GIT

Question 1

Endocrine causes of chronic or recurrent abdominal pain

Answer 1

Diabetes mellitus

Addison’s disease

Question 2

Drugs/Toxins causing chronic or recurrent abdominal pain

Answer 2

Drugs - corticosteroids, azathioprine

Toxins - alcohol, lead

Question 3

Zollinger Ellison syndrome

Answer 3

Non B-cell islet tumour of pancreas (gastrinoma)

Gastric acid hyper secretion

Severe peptic ulceration

Question 4

Musculoskeletal manifestations of Whipple’s disease

Answer 4

Seronegative large joint arthropathy

Sacroiliitis

(Most patients have joint symptoms to some degree)

Question 5

CNS manifestations of Whipple’s disease

Answer 5

Apathy

Dementia

Fits

Myoclonus

Meningitis

Cranial nerve lesions

Question 6

Hematological manifestations of Whipple’s disease

Answer 6

Anemia

Lymphadenopathy

Question 7

GI manifestations of Whipple’s disease

Answer 7

Diarrhoea (75%)

Steatorrhoea

Weight loss (90%)

Protein losing enteropathy

Ascites

Hepatosplenomegaly (

Question 8

Metabolic causes of chronic or recurrent abdominal pain

Answer 8

Hypercalcemia

Acute intermittent porphyria

Question 9

Hemochromatosis - organs affected

Answer 9

Liver

Pancreatic islets - DM

CVS - heart failure, dysrhythmia

Skin - leaden grey pigmentation due to excess melanin (in exposed parts, axilla, groins, genitalia)

Question 10

Wilson’s disease - genetic abnormality

Answer 10

AR

Mutations in ATP7B gene on
chr.13

Question 11

Organs affected in Wilson’s disease

Answer 11

Liver

Basal ganglia

Eyes

Kidneys - renal tubular damage

Skeleton - osteoporosis

Question 12

Major elevation of serum transaminases

>300 U/L

Answer 12

Acute viral hepatitis

Autoimmune liver disease

Ischemic liver

Drugs - Paracetamol

Toxins - Amanita phalloides

Question 13

Pruritus ani - Causes

Answer 13

Local anorecal

• Poor hygiene
• Haemorrhoids
• Fistula, fissures

Infections

• Threadworms
• Candidiasis

Skin disorders

• Contact dermatitis
• Lichen planus
• Psoriasis