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Question 1

Pyogenic liver abscesses
1) What is the commonest organism found in pyogenic liver abscesses in children?
2) What is the commonest organism found in pyogenic liver abscesses in adults?
3) How is a pyogenic liver abscess managed?

Answer 1

1) Staphylococcus aureus
2) Escherichia coli
3) IV antibiotics and drainage (usually percutaneous)

Question 2

Which part of the colon is most commonly affected by ischemic colitis?

Answer 2

Splenic flexure

Question 3

Serum albumin ascites gradient
1) Name a cause of a high SAAG (>1.1g/dl)
2) Name a cause of a low SAAG (<1.1g/dl)

Answer 3

1) Liver cirrhosis, HF, Budd Chiari syndrome, constrictive pericarditis, hepatic failure
2) Peritoneal cancer, TB, pancreatitis, nephrotic syndrome

Question 4

What is the 1st line management for gastroparesis?

Answer 4

Domperidone

Question 5

What score can be used to assess malnutrition?

Answer 5

MUST

Question 6

How many weeks should PPIs be stopped before an upper GI endoscopy?

Answer 6

2

Question 7

A neutrophil count of what is diagnostic for spontaneous bacterial peritonitis?

Answer 7

> 250 cells/ul

Question 8

What is the commonest cause of spontaneous bacterial peritonitis?

Answer 8

E.Coli

Question 9

What is the commonest cause of pseudomembranous colitis?

Answer 9

C. Diff

Question 10

How does C. Diff present on sigmoidoscopy

Answer 10

Yellow plaques on the intraluminal wall of the colon

Question 11

Why is C. Diff so difficult to destroy?

Answer 11

Spore formation

Question 12

What is the main way to differentiate from type 1 and type 2 hepatorenal syndrome?

Answer 12

Type 1 = fast onset. Type 2 = slow

Question 13

When is melanosis coli?

Answer 13

Dark brown pigmentation of macrophages in the lamina propria on colonoscopy due to chronic laxative abuse (senna = commonest culprit)

Question 14

What antiemetic should be avoided in bowel obstruction?

Answer 14

Metoclopramide (pro-kinetic which increases perforation risk)