24/02

Question 1

What vaccine should be given to all coeliac disease sufferers?

Answer 1

Pnuemococcal vaccine

Booster given every 5 years

Question 2

What factors increase the risk of gastric cancer?

Answer 2

H.pylori infection
Pernicious anaemia
Atrophic gastritis
Salty foods
Smoking
Blood group

Question 3

What is the imaging modality of choice in primary sclerosing cholangitis?

Answer 3

MRCP or ERCP

p-ANCA may be positive

Question 4

What is Lynch Syndrome (HNPCC)?

Answer 4

Genetic condition that predisposes patient to colon cancer
Often affects proximal colon and commonly poorly differentiated

Common metastasis site is the endometrium

Question 5

How is malnutrition diagnosed?

Answer 5

> 10% weight loss in the past 3-6 months

BMI <18.5

Weight loss of >5% within last 3-6months and BMI <20

All weight loss should be unintentional

Question 6

What are features of Wilsons disease?

Answer 6

Hepatitis or Cirrhosis
Speech/behavioural/psychiatric problems
Kayser-Fleischer rings- green brown rings surrounding the iris
Haemolysis
Acute tubular necrosis
Blue nails

Question 7

What is the management of hepatorenal syndrome?

Answer 7

Vasopressers such as terlipressin
Volume expansion with 20% albumin
TIPS procedure

Question 8

What is the management of primary biliary cirrhosis?

Answer 8

1st line Ursodeoxycholic acid
Cholestyramine for itching
Fat soluble Vitamin replacement
Liver transplant