Pastest

Question 1

Signet cells and linitis plastica?

Answer 1

Adenocarcinoma

signet cells confirms a poorly differentiated adenocarcinoma

Question 2

Carcinoid syndrome

Answer 2

Flush is the main symptom
Hypotension
Tachycardia
Right sided cardiac valve fibrosis
Increased skin temperature
PROFUSE secretory diarrhoea

Question 3

Charcot’s triad

Answer 3

• Fever
• Jaundice
• Abdominal pain

(acute cholangitis)

Question 4

Spider naevie and hepatic disease?

Answer 4

True

Question 5

Acanthosis nigricans and gastrointestinal malignancy?

Answer 5

True

Question 6

Cutaneous pigmentation and Peutz-Jeghers syndrome?

Answer 6

True

Question 7

Most common cause of GI haemorrhage?

Answer 7

Peptic ulcer disease

Question 8

Can GI be a complication of overwhelming sepsis?

Answer 8

Stress ulcers causing severe GI bleeding are a recognised complication of severe burns and overwhelming sepsis

Question 9

Causes of orogenital ulceration?

Answer 9

Behcets
Pemphigus and pemphigoid
Erythema multiforme
Reiter's syndrome
Herpes simplex virus
HIV
Syphilis

Question 10

Prognostic indicators for acute pancreatitis?

Answer 10

Age over 55
Raised white count
Blood glucose
Urea
A fall in haemocrit and calcium and blood gas derangement
Amylase is not of prognostic value, it is only useful to make the inital diagnosis

Question 11

Diptheria treatment?

Answer 11

Diptheria anti-toxin and penicillin/erythromycin

Question 12

Nasal flaring. intercostal recession, increased respiratory effort and cyanosis are signs of what?

Answer 12

Respiratory distress

Question 13

How might tracheo-oesophageal fistulae present?

Answer 13

May present immediately with an inability to feed

• Chronic cough
• pneumonia
• cyanosed when feeding
• failure to grow/thrive
• when coughin, produces copious amounts of secretions and appear to “blow bubbles”

Question 14

A 5 year old presents with a severe sore throat, drooling of saliva, high temperature and difficulty in breathing

Answer 14

The is the unforgettable clinical picture of acute epiglottitis

Question 15

Breslow thickness?

Answer 15

The depth from the granular layer of the epidermis to the deepest melanoma cell
-The breslow thickness is a prognostic indicator

Question 16

UVB, direct or inderect DNA damage?

Answer 16

UVB causes direct DNA damage

UVA causes indirect DNA damage

Question 17

Prognostic indicators which worsen the diagnosis of malignant melanoma?

Answer 17

Ulceration
Vascular invasion
Nodular subtype

Question 18

How do you investigate achalasia?

Answer 18

Oesophageal manometry

Question 19

Carcinoid syndrome flush is associated with what?

Answer 19

Tachycardia, hypotension and increased skin temperature

Question 20

Intermittent dysphagia could be caused by what

Answer 20

Benign oesophageal strictures

Question 21

Dukes A colon cancer

Answer 21

Confined to muscular lining of intestinal wall

Question 22

Dukes C colon cancer

Answer 22

Node involvement

Question 23

Dukes D colon cancer

Answer 23

Distant metastases are present

Question 24

Where does carcinoma of the stomach most commonly occur?

Answer 24

The pylorus

Question 25

Troisers sign?

Answer 25

Presence of a palpable lymph node in the left supraclavicular fossa, which is a sign of abdominal malignancy -may be present in gastric cancers (also called Virchows node)

Question 26

Absorption of what may be impaired after gastrectomy?

Answer 26

fat and fat soluble vitamins (D)

Question 27

Crypt abscesses

Answer 27

Ulcerative colitis (rare in Crohn's)

Question 28

Rose thorn (deep) ulcers

Answer 28

Crohn's disease

Question 29

Lymphod aggregates in Crohns or UC?

Answer 29

Crohns

Question 30

Dukes B colon cancer

Answer 30

Tumour extends across the bowel wall

Question 31

Causes of bright red PR bleeding?

Answer 31

Haemorrhoids or an anal fissure