GI summery notes

Question 1

What modality of imagine is most sensitive for boney metastasis?

Answer 1

PET scaning

Question 2

Explain the diagnosis of hemochromatosis

Answer 2

There will be high ferritin (although this is not sensitive as it is an acute inflammatory marker) AND high transferrin saturations. Also need genetic testing - C282Y mutation on HFE gene

Question 3

What blood test shows if there is excess copper?

Answer 3

Low caeruloplasmin (copper binding protein so if you have excess copper then caeruloplasmin will be low)

Question 4

What is the blood marker of HCC?

Answer 4

AFP - Alpha fetoprotein

Question 5

What is a complication of ascities?

Answer 5

Spontaneous bacterial pneumonitis. Occurs when there is over 250 neutrophils/mm cubed of fluid. Can be asymptomatic so anyone with ascites required a diagnostic tap.

Question 6

What are the two initial pharmacological therapies for management of acute variceal bleeding?

Answer 6

Terlipressin (not vasopressin as that causes constriction of cardiac vessels) and antibiotics (such as co-amoxiclav)

Question 7

What is the management of an acute presentation of IBD?

Answer 7

• IV steroids,
• LMWH (patients are prothrombotic),
• Stool cultures

Question 8

What are indicators of poor prognosis in Crohn’s disease?

Answer 8

Upper GI involvement, young age of onset, smokers and perianal disease.

Question 9

If the AST and ALT are over 400, what should you be thinking

Answer 9

That it is not alcohol related liver disease!