Gastrointestinal

Question 1

biliary colic first line investigation

Answer 1

US abdo

Question 2

liver synthetic function test

Answer 2

albumin, PT or INR

Question 3

obstructive pattern LFTs ie cholestasis

Answer 3

High ALP and bilirubin with normal or almost AST and ALT

Question 4

features of Wernicke’s encephalopathy

Answer 4

confusion, gait ataxia, nystagmus and ophthalmoplegia (CAN OPEN)

Question 5

liver failure triad

Answer 5

encephalopathy, jaundice and coagulopathy
eg confusion, liver flap, low albumin, raised PT

Question 6

features of korsakoffs syndrome

Answer 6

amnesia and confabulation

Question 7

SAAG >11

Answer 7

(PORTAL HYPERTENSION)
cirrhosis/ alcoholic liver disease
acute liver failure
liver mets
heart failure
portal vein thrombosis
B-C

Question 8

SAAG <11

Answer 8

nephrotic syndrome
peritoneal malignancy
pancreatitis
bowel obstruction

Question 9

ways to prognosticate pancreatitis

Answer 9

PANCREAS
PaO2, Age, Neutrophilia, Calcium, Renal function (urea), Enzymes (LDH), albumin and sugar

Question 10

microcytic anaemia, glossitis and oesophageal webs (causing stricture-like effects)

Answer 10

Plummer-Vinson syndrome

Question 11

autoimmune hepatitis antibody

Answer 11

smooth muscle antibody

Question 12

what can be used for bowel colic in palliative care?

Answer 12

hyoscine butylbromide

Question 13

dysphagia to both solids and liquids gradually

Answer 13

achalasia

Question 14

hepatic encephalopathy management

Answer 14

lactulose (to reduce ammonia) and rifaximin

Question 15

severe alcoholic hepatitis management

Answer 15

steroids

Question 16

C diff micro

Answer 16

gram positive rods

Question 17

flu-like symptoms, RUQ pain, tender hepatomegaly and deranged LFTs recent travel

Answer 17

Hep A

Question 18

autoimmune hepatitis management

Answer 18

steroids

Question 19

test for H pylori post-eradication therapy

Answer 19

UREA breath test

Question 20

pernicious anaemia cancer

Answer 20

gastric cancer