GI

Question 1

a middle-aged white woman presenting with itching, a positive AMA and a raised alkaline phosphatase

Answer 1

Primary biliary cholangitis

Question 2

Management of primary biliary cholangitis

Answer 2

Ursodeoxycholic acid

Question 3

Middle aged man with abdominal pain in RUQ with jaundice and pruritis and raised ALP

Answer 3

Primary sclerosing cholangitis

Question 4

Other GI conditions linked to primary sclerosing cholangitis

Answer 4

Ulcerative colitis
Cholangiocarcinoma

Question 5

Metaplasia in the oesophagus

Answer 5

Barrett’s oesophagus

Question 6

Differentiating features of Crohns

Answer 6

No blood or mucus
Entire GI tract
Skip lesions
Terminal ileum most affected
Smoking is a risk factor

Question 7

Mild to moderate management of UC

Answer 7

Aminosalicylate (e.g., oral or rectal mesalazine) first-line
Corticosteroids (e.g., oral or rectal prednisolone) second-line

Question 8

Severe management of UC

Answer 8

Intravenous steroids (e.g., IV hydrocortisone) first-line

Question 9

Crohns management of exacerbation

Answer 9

Steroids (e.g., oral prednisolone or IV hydrocortisone) first-line
Enteral nutrition as an alternative, particularly where there are concerns about steroids affecting growth

Question 10

If steroids are inadequate in Crohns

Answer 10

Azathioprine
Mercaptopurine
Methotrexate
Infliximab
Adalimumab