Gastroenterology

Question 1

Liver disease examination findings

Answer 1

High BMI
Spider naevi
Haptomegaly/abdo mass
Splenomegaly
Gynaecomastia/Testicular atrophy
Palmar erythema
Leukonychia
Dupetryn's contracture
Ascites
Caput medusae
Metabolic flap
Jaundice
Confusion

Question 2

Colon Cancer Screening

Answer 2

Normal: = 1.6% risk of dying CRC by age 85
- no FHx CRC
= FOBT 50-74
- 1x first degree relative CRC at any age OR 1x first degree relative + 1x second degree relative CRC at any age
= FOBT 50-74 + aspirin 100mg at 50yo for at least 2.5 years

Moderately increased risk = 1-4% increase risk of CRC at 10 years
- 1x first-degree relative diagnosed CRC <55 year age
- 2x first degree relative of CRC any age
- 1x first degree relative + 2x second degree relative of CRC at any age
= FOBT 40-49 every 2 years + colonoscopy 50-74 every 5 years + aspirin 100mg at 50yo for at least 2.5 years

High risk: = >4% increase risk of CRC at 10 years
- >3 first degree relatives diagnosed CRC at age age
- >3 first or second degree relatives with CRC, at least one diagnosed <55yo
- 1x first degree relatives with multiple CRC
- 1x first degree relative diagnosed with CRC <50
- 1x first or second degree relatives diagnosed with CRC + large number of bowel adenomas (Think familial polyposis syndromes)
= FOBT every 2 years 35-44 every 2 years + colonoscopy every 5 years from 45-74 + gastro referral + consider genetic referral