Stomach catch all

Question 1

What Blood abnormality would you expect to find in someone presenting with and acute upper gastrointestinal bleed?

Answer 1

Raised Urea. The bleed acts like a mean raising blood urea.

Question 2

What vitamin is deficient in alcoholics? and what is used to treat this vitamin deficiency?

Answer 2

• Vitamin B1 → Thiamine

* Pabrinex

Question 3

on abdo-xray what is Kantors string sign indicative of?

Answer 3

Crohns disease.

Question 4

If someone presents With coeliac disease, what other diseases should they be screened for?

Answer 4

• Autoimmune thyroid disease
• Dermatitis herpetiformis
• Irritable bowel syndrome
• Type 1 diabetes
• First-degree relatives (parents, siblings or children) with coeliac disease

Question 5

What is the index used to assess the severity of flare up in ulcerative colitis?

Answer 5

Truelove and witt index of severity

Question 6

What is used to treat Wilsons disease?

Answer 6

Penicillamine

Question 7

What is used to treat oesophageal varices?

Answer 7

Propranolol

Question 8

What is primary sclerosing cholangitis associated with?

Answer 8

Ulcerative colitis. 80% of people with PSC have UC

Question 9

What is the single most important factor that would indicate the need for a liver transplant?

Answer 9

Blood Ph < 7.34

Question 10

What does a +ve murphys sign indicate?

Answer 10

Cholecystitis

Question 11

Which antibiotics are associated with Clostridium difficile?

Answer 11

Flucloxacilin + 2nd + 3rd generation cephalosporins

Question 12

What does C.diff cause?

Answer 12

• `pseudomembranous colitis
• It is an acute inflammatory disease of the colon that in mild cases may appear as minimal inflammation or edema of the colonic mucosa. In more severe cases, the mucosa often is covered with loosely adherent nodular or diffuse exudates.
• It is intimately linked to C.diff

Question 13

What do you test when you are trying to determin if a patient has wilsons disease?

Answer 13

• Ceruloplasmin levels

Question 14

What is oesophageal Candidiasis a well known side effect of?

Answer 14

• inhaled steroid therapy

Question 15

What is xerostomia?

Answer 15

dryness of the mouth

Question 16

Name 5 chronic causes of diarrhoea?

Answer 16

• IBS
• Crohns
• Ulcerative colitis
• Coeliacs disease
• Colorectal cancer

Question 17

Name 4 usually acute causes of diarrhoea?

Answer 17

• Gastroenteritis
• diverticulitis
• Antibiotic therapy → C.diff → pseudomembranous colitis
• Bypass secondary to constipation

Question 18

What do pigment laden macrophages on colonic biopsy indicate?

Answer 18

Melanosis coli → caused by laxative abuse

Question 19

What is the first line treatment for Amoebiasis?

Answer 19

Metronidazole

Question 20

What is whipples disease?

Answer 20

• Whipple’s disease is a rare multi-system disorder caused by Tropheryma whippelii infection
• malabsorption: diarrhoea, weight loss
• large-joint arthralgia
• lymphadenopathy
• skin: hyperpigmentation and photosensitivity
• pleurisy, pericarditis
• neurological symptoms (rare): ophthalmoplegia, dementia, seizures, ataxia, myoclonus

Question 21

What is the investigation for whipples disease?

Answer 21

• Jejunal biopsy shows deposition of macrophages containing Periodic acid-Schiff (PAS) granules.
• treat with co-trimoxazole

Question 22

What is proctalgia fugax?

Answer 22

Proctalgia fugax (a variant of levator ani syndrome) is a severe, episodic, rectal and sacrococcygeal pain. It can be caused by cramp of the levator ani muscle, particularly in the pubococcygeus.

Question 23

What is porphyria?

Answer 23

• Porphyria’s are the defects of enzymes needed at various steps of heme synthesis and result in distinct clinical syndromes that invariably result in accumulation and increased excretion of porphyrins and their precursors.
• Symptoms are dependent on the porphyria.
• emaples of acute porphyria include: Doss porphyria, Acute intermittent porphyria, Hereditary coproporphyria, Variegate porphyria.