GI

Question 1

Haemochromatosis mutation

Answer 1

HFE C282Y

Question 2

What is TIPS

Answer 2

Transjugular intrahepatic portosystemic shunt
stablishes communication between the inflow portal vein and the outflow hepatic vein. It is used to treat portal hypertension (which is often due to liver cirrhosis) which frequently leads to intestinal bleeding, life-threatening esophageal bleeding (esophageal varices) and the buildup of fluid within the abdomen (ascites).

Question 3

Primary biliary cholangitis

Answer 3

autoimmune condition of liver
AMA antibody positive against pyruvate dehydrogenase complex (PDC-E2), raised ALP,
slow, progressive destruction of the small bile ducts of the liver, causing bile and other toxins to build up in the liver, a condition called cholestasis. Further slow damage to the liver tissue can lead to scarring, fibrosis, and eventually cirrhosis.

Question 4

Whipples disease

Answer 4

caused by Tropheryma whipplei bacteria, gram +ve
present with diarrhoea and arthropathy

two to four weeks of ceftriaxone or penicillin followed by oral TMP-SMX for a year
PAS stain positive, duodenal biopsy, subtotal villous atrophy

Question 5

NAFLD

Question 6

Refeeding syndrome

Answer 6

Refeeding Syndrome = a group of clinical findings that occur in severely malnourished individuals undergoing nutritional support.
underecognised
occurs in the setting of prolonged starvation followed by provision of nutritional supplementation from any route.
chronic malnutrition leads to protein catabolism with total body phosphate depletion despite normal serum phosphate
introduction of carbohydrates leads to an anabolic state which unmasks total body phosphate depletion and leads to precipitous drop in serum phosphate
insulin + glucose = massive uptake of phosphate, K+ and Mg2+ into cells
Most important electrolyte to replace is phosphate

Question 7

Primary sclerosing cholangitis

Answer 7

75% of individuals with PSC also have inflammatory bowel disease (IBD), most often ulcerative colitis
steatorrhoea, malabsorption, portal hypertension
anti smooth muscle Ab, p=ANCA, ANA antibodies,
HLA DR3

Question 8

peutz jeghers

Answer 8

autosomal dominant

Question 9

wedge hepatic venous pressure

Answer 9

catheter wedged in a hepatic vein, reflects portal venous pressure in hepatic sinusoids

Question 10

tropical sprue