GI

Question 1

ABG of prolonged vomiting, diuretics, 1ry hyperaldosteronism, cushing’s

Answer 1

metabolic alkalosis + hypokalaemia

Question 2

artery likely bleeding in duodenal ulcer bleed

Answer 2

gastroduodenal artery

Question 3

lymphomnas associated with coeliac + h pylori

Answer 3

coeliac –> enteropathy-associated T cell lymphoma
h pylori –> MALT lymphoma

Question 4

FBC results in sickle cell disease

Answer 4

intravascular haemolysis: – Hb, normal MCV, ++ reticulocytes

Question 5

chronic anal fissure mx

Answer 5

topical glyceryl trinitrate

Question 6

AST:ALT 2:1

Answer 6

alcoholic hepatitis (steroids)

Question 7

rectal pain
- fissure
- fistula
- haemorrhoids

Answer 7

• crack in mucosa posteriorly & in midline , fresh rectal bleeding on defecation
• abnormal connection, intermittent discharge, pain perianal, abnormal opening
• pain, itching, bleeding, red-flesh coloured

Question 8

• ascending cholangitis mx
• biliary colic tx
• cholecystectomy

Answer 8

• IV abx then ERCP
• laparoscopic cholecystectomy
• cholecystitis

Question 9

mental complication of wilsons

Answer 9

psychosis

Question 10

Abdominal pain, constipation, neuropsychiatric features, basophilic stippling

Answer 10

lead poisoning

Question 11

primary sclerosis cholangitis is a RF for

Answer 11

cholangiocarcinoma (CA19-9)
persistent biliary colic symptoms
associated with anorexia, jaundice and weight loss
a palpable mass in the right upper quadrant (Courvoisier sign)
periumbilical lymphadenopathy (Sister Mary Joseph nodes) and left supraclavicular adenopathy (Virchow node) may be seen

Question 12

characterised by anorectal pain and a tender lump on the anal margin

Answer 12

thrombosed haemorrhoids

Question 13

An isolated rise in bilirubin in response to physiological stress is typical of

Answer 13

Gilbert’s syndrome

Question 14

prognostic enzyme in acute pancreatitis

Answer 14

lipase

Question 15

imaging in GI
- gallstones
- appendicitis

Answer 15

USS

Question 16

surgical approaches

Answer 16

Hartmann’s –> emergency

Question 17

most common affected area crohn’s

Answer 17

ileum

Question 18

The appearance of ground-glass hepatocytes on light microscopy can point towards a diagnosis of …

Answer 18

chronic hepatitis B infection

Question 19

Deterioration in patient with hepatitis B think

Answer 19

hepatocellular carcinoma

Question 20

A … can be used to defunction the colon to protect an anastomosis

Answer 20

loop ileostomy

Question 21

Large-volume paracentesis for the treatment of ascites requires… ‘cover’. Evidence suggests this reduces paracentesis-induced circulatory dysfunction and mortality

Answer 21

albumin

Question 22

Patients who have had an episode of SBP require …

Answer 22

antibiotic prophylaxis (ciprofloxacin)

Question 23

modified-Glasgow for pancreatitis severity

Answer 23

P - PaO2 <8kPa

A - Age >55-years-old

N - Neutrophilia: WCC >15x10(9)/L

C - Calcium <2 mmol/L

R - Renal function: Urea >16 mmol/L

E - Enzymes: LDH >600iu/L; AST >200iu/L

A - Albumin <32g/L (serum)

S - Sugar: blood glucose >10 mmol/L

Question 24

commonest genetic lipid disorder

Answer 24

D. Heterozygous familial hypercholesterolaemia

Question 24

Liver function tests are typically normal in patients with this GI condition

Answer 24

acute cholecystitis

Question 25

pathogens in diseases c diff infection traveller's diarrhoea non-bloody diarrhoea with steatorrhoea

Answer 25

clindamycin e coli giardiasis

Question 26

markers & cancer risk of - primary sclerosing cholangitis - primary biliary cholangitis

Answer 26

- pANCA --> cholangiocarcinoma (CA19-9) - anti-mitochondrial (anti-smooth muscle less often) --> hepatocellular carcinoma (AFP)