GI

Question 1

What is the screening programs in England for colorectal Ca?

Answer 1

Aged 60-74 FIT test sent every 2 years, and if positive then patient is sent for colonoscopy

Question 2

Obstructive pattern LFTs plus positive anti-mitochondrial antibodies indicates what disease?

Answer 2

Primary biliary cholangitis (autoimmune condition that damages the bile ducts in the liver, classically presents with itching, treated with ursodeoxycholic acid)

Question 3

What is the preferred diuretic to use in ascites?

Answer 3

Spironolactone
(Good as aldosterone antagonist so combats sodium retention)

Question 4

When should LFTs be monitored for starting statin therapy?

Answer 4

At baseline, 3 months and 12 months

Question 5

How does LFTs differ for alcoholic liver disease vs non alcoholic fatty liver disease?

Answer 5

Salt before Lime in alcoholics
AST>ALT

Non alcoholic fatty liver disease: ALT>AST

Question 6

What is the treatment if confirmed H Pylori?

Answer 6

Triple therapy with PPI + clarithromycin + amoxicillin or metronidazole

Question 7

What organism classically causes a gastroenteritis with severe vomiting yet a short incubation period?

Answer 7

Staph aureus

Question 8

What drugs should be given prior to endoscopy for suspected variceal bleed?

Answer 8

Terlipressin (splanchic vasoconstiction to reduce blood loss)

Abx prophylaxis to reduce SBP eg ciprofloxacin

Don’t give PPI as may obscure findings
Propranolol is used as prophylaxis for bleeding if varices are known

Question 9

Which blood group is associated with an increased risk of gastric Ca?

Answer 9

Blood group A

Question 10

Smoking is a protective factor for which GI condition?

Answer 10

Ulcerative colitis

Question 11

Which parts of the GI system do ulcerative colitis and Crohn’s disease affect?

Answer 11

UC affects the rectum and colon, distantly to proximally

Crohns affects anywhere mouth to anus, with skip lesions

Question 12

When would prophylactic antibiotics against SBP be given after an ascitic tap?

Answer 12

If ascitic fluid protein count is <15g/L

Question 13

Which marker is used to assess pancreatic exocrine function in pancreatitis?

Answer 13

Faecal elastase

Question 14

Which antibiotic is used for Campylobacter infection?

Answer 14

Clarithromycin

Question 15

What is the treatment of haemochromatosis?

Answer 15

Regular venesection to remove excess iron
Desferrioxamine (iron chelating agent)