GI Medicine

Question 1

Staph. aureus: enterotoxin from food Vomiting shortly after consumption Bacillus cereus: reheated rice Vomiting later, 1-2h hx

Answer 1

Gastroenteritis

Question 2

Salmonella, Shigella, Campylobacter Lower abdo pain + diarrhoea

Answer 2

Dysentry

Question 3

Baby, 3-6 weeks old, projectile vomiting Palpable mass in epigastrium, succession splash

Answer 3

Pyloric Stenosis

Question 4

Burns, haematemesis

Answer 4

Curling’s Ulcer

Question 5

Sepsis, IC lesion, organ failure, haematemesis

Answer 5

Cushing’s Ulcer

Question 6

Gastrin-secreting tumour

Recurrent ulceration, high serum gastrin

Answer 6

Zollinger Ellison

Question 7

Massive haematemesis, macrocytic anaemia, Hx of alcoholism

Answer 7

Oesophageal Varices

Question 8

Short hx of change in bowel habit Tenesmus and mucus

Answer 8

Rectal Carcinoma

Question 9

Reduced food intake, low fibre diet, lack of exercise/mobility, elderly

Answer 9

Simple Constipation

Question 10

Constipation due to pain

Answer 10

Anal Fissure

Question 11

Young, constipated, distended abdomen

Answer 11

Agangliosis

Question 12

Hx of broad-spec abx, green diarrhoea

Answer 12

C Diff

Question 13

Visit to Eastern Europe/Russia

Pale stool, foul flatus, watery diarrhoea

Answer 13

Giardia

Question 14

Prev hx. of chronic constipation

Answer 14

Overflow

Question 15

Diarrhoea, recently started OCP, diet controlled

Answer 15

Lactose Intolerance

Question 16

Bloody diarrhoea + intense abdo pain

Answer 16

Ischaemic Colitis

Question 17

Loose stool, weight loss, hypopigmentation, onycholysis

Answer 17

Thyrotoxicosis

Question 18

Worse epigastric pain on meals/EtOH

Answer 18

Chronic Pancreatitis

Question 19

Rapidly progressive dysphagia, weight loss, hypoproteinaemia

Apple core lesion on barium swallow

Answer 19

Oesophageal Carcinoma

Question 20

Progressive difficulty with speech/ swallowing

Weak facial muscles, absent jaw jerk

Answer 20

Bulbar Palsy

Question 21

Weight loss + anorexia + iron deficiency Signet-ring cells, leather bottle stomach

Answer 21

Adenocarcinoma

Question 22

Immunosuppression

Generalised ulceration of oesophagus

Answer 22

Oesophageal Candidiasis

Question 23

Infiltration of atypical lymphocytes Thickened folds

Answer 23

MALT lymphoma

Question 24

Slit-like vascular spaces Proliferating spindle cells Purple, plaque-like lesions

Answer 24

Kaposi’s Sarcoma

Question 25

Cholestatic jaundice, ↑ALP Beading of intrahepatic ducts Associated with UC

Answer 25

Sclerosing Cholangitis

Question 26

Ulcer on L shin IBD/Vasculitis/haem malignancy

Answer 26

Pyoderma Gangrenosum

Question 27

Acute illness + raised bilirubin

Answer 27

Gilbert’s Syndrome

Question 28

RNA

Jaundice, Diarrhoea + Fever

Answer 28

Hepatitis A

Question 29

Thrombus in hepatic portal vein Secondary to thrombogenic disorders

Answer 29

Budd Chiari

Question 30

Chronic liver disease + jaundice Antimitochondrial antibodies

Answer 30

Primary Biliary Cirrhosis

Question 31

dsDNA

Mild fibrosis

Answer 31

Chronic Hep B

Question 32

Haemosiderin within hepatocytes Darken skins

Raised transaminase

Answer 32

Genetic Haemochromatosis

Question 33

Copper accumulation

Neuro (adults), liver (children)

Answer 33

Wilson’s disease