Pass Med Q's

Question 1

most common site of ischaemic colitis

Answer 1

splenic flexure

Question 2

most common inherited colorectal cancer risk factor

Answer 2

HNPCC

Question 3

what cancers does HNPCC increase risk of

Answer 3

colorectal

endometrial

Question 4

which vitamin can be teratogenic in high doses

Answer 4

vitamin A

Question 5

what vitamin deficiency can Isoniazid cause?

what are the clinical effects?

Answer 5

vitamin B6

- causes peripheral neuropathy

Question 6

what blood gas abnormality can mesenteric ischaemia cause

Answer 6

lactic acidosis

Question 7

1st line treatment of C.Diff

Answer 7

metronidazole 10-14 days

Question 8

2nd line treatment of C.Diff if severe/not responding to metronidazole

Answer 8

vancomycin

Question 9

findings on duodenal biopsy in Coeliacs disease

Answer 9

villous atrophy
crypt hyperplasia
increased lymphocytes

Question 10

most common causative organism in spontaneous bacterial peritonitis

Answer 10

E.Coli

Question 11

tx of spontaneous bacterial peritonitis

Answer 11

IV Cefotaxime

Question 12

what it toxic megacolon?

how does it present?

Answer 12

inflammation causes gas to become trapped

• can be a complication of UC
• presents with pain, increased temp, tachycardia
• Abdo XRAY: transfère colon >6cm diameter

Question 13

antibodies in autoimmune hepatitis

Answer 13

anti-smooth muscle

Question 14

typical patient for autoimmune hepatitis

Answer 14

young females

- amenorrhoea common

Question 15

what is carcinoid syndrome

Answer 15

liver mets release serotonin into circulation

Question 16

symptoms of carcinoid syndrome

Answer 16

flushing, diarrhoea, bronchospasm, hypotension, weight loss

Question 17

Ix of carcinoid syndrome

Answer 17

urinary 5-HIAA

Question 18

tx of carcinoid syndrome

Answer 18

octeotride

Question 19

what is melanosis coli

Answer 19

dark pigments in colon due to chronic laxative use

Question 20

what Haematological cancer is there increased risk of in coeliacs

Answer 20

T cell lymphoma

Question 21

why is pneumococcal vaccine given in coeliac disease

Answer 21

functional hyposplenism

Question 22

what is Peutz Jeghers

Answer 22

autosomonal dominant

• hamartous polyps in GI tract
• freckles around lips

Question 23

what needs to be checked before giving a patient with IBD azathioprine / mercaptopruine

Answer 23

TPMT activity

- some patients may have genetic mutations that can increase side effects with these drugs

Question 24

how does Budd Chiari Present

Answer 24

sudden onset abdo pain, ascites, tender hepatomegaly

Question 25

how does intestinal angina present

Answer 25

triad of severe colicky pain post prandial, abdominal bruit, weight loss

Question 26

side effects of PPIs

Answer 26

hyponatraemia, hypomagnesmia osteoporosis -- increased fracture risk increased C.Diff risk

Question 27

what patients should receive prophylaxis against spontaneous bacterial peritonitis

Answer 27

patients with ascites if: - previous episode - fluid protein < 15 g/L

Question 28

hepatomegaly with hard irregular edge

Answer 28

metastasis

Question 29

biochemistry in Wilsons

Answer 29

decreased caeruloplasmin decreased serum copper increased urinary copper excretion

Question 30

what is pellagra

Answer 30

vitamin D3 deficiency | - dermatitis, diarrhoea, cognitive defecit

Question 31

common causes of pancreatitis

Answer 31

alcohol gallstones post ERCP

Question 32

what is a TIPS procedure

Answer 32

connects hepatic vein to portal vein

Question 33

what is globs pharyngitis

Answer 33

persistent feeling of lump in throat even though there isn't one

Question 34

iron study results in patient with Haemochromatosis

Answer 34

transferrin saturation > 55% raised ferritin + iron low TIBC

Question 35

causes of Budd Chiari syndrome

Answer 35

polycythemia rubra vera pregnancy COC thrombophilia

Question 36

signs of right heart failure

Answer 36

``` hepatomegaly - liver is firm, smooth, tender, pulsatile ascites raised JVP oedema ```

Question 37

what is pernicious anaemia

Answer 37

autoimmune antibodies to gastric parietal cells/intrinsic factor - B12 deficiency

Question 38

mechanism of action loperamide

Answer 38

decreased gastric motility through stimulation of opiod receptors

Question 39

1st line Ix for liver cirrhosis

Answer 39

'Fibroscan' - transient elastography

Question 40

what is sister Mary Josephs node

Answer 40

palpable node in umbilicus due to mets

Question 41

why should metoclopramide be avoided in bowel obstruction

Answer 41

increased risk of perforation

Question 42

what should patients be given prior to appendectomy

Answer 42

prophylactic antibiotics | - Co -amoxiclav

Question 43

how is TIBC affected in - iron deficiency anaemia - anaemia of chronic disease

Answer 43

high in iron deficiency | low in anaemia of chronic disease

Question 44

how long should a patient stop PPIs before endoscopy

Answer 44

2 weeks prior

Question 45

most common site for diverticulitis

Answer 45

sigmoid colon