Quesmed GI 2

Question 1

Which anti-constipation agent is ideal for IBS?

Answer 1

Isphagala husk

Question 2

What is used to monitor treatment response in hepatitis?

Answer 2

Viral load which is ideally undetectable after 12 weeks

Question 3

What should be performed following H.pylori infection eradication therapy?

Answer 3

Urea breath test
This should be done at least 4 weeks after completing antibiotics
2 weeks after stopping PPIs

Question 4

What is the escalated treatment for severe chronic disease?

Answer 4

Inflixmab for biological therapy with anti-tumour necrosis factor therapy

Question 5

What gene is caused by alpha 1 antitrypsin?

Answer 5

PiZZ

Question 6

What is the normal genotype for alpha 1 antripysin of the liver?

Answer 6

PiMM

Question 7

What does the PiSS genotype indicate?

Answer 7

50% normal alpha 1 antitrypsin disease and rarely presents with disease in young, healthy

Question 8

What is the risk of Crohn’s disease ?

Answer 8

Bile acid malabsorption due to removal of terminal ileum

Question 9

What imaging is used to confirm toxic megacolon?

Answer 9

Abdominal X-ray

Erect chest X-ray for pneumoperitoneum

Question 10

What is contraindicated for imaging toxic megacolon?

Answer 10

Barium enema
Colonoscopy

Question 11

How does toxic megacolon present?

Answer 11

temperature >38 degrees, heart rate >120bpm, neutrophilic leucocytosis or anaemia, plus one of: dehydration, altered consciousness, electrolyte disturbance and hypotension

Question 12

What is the management of toxic megacolon?

Answer 12

Nil by mouth
Nasogastric tube
Intravenous fluids
Corticosteroids
Antibiotics

Question 13

Wha is a complication of typhoid fever?

Answer 13

Intestinal perforation

Question 14

What is the indication of spontaneous bacterial peritonitis in the ascitic fluid?

Answer 14

High numbers of WBCs mainly (PMNs) or of the fluid contains more than 250/mm^3 of neutrophils.

Question 15

What is the features of Intraductal-abdominal malignancy with ascites?

Answer 15

Raised lymphocytes in ascitic fluid

Question 16

What consideration should be given for traumatic ascitic tap?

Answer 16

one neutrophil is subtracted for every 250 red cells to correct for the serum contamination

Question 17

What is the initial treatment for alcohol withdrawal?

Answer 17

Lorazepam

Question 18

What is the chronic pharmacological management of alcohol?

Answer 18

Chlordiazepoxide

Question 19

What is first line for primary biliary cholangitis?

Answer 19

Ursodeoxycholic acid
With cholestyramine for pruritus.

Question 20

What organism causes GUillan-Barre syndrome?

Answer 20

Campylobacter jejuni
-> immune mediated demyelination of peripheral of the four limbs

Question 21

What is considered a severe flare of UC?

Answer 21

6 or more stools a day and
Fever over 37.8 degrees
Over 90bpm
Anaemia

-> There is risk of VTE so prophylaxis is required with LMWH

Question 22

What is the management of severe flare of UC?

Answer 22

IV fluids
IV hydrocortisone
Prophylactic LMWH

Question 23

What aggravates duodenal ulcers?

Answer 23

Bisphosphonates
Immunosuppressive agents
Potassium chloride
SSRIs

Question 25

What is the protocol for PPI therapy starting?

Answer 25

Repeat endoscopy after 6-8 weeks

Question 27

What does dyspepsia with normal endoscopy and no H.pylori indicate?

Answer 27

Functional dyspepsia

Question 28

Wbat are the symptoms of vitamin A deficiency?

Answer 28

Dry rough skin White spots on conjuctiva called Bitot’s spots

Question 29

What does Sjögren’s syndrome increase the risk of?

Answer 29

Anti-mitochondrial antibodies

Question 30

What is the cause of CA125?

Answer 30

IBS

Question 31

What is the time limit for investigating SBP?

Answer 31

Ascitic tap within 8 hours of clinical suspicion

Question 32

What is indomethacin?

Answer 32

NSAID associated with peptic ulcer disease

Question 33

What causes urobilinogen in urine?

Answer 33

Hepatic cause of jaundice

Question 34

What causes jaundice in the absence of urobilinogen in urine?

Answer 34

Obstructive jaundice like pancreatic adenocarcinoma

Question 35

What causes normal ALP and bilirubin but severely raised ALT?

Answer 35

Ischaemic hepatitis

Question 36

What is the effect of giardiasis on the small intestine?

Answer 36

Causes malabsorption, especially of vitamin A, D, E, K and B12 and leads to weight loss

Question 37

What modlaity is used to re-test for H.pylroi?

Answer 37

Carbon-13 urea breath test

Question 38

What is the pharmacological treatment of IBS?

Answer 38

Mebeverine, an antispasmodic medication

Question 39

What medication commonly causes dyspepsia?

Answer 39

NSAIDs Bisphosphonates

Question 40

What extra0intsitnal manifestation of IBD occurs even in remission?

Answer 40

Primary sclerosis in cholangitis

Question 41

What is a complication of C.diff infection?

Answer 41

Toxic megacolon

Question 42

What does the entire large bowel being dilated indicate?

Answer 42

Toxic megacolon

Question 43

What does proximal dilation and distal restriction indicate?

Answer 43

Mechanical obstruction

Question 44

What is assessed in the stool of a patient with IBS?

Answer 44

FAECAL CALPROTECTIN

Question 45

How is anterior uveitis managed?

Answer 45

Cycloplegic mydriasis drops

Question 46

What is given for septic C.diff?

Answer 46

IV metronidazole Oral vancomycin

Question 47

What antiemetic should be avoided in bowel obstruction?

Answer 47

Metoclopramide

Question 48

What causes rice water stool, bloating and flatulence?

Answer 48

Giardiasis which has an incubation period of 1-3 weeks

Question 49

What should be co-prescribed with patients starting opiates?

Answer 49

Senna

Question 50

What is used to stage Crohn’s disease?

Answer 50

MRI of bowel

Question 51

What causes fatigue, dry skin and itching with raised ALP?

Answer 51

PRIMARY biliary cholangitis associated with autoimmune conditions

Question 52

What is given to reduce cerebral oedema in hepatic encephalopathy?

Answer 52

IV mannitol

Question 53

What is the reccomendations for confirmed h.pylri infection?

Answer 53

Full dose PPI

Question 54

Which infection are you at risk for eating raw meet?

Answer 54

Taenia sis from uncooked pork or beef, which can cause “grapefruit seed-shapes” in stools