleropathy (veins injected with a sclerosing agent causing them to shrink and eventually be absorbed by the body)

Question 46

What are the four additional criteria stated by NICE for a diagnosis of IBS? (In addition to pain/discomfort relieved by defecation or associated with change in bowel frequency/stool form)

Answer 46

Question 47

What are the final two criteria for diagnosis of IBS?

Answer 47

Question 48

What's the medical term for painful swallowing?

Answer 48

Odynophagia

Question 49

Give four non-pharmacological options for treatment of GORD.

Answer 49

Question 50

What's 1st line treatment for GORD?

Answer 50

PPI

Question 51

Parasitic cause of diarrhoea?

Answer 51

Question 52

Two viruses that cause diarrhoea?

Answer 52

Question 53

Give four red flag symptoms for GI cancer.

Answer 53

Question 54

Give four complications of diverticulitis.

Answer 54

Question 55

1st line treatment after an oesophageal rupture?

Answer 55

Question 56

2nd line treatment after an oesophageal rupture?

Answer 56

Question 57

Gold standard investigation for appendicitis?

Answer 57

Question 58

Give four differentials of appendicitis.

Answer 58

Question 59

What three blood tests can be performed to investigate appendicitis?

Answer 59

Question 60

An ultrasound can be done to investigate appendicitis. Give two other tests that can be done to rule out other conditions.

Answer 60

Question 61

What tumour marker can be raised in colorectal cancer?

Answer 61

Carcinoembryonic antigen (CEA)

Question 62

Definition of malabsorption?

Answer 62

- Inadequate absorption of nutrients - by the small intestines

Question 63

What does IgA anti-TTG and EMA stand for?

Answer 63

Question 64

Gold standard for diagnosis of acute diverticulitis?

Answer 64

Contrast CT colonography