Gi And Liver

Question 1

Diverticulitis

Answer 1

Dmc

Metronidazole ciprofloxacin

Question 2

Diverticular disease

Answer 2

High fibre

Mebeverine - smooth muscle relaxant

Question 3

Varices

Answer 3

Resuscitation, fluids
Terlipressin (Adh analogue)
Balloon tamponade
Band ligation

Question 4

Achalasia

Answer 4

Endoscopic balloon dilation

Ccb and nitrates

Question 5

Reflux / gord

Answer 5

Antacid - magnesium trisilicate or magnesium salts
Calcium carbonate alginates - gaviscon
H2 receptor block - ranitidine
Ppi - lansoprazole

Question 6

Volvulus

Answer 6

Sigmoid colectomy

Flatus tube

Question 7

Mesenteric ischaemia

Answer 7

Fluid
Abx (gentamicin, metronidazole)
Revascularisation

Question 8

Ulcerative colitis

Answer 8

Aminosalicyclates - sulfalazine, mesalazine
Pred if no response
If systemic - hydrocortisone, ciclosporin, infliximab e.g. kidney stones, uvitis
Surgery if this all fails

Question 9

Crohns disease

Answer 9

Stop smoking
Coricosteroids 1) budesonide 2) pred 3) hydrocortisone
Metronidazole if infections
Anti tnf antibodies - infliximab adalimumab

Maintaining remission - azathioprine or methotrexate
Surgery

Question 10

Ibs

Answer 10

FODMAP diet
Antispasmodic - buscopan
Constipation - movicol or Linaclotide if over 12 months
Diarrhoea - loperamide
Tricyclic antidepressants if nothing works

Question 11

Peritonitis

Answer 11

IV fluids, nasogastric tube,

Cefuroxime, metronidazole

Question 12

Appendicitis

Answer 12

Appendectomy

Metronidazole, cefuroxime

Question 13

H.pylori

Answer 13

Amoxicillin or metronidazole if allergic + clarithromycin + omeprazole

Question 14

Wilsons disease

Answer 14

Penicillamine

Question 15

Haemochromatosis

Answer 15

Venesection

Desferrioxamine (iron chelator)

Question 16

Primary billiary cirrhosis

Answer 16

Uraodeoxycholic acid
Cholestyramine
Itching
Steroids

Question 17

Primary sclerosing cholangitis

Answer 17

Liver transplant

Question 18

Acute pancreatitis

Answer 18

Nil by mouth
Nasogastric intubation
Analgesia
If infection - cefuroime / metronidazole
Gallstones = extracorporeal shockwave lithotripsy

Question 19

C diff infection

Answer 19

Metronidaole and vancomycin

Question 20

Gallstones

Answer 20

Laparscopic cholecystectomy
Ursodeoxycholic acid
Statins - simvastatin
Shockwave lithotripsy
Endoscopic retrograde cholangiopancreatography

Question 21

Ascending cholangitis

Answer 21

Cefotaxime and metronidazole
Ercp to drain biliary tree
Surgery if large stone

Question 22

Ascending / acute cholcystitis

Answer 22

Abx - cefuroxime ceftriaxone

Laparascopic cholecystectomy

Question 23

Ascites

Answer 23

Diuretic - sprionolactone
Drain fluid
Shunt if resistant

Question 24

Hep a

Answer 24

Supportive, fluids, avoid alcohol

Close contacts - Ig and hep a vaccine within 14 days

Question 25

Hep b

Answer 25

Supportive avoid alcohol, contacts - hep b vaccine

If chronic - pegylated inteferon alpha 2a or tenofovir

Question 26

Hep c

Answer 26

Pegylated inteferon alpha 2a

Oral ribavirin

Question 27

Hep d

Answer 27

Pegylated inteferon alpha 2a

Question 28

Hep E

Answer 28

Ressolves on its own

Question 29

Portal htn

Answer 29

Porpranolol

Liver transplant

Question 30

Alcoholic liver disease

Answer 30

Withdrawal - diazepam

Iv thiamine