GI

Question 1

2 easy histological for crohns

Answer 1

granuloma formation

transmural inflammation

Question 2

2 comps of crohns

Answer 2

absess
fistula 
perforation 
Ca
Malnutrition

Question 3

how does cirrhosis lead to varicies

Answer 3

venous portal hypertension

Question 4

Medical mx of varicies

Answer 4

terlipressin / b blockers

Question 5

How to reduce portal pressures

Answer 5

Transjugular Intrahepatic Portosystemic Shunt

Question 6

GI malignancy Red flag

Answer 6

ALARMS

Anaemia, Loss of wt, Anorexia, Recent onset (if >55), Melaena, Swallowing difficulty

Question 7

Ix for abdo perf

Answer 7

Upright CXR

Question 8

High gastrin levels seen in ?

Answer 8

zollinger Ellison syndrome

-Pancreatic gastrinoma / part of MEN syndrome

Question 9

How does urea breath test work

Answer 9

H pylori produce urease to break down urea into ammonia and co2

Radio C in form of urea injested - if broken down radioisotope of CO2 can be measured

Question 10

Gold standard Ix to prove reflux

Answer 10

oesophageal pH manometry

Question 11

name a SE of fundoplication

Answer 11

Dysphagia from compression of GOJ
Achalasia
Dumping syndrome

Question 12

why does conjugated bilirubin appear in urine and unconugated not

Answer 12

Water soluble

Question 13

Dx / Mx of cholestasis

Answer 13

Endoscopic retrograde cholangiopancreatography + stent

Question 14

pancreatic Ca marker

Answer 14

Ca 19-9

Question 15

persistent jaundice comps

Answer 15

itching 
susceptibility to infection 
liver dysfunction 
acute renal failure 
nutritional dysfucntion

Question 16

What does having anti-HBC (HepB core antigen) in serum mean?

Answer 16

Past infection

Question 17

Signs of liver failure OE

Answer 17

leuconychia 
clubbing 
palmar erythema 
duputryens 
spider naevi 
hepatomegaly 
asicities

Question 18

2 tests to determine synthetic function of liver

Answer 18

Albumin
INR
PT

[synthetis of clotting factors]

Question 19

Mx of ascites

Answer 19

Conservative
fluid restrict
low salt diet,

Medical
diuretics
albumin infusion

Surgical
drain

Question 20

Ix on ascitic fluid

Answer 20

WCC
Albumin
LDH
MC+S

Question 21

What drug can you give in hepatic encephalopathy and why

Answer 21

Lactulose

Increase bowel speed

• > reduces the number of nitrogen producing bacteria
• > Less nitrogen which contributes to hepatic encephalopathy

Question 22

Most common place gluten found

Answer 22

wheat

Question 23

In severe coeliac why might endomysial antibodies be negative

Answer 23

severe malabsorption -> deficiency in proteins eg IgA

Question 24

Name 3 Ix in coeliac

Answer 24

Tissue transglutinmase 
anti endomysial 
iron studies [deficiency anaemia] 
FBC
Bone profile

Question 25

name 2 conditions related to coeliac

Answer 25

thyroid disease type 1 diabetes microscopic colitis

Question 26

Coeliac HLA?

Answer 26

HLA DQ2

Question 27

Name 2 comps of coeliac

Answer 27

malnutrition T cell lymphoma gastric/oesophageal Ca

Question 28

Name 2 viruses that can cause diarrhoea

Answer 28

rotavirus norovirus adenovirus

Question 29

Infection control for acute infective diarrhoea

Answer 29

Barrier nursing isolation of pt PPE Reduce contacts with PT