GI passmed

Question 1

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whats the best measure of acute liver failure and why
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Answer 1

Prothrombin time
-liver enzymes are not reliable as they may stay within normal limits for an extended period

-prothrombin has a shorter half life to albumin

Question 2

in crohns, how do you treat a perianal abscess

Answer 2

incision and drainage

Question 3

what blood tests to monitor treatment in haemochromatosis

Answer 3

transferrin saturation and serum ferritin

Question 4

what scoring system is used after endoscopy to determine risk of rebleeding and mortality (upper GI)

Answer 4

rockall

glasgow blatchford is used before endoscopy in low risk patient

Question 5

should patients with pancreatitis be made nil-by-mouth

Answer 5

NO
-not unless voming loads

Question 6

prognostic values for pancreatitis

Answer 6

PaO2
Age>55
Neutrophils
Calcium < 2
uRea > 16
Enzymes (LDH >600, AST/ALT >200)
Albumin < 32
Sugar (glucose >10)

Question 7

what drugs can cause cholestasis

Answer 7

-combined oral contraceptive pill
-antibiotics: flucloxacillin, co-amoxiclav, erythromycin*
-anabolic steroids, testosterones
-phenothiazines: chlorpromazine, prochlorperazine
-sulphonylureas
-fibrates
-rare reported causes: nifedipine

Question 8

what drugs can damage liver

Answer 8

paracetamol
sodium valproate, phenytoin
MAOIs
halothane
anti-tuberculosis: isoniazid, rifampicin, pyrazinamide
statins
alcohol
amiodarone
methyldopa
nitrofurantoin

Question 9

most common type of hereditary colon cancer

Answer 9

HNPCC

Question 10

why should PPIs be stopped 2 weeks before endoscopy for suspected cancer

Answer 10

because PPIs can reduce the size of ulcerative gastro-oesophageal malignancy