GIT clinical skills

Question 1

which of the following examination findings is most likely in a patient with chronic alcoholic liver disease?

a. large left supraclavicular lymph node
b. absent bowel sounds
c. gynaecomastia
d. kayser-fleischer rings

Answer 1

gynaecomastia

Question 2

A 70-year-old male presents with LLQ colicky pain, altered bowel habits, fever, bloating and constipation. What is the most likely diagnosis?

a. Colorectal cancer
b. Crohn’s disease
c. Appendicitis
d. Diverticular disease

Answer 2

d. diverticular disease

Suprapubic colicky pain initially, localising in LLQ

Question 3

A 35-year-old male has a bulge above the crease of the groin, and there is a positive cough impulse. What is the most likely diagnosis?

a. Indirect inguinal hernia
b. Direct inguinal hernia
c. Testicular torsion
d. Femoral hernia

Answer 3

indirect inguinal hernia

Question 4

23M, haematemesis, b/g of multiple vomiting episodes presents after binge drinking. What is the most likely diagnosis?

a. Mallory-weiss tear
b. bowel perforation
c. eosinophilic oesophagitis
d. peptic ulceration

Answer 4

mallory-weiss tear

Question 5

In cases of severe vomiting, which would you be concerned about?

a. Hyperchloremia
b. Acidosis
c. Hyperkalaemia

Answer 5

a. hyperchloremia

Question 6

If you suspect an enteric fever, which test should you perform in addition to culturing from the stool?

a. Urine antigen test
b. Blood culture
c. ELISA
d. Growth on rich media to detect all possible pathogens

Answer 6

b. blood culture

Question 7

A 17-year-old presents with abdominal pain, bloating, diarrhoea, weight loss and itchy skin rash. What is the most likely diagnosis?

a. Crohn’s disease
b. Angiodysplasia
c. Coeliac disease
d. Ulcerative colitis

Answer 7

c. coeliac disease

Question 8

A 60-year-old presents with abdominal pain out of proportion to physical exam findings. They have 10/10 pain, but NIL guarding or rebound tenderness. What is the most likely diagnosis?

a. Indirect inguinal hernia
b. Bowel perforation
c. Mesenteric ischaemia
d. Appendicitis

Answer 8

c. mesenteric ischaemia

Question 9

what is a risk factor for AAA?

Answer 9

marfan syndrome

Question 10

Matilda, aged 46 years, contracted Hepatitis C 15 years ago when she was using intravenous ICE (methamphetamine). She presents to her gastroenterologist for her 6 monthly review. Which of the following groups of signs would the doctor be most likely to find if Matilda has developed liver cirrhosis secondary to chronic Hepatitis C?

a. Clubbing, Dupuytren’s contracture, spider naevi
b. Ecchymosis, palmar erythema, spider naevi
c. Gynaecomastia, parotid enlargement, striae
d. Jaundice, Kayser-Fleisher rings, leukonychia

Answer 10

b. ecchymosis, palmar erythema, spider naevi