Misc

Question 1

abx for c diff (first line and if recurs)

Answer 1

1st: metronidazole, 2nd: vanc or fidaxomicin

Question 2

medical rx in appendicitis

Answer 2

prophylactic abx

metronidazole and cefuroxime

Question 3

complications of pancreatitis

Answer 3

perforation

appendix abscess

Question 4

blood results in pancreatitis

Answer 4

raised CRP

raised neutrophils

Question 5

sx peritonitis

Answer 5

severe sudden onset abdo pain
tenderness
guarding

Question 6

causes of peritonitis

Answer 6

perforation
trauma
secondary to ascites

Question 7

treatment for GORD

Answer 7

PPI
avoid precipitating factors
lose weight
stop smoking

Question 8

what cancer may occur from barrett’s

Answer 8

adenocarcionoma

Question 9

what classification may be used to record distribution of Barrett’s

Answer 9

prague

Question 10

what is achalasia

Answer 10

oesophageal aperistaliss and impaired relaxation of the lower oesophageal sphyncter

Question 11

symptoms of achalasia

Answer 11

intermittent dysphagia (liquids and solids from onset)
regurgitation of food
spontaneous chest pain

Question 12

what is seen on barium swallow in achalasia

Answer 12

birds beak sign

Question 13

what happens in autoimmune gastritis

Answer 13

autoimmune destruction of parietal cells causing achlorhydria and (no HCl) and intrinsic facftor deficiency

Question 14

what type of organism is h pylori

Answer 14

gram negative urease producing bacteria

Question 15

what diseases is helicobacter pylori associated with

Answer 15

chronic gastritis
peptic ulcer disease
gastric cancer

Question 16

ix peptic ulcer

Answer 16

urease breath test

stool antigen test

Question 17

management of peptic ulcer caused by h pylori

Answer 17

triple therapy

PPI + clarithro + amox/metro

Question 18

when is endoscopy required for symptoms that may be ulcer

Answer 18

presenting for first time age >55

other cancer risk factors e.g. anaemia, weight loss, progressive dysphagia, mass

Question 19

which is relieved by eating gastric vs duodenal ulcer

Answer 19

duodenal

nb gastric gets worse as more acid is secreted

Question 20

treatment of peptic ulcer

Answer 20

h pylori +ve -> treat infection and ulcer will repair itself

h pylori negative -> usually due to NSAIDs so stop them

Question 21

viruses that cause diarrhoea

Answer 21

rotavirus
norovirus
adenovirus

Question 22

bacteria that cause diarrhoea

Answer 22

campylobacter
ecoli
salmonella
shigella
c diff

Question 23

histological findings coeliac disease

Answer 23

crypt hyperplasia

villous atrophy

Question 24

endoscopic signs coeliac disease

Answer 24

scalloping
reduced folds
fissuring
cobblestone appearance

Question 25

histopathology CD VS UC

Answer 25

CD = non-caseating granulomas. transmural. skip lesions. uc = punctate ulcers, crypt abscess. NOT transmural

Question 26

diarrhoea in CD vs UC

Answer 26

CD -> get up at 4am and go 5 times in next 45 mins UC = bloody mucus diarrhoea

Question 27

drugs for CD vs UC

Answer 27

steroids to induce remission for both CD = immunosuppressants e.g. azathioprine/methotrexate, anti TNF UC = mesalazine (you see a pooey mess) surgery

Question 28

symptoms of haemorrhoids

Answer 28

blood on toilet paper blood on outside of stools itchy bottom

Question 29

treatment of haemorrhoids

Answer 29

Bulk-forming laxatives if constipated high fibre and fluid diet topical anaesthetic rubber band ligation

Question 30

antibiotics that cause c diff

Answer 30

clindamycin ciprofloxacin coamoxiclav cephalosporins

Question 31

2 causes of oesophageal dysmotility

Answer 31

achalasia (failure of smooth muscle to relax so lower oesophageal sphincter won't open) scleroderma

Question 32

what sign on barium swallow of achalasia

Answer 32

bird beak

Question 33

treatment of achalasia

Answer 33

nifedipine | or surgery if not responsive to CCB