1 - PM

Question 1

Bowel cancer red flags

Answer 1

rectal bleeding
unexplained/unintentional weight loss
family history of bowel or ovarian cancer
onset after 60 years of age

Question 2

which IBD: bloody diarrhoea

Answer 2

UC

Question 3

incomplete emptying

Answer 3

tenesmus

Question 4

Which IBD: increased cancer risk

Answer 4

UC

Question 5

Which IBD: weight loss

Answer 5

Crohns

Question 6

Which IBD: skip lesions

Answer 6

crohns

Question 7

Which IBD: crypt abscess

Answer 7

UC

Question 8

Which IBD: loss of houstral markings

Answer 8

UC

Question 9

what is dysarthria

Answer 9

unclear articulation

Question 10

what is wilsons disease

Answer 10

is an autosomal recessive condition characterized by toxic accumulation of copper in the liver, cornea and brain. Neurological problems may manifest as dementia, tremor or dyskinesias.

Question 11

Copper deposition in cornea

Answer 11

Kayser-Fleischer rings = wilsons

Question 12

Diagnosis: blue nails

Answer 12

wilsons

Question 13

Wilsons treatment

Answer 13

penicillamine (chelates copper)

Question 14

painless jaundice

Answer 14

pancreatic cancer

Question 15

Investigation for suspected pancreatic cancer

Answer 15

US

Question 16

acute Ab

Answer 16

IgM

Question 17

chronic Ab

Answer 17

IgG

Question 18

which type of hepatitis cannot exist on its own

Answer 18

hep D, must be with Hep B

Question 19

MEN - 1

Answer 19

parathyroid (95%): hyperparathyroidism due to parathyroid hyperplasia
pituitary (70%)
pancreas (50%, e.g. Insulinoma, gastrinoma)
also: adrenal and thyroid

Question 20

Diagnosis: + anti-nuclear and/or anti-smooth muscle antibodies.

Answer 20

autoimmune hepatitis

Question 21

Diagnosis: + antimitochondrial antibodies

Answer 21

primary biliary cirrhosis

Question 22

autoimmune hepatitis treatment

Answer 22

steroids, other immunosuppressants e.g. azathioprine

liver transplantation

Question 23

UC is associated with which biliary condition

Answer 23

primary sclerosing cholangitis

Question 24

which ANCA seen in primary biliary cirrhosis

Answer 24

p-ANCA

Question 25

Diagnosis: ERCP showing multiple biliary strictures giving a 'beaded' appearance

Answer 25

primary sclerosing cholangitis

Question 26

Diagnosis: diabetes, arthralgia, deranged ALT and very high ferritin

Answer 26

Haemochromatosis

Question 27

What is Haemochromatosis

Answer 27

autosomal recessive disorder of iron absorption and metabolism resulting in iron accumulation

Question 28

what IBD: inflammatory cell infiltrate in lamina propria

Answer 28

UC

Question 29

paracetamol overdose treatment

Answer 29

Acetylcysteine

Question 30

Murphy's sign positive indicates what

Answer 30

Acute cholecystitis

Question 31

what is Acute cholecystitis

Answer 31

inflammation of gallbladder

Question 32

female, forties, fat and fair applies to which condition

Answer 32

Biliary colic

Question 33

what is biliary colic

Answer 33

pain occurs due to a gallstone temporarily blocking the bile duct.

Question 34

what is ascending cholangits

Answer 34

infection of the bile ducts commonly secondary to gallstones

Question 35

Diagnosis: fever (riggers), RUQ pain, jaundice

Answer 35

ascending cholangitis

Question 36

Diagnosis: palpable mass in the right upper quadrant, periumbilical lymphadenopathy and left supraclavicular adenopathy

Answer 36

Cholangiocarcinoma

Question 37

what causes pseudomembranous colitis.

Answer 37

C. diff: exotoxin which causes intestinal damage

Question 38

diarrhoea, what finding on bloods will suggest C. diff

Answer 38

raise WBC

Question 39

C. diff diagnosis

Answer 39

by detecting Clostridium difficile toxin (CDT) in the stool

Question 40

C. diff treatment

Answer 40

first-line therapy is oral metronidazole for 10-14 days if severe or not responding to metronidazole then oral vancomycin may be used for life-threatening infections a combination of oral vancomycin and intravenous metronidazole should be used

Question 41

who gets colonoscopy if found to have iron deficient anaemia

Answer 41

> 60 (suspect colon cancer)

Question 42

H. pylori treatment

Answer 42

a proton pump inhibitor + amoxicillin + clarithromycin, or | a proton pump inhibitor + metronidazole + clarithromycin

Question 43

what is Budd-Chiari syndrome

Answer 43

obstruction to hepatic venous outflow

Question 44

How may Budd-Chiara syndrome present

Answer 44

abdominal pain: sudden onset, severe ascites tender hepatomegaly

Question 45

coeliacs diagnosis

Answer 45

serology and jejunal biopsy

Question 46

which blood test indicated crohns activity

Answer 46

CRP

Question 47

Crohns diagnosis

Answer 47

colonoscopy + biopsy

Question 48

Diagnosis: positive anti-endomysial antibodies

Answer 48

coeliacs

Question 49

what is achalasia

Answer 49

failure of smooth muscle fibers to relax, which can cause a sphincter to remain closed and fail to open when needed

Question 50

diagnosis: extraocular muscle weakness or ptosis | Dysphagia with liquids as well as solids

Answer 50

Myasthenia gravis

Question 51

fatty stools, anaemia and low ferritin/folate levels,

Answer 51

coeliacs