Passmedicine/Pastest

Question 1

melanosis coli

Answer 1

pigment deposit in bowel wall associated with laxative abuse

Question 2

soft but tender abdomen

Answer 2

sign of mesenteric ischaemia

Question 3

palpable umbilical nodule due to metastaic cancer

Answer 3

sister mary josephs node

Question 4

what is NOT a notifiable disease

Answer 4

HIV

Question 5

how is coeliac disease investigated

Answer 5

tissue transglutaminase antibody (IgA) - 1st line screening test
jejunal biopsy - diagnostic, shows villous atrophy

Question 6

what should you always ask with dyspesia

Answer 6

ALARM symptoms

anaemia, loss of weight, anorexia, recent onset progressive, melaena

Question 7

name an antidiarrheal

Answer 7

loperamide - stimulates opiod receptors

Question 8

what score is used to assess pancreatitis severity

Answer 8

modified glasgow score

Question 9

triad of dysphagia, iron deficiency anaemia and glossitis

Answer 9

Plummer vinsen syndrome

Question 10

what is budd chiari syndrome

Answer 10

hepatic vein thrombosis

Question 11

what typically causes budd chiari and how does it present

Answer 11

haematological disease e.g. polycythaemia, thrombophilia,
pregnancy
contraceptive pill

presents with abdo distention and ascites and tender hepatomegal

Question 12

how is budd chiari investigation

Answer 12

SAAG - serum- ascites albumin gradient will be raised

this shows the ascites is due to portal hypertension

Question 13

what is zollinger ellison syndrome

Answer 13

condition characterised by excessive levels of gastrin, usually from a gastrin secreting tumour usually of the duodenum or pancreas. Around 30% occur as part of MEN type I syndrome
causes epigastric pain and diarrheao
results in multiple gastroduodenal ulcers

Question 14

what is spontaneous bacterial peritonitis

Answer 14

Spontaneous bacterial peritonitis (SBP) is a form of peritonitis usually seen in patients with ascites secondary to liver cirrhosis

Question 15

how is SBP treated in tayside

Answer 15

severe : taxobactam and pipercillin - step down to co trimox

incidental finding - co trimox

Question 16

when is prophylaxis ABx of SBP indicated in ascites and what are usually given

Answer 16

if ascitic protein less than 15g/L
hepatorenal syndrome

passmedicine says cipro not sure of local guidance

Question 17

how is toxic megacolon diagnosed on Abdo x ray

Answer 17

transverse colon greater than 6cm

Question 18

what is kernicteris

Answer 18

prolonged jaundice in newborn results in brain damage - can cause cerebral palsy

Question 19

what happens if you rapidly diurese for ascites

Answer 19

hypochloraemic alkalosis

Question 20

what test should be done after finding NAFLD incidentally

Answer 20

.
NICE recommend that if NAFLD is found incidentally then an enhanced liver fibrosis (ELF) blood test should be performed to assess for more severe liver disease.

Question 21

investigation of choice for liver cirrhosis

Answer 21

transient elastography

Question 22

melanosis coli

Answer 22

laxative abuse

Question 23

how do you calculate alcohol units

Answer 23

vol (ml) x EBV/1000

Question 24

Which diabetes drug is most likely to cause cholestasis?

Answer 24

gliclazide

Question 25

define toxic megacolon

Answer 25

transverse colon more than 6cm

Question 26

migratory areas of depapillation on dorsum of tongue associated with pain/burnign when eating spicy foods

Answer 26

geographic tongue