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MRCP > MRCP Gastroenterology > Flashcards

MRCP Gastroenterology Flashcards

1
Q

Typical biochemical picture with pregnancy-related cholestasis?

A

Elevated serum bile acids, normal urate, fat soluble vitamin malabsorption (resulting in prolonged PT)

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2
Q

Lab findings in Wilson’s disease (serum copper, serum caeruloplasmin, urine copper, uric acid)

A

LOW serum copper, LOW serum caeruloplasmin, LOW serum uric acid (increased excretion)
RAISED urinary copper excretion

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3
Q

How is Peutz-Jeghers syndrome usually inherited?

A

Autosomal dominant

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4
Q

Test to confirm H Pylori eradication

A

13C urea breath test

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5
Q

Investigation of bile acid malabsorption

A

SeHCAT test

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6
Q

Most sensitive test for confirming diagnosis of haemochromatosis

A

Transferrin sats

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7
Q

Barrett’s oesophagus increases risk of which cancer?

A

Adenocarcinoma of oesophagus

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8
Q

IDA + aortic stenosis

A

Angiodysplasia (Heyde syndrome)

Common site is caecum & ascending colon (77%) - need colonoscopy

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9
Q

Ulcerative colitis is a risk factor for developing which biliary tract pathology?

A

Primary sclerosing cholangitis (PSC)

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10
Q

Periodic acid-Schiff within macrophages on histology

A

Whipple’s disease

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11
Q

Middle aged woman, itch, AMA +ve

A

Primary biliary cholangitis (PBC) (prev known as primary biliary cirrhosis)

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12
Q

Which vitamin type is thiamine?

A

Vitamin B1

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13
Q

First virological marker to become abnormal in hep B infection?

A

HBsAg

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14
Q

Venesection in haemochromatosis can improve which feature?

A

Cardiomyopathy

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15
Q

Mode of action of PPIs

A

Inhibit the hydrogen-potassium-ATP proton pump

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16
Q

OGD showing ‘watermelon stomach’ (tortuous vessels in the stomach)

A

Gastric antral vascular ectasia (GAVE)

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17
Q

First-line investigation for coeliac disease?

A

Anti-TTG antibodies

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18
Q

Features of zinc deficiency

A

Dermatitis and alopecia

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19
Q

Hypervascular lesion liver, young woman on OCP

A

Hepatic adenoma

Benign & usually asymptomatic

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20
Q

Treatment of symptomatic bile salt malabsorption (following ileal resection)

A

Cholestyramine

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21
Q

What drug can be given to reduce incidence of colon ca in people with HNPCC?

A

Aspirin

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22
Q

Lab test for monitoring response to venesection in haemochromatosis

A

Serum ferritin

transferrin sats are screening test for diagnosis

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23
Q

Kings college criteria for liver transplant following paracetamol OD:

A

Arterial pH <7.3, 24h after ingestion

OR ALL of the following:
PT >100 / INR >6.5
Creatinine >300
Grade III or IV encephalopathy

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24
Q

Difference in transaminases with alcohol vs para OD liver failure

A

Alcohol: rarely exceed 500, AST:ALT ratio >2

Para OD: AST & ALT can reach 1000s

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25
Q

Vitamin C and collagen synthesis

A

Hydroxylation of procollagen proline and lysine

26
Q

Type of hyperbilirubinaemia in Gilberts

A

Unconjugated

27
Q

Two possible diagnoses in case of isolated raised bilirubin

A

Gilberts

Haemolytic anaemia

28
Q

Describe features of mild UC flare

A

<4 stools per day +/- blood
No systemic disturbance
CRP & ESR normal

29
Q

Describe features of moderate UC flare

A

4-6 stools per day, minimal systemic upset

30
Q

Describe features of severe UC flare

A

> 6 stools per day containing blood

Systemic disturbance eg fever, tachycardia, abdo tenderness, anaemia

31
Q

Diagnosis of C Diff

A

C Diff stool toxin

Antigen only shows exposure to bacteria rather than current infection

32
Q

Treatment for itch in liver disease

A

Cholestyramine (reduces bile acid accumulation)

33
Q

Most sensitive imaging for pancreatic pathology

A

CT

34
Q

Lipaemic sample in acute pancreatitis is most likely to be caused by what?

A

Chylomicrons

35
Q

Most effective therapy for NAFLD?

A

Weight loss

Pioglitazone or vitamin E for advanced fibrosis

36
Q

Mycofenolate can cause what GI upset?

A

Chrons-like enterocolitis, raised calprotectin & skip lesions.

Symptoms resolve with discontinuation of drug

37
Q

What size on AXR signifies toxic megacolon?

A

Colon dilated to 6cm or more

38
Q

Causes of a protein-losing enteropathy

A

Sarcoidosis, IBD, CMV colitis, pseudomembranous colitis, TB, CTDs

39
Q

What substances are released in carcinoid syndrome?

A

Serotonin and prostaglandins

40
Q

Symptoms of Whipples disease

A

Malapsorption eg bulky smelly stool
Pleuritic chest pain
Fever, arthralgia

41
Q

Test for confirming pancreatic insufficiency as cause of diarrhoea?

A

Faecal elastase

42
Q

Most effective long-term therapy for achalasia?

A

Balloon dilatation of LOS

43
Q

AST and ALT ratios with ALD & NAFLD

A

AST:ALT ratio > 2 - Alcoholic liver disease

ALT:AST ratio >2 - NAFLD

44
Q

Pharmacological management of hepatorenal syndrome

A

Terlipressin (splanchnic vasoconstrictor)

45
Q

Treatment for relapsed IBD in pregnancy

A

First line: corticosteroids

46
Q

Treatment of pyoderma gangrenosum

A

Systemic/topical steroids

47
Q

Treatment for intrahepatic cholestasis of pregnancy

A

Ursodeoxycholic acid

- improves liver enzymes and itch

48
Q

Histology: intracytoplasmic/intranuclear inclusion bodies in epithelial cells of intestinal mucosa

A

CMV associated colitis

treat with ganciclovir

49
Q

Commonest electrolyte abnormality in anorexia

A

Hypokalaemia

50
Q

Describe features of Zieve syndrome

A

Alcoholics, haemolysis, hypercholesterolaemia, abdo pain, raised bilirubin.
Resolves once alcohol consumption stopped

51
Q

Treat GORD in pregnancy

A

Sodium alginate

52
Q

What does a positive SeHCAT test signify?

A

Bile acid malabsorption (commonly following ileal recection)

53
Q

Arthralgia followed by diarrhoea & malabsorption

A

Whipple’s disease

- treat with co-trimoxazole

54
Q

Which immunoglobulin is most markedly raised in AI hepatitis?

A

IgG

a small rise in IgM is sometimes also seen

55
Q

Triad of symptoms seen in pellagra

What vitamin deficiency causes pellagra

A
  1. dermatitis 2. diarrhoea 3. dementia

Nicotinic acid deficiency

56
Q

Initial investigation for Zollinger-Ellison syndrome

A

Fasting gastrin levels on three different days (pulsatile release)
Followed by basal acid output estimation and secretin stimulation test

57
Q

Histological appearance of gastric MALToma

A

Lymphocytes with irregular nuclear contours and abundant cytoplasm

58
Q

Kantor’s string sign on barium follow-through is pathognomonic of which condition?

A

Crohn’s disease

59
Q

Liver biopsy showing concentric periductal fibrosis (like an onion skin) is seen in which condition?

A

Primary sclerosing cholangitis

the one associated with IBD

60
Q

Treatment/prevention of familial Mediterranean fever

A

Colchicine

MRCP (14 decks)

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