Abdo

Question 1

Features of Crohn’s on biopsy?

Answer 1

Rose thorn ulcer

Cobble stoning

Question 2

Features of UC on biospy?

Answer 2

Crypt abscess
Mucosal ulcer
Goblet cell damage

Question 3

Features of Coeliac on biopsy?

Answer 3

Villous atrophy
Crypt hyperplasia
WBC infiltration

Question 4

Features of PSC

Answer 4

MRCP- beads on string, multiple areas of stricture

Question 5

PSC symptoms and signs plus weight loss?

Answer 5

Cholangiocarcinoma

Question 6

Treatment of Crohns?

Answer 6

Steroids- topical/oral/IV
Enteral feeding

Second line: Mesalazine/Mercaptopurine/Azathioprine/Infliximab

Question 7

Remission of Crohns?

Answer 7

Azathioprine/mercaptopurine

Or metronidazole if isolated perianal disease

Second line: methotrexate

Question 8

Treatment of UC?

Answer 8

Mesalazine

If severe: IV steroids

Question 9

Remission of UC?

Answer 9

Mesalazine

Second line: Azathioprine/mercaptopurine

Question 10

Extra articular features of IBD related to disease process?

Answer 10

Asymmetrical oligoarthritis
Episcleritis
Osteoporosis
Erythema nodosum

Question 11

Extra articular features of IBD not related to disease process?

Answer 11

Symmetrical polyarthritis
Uveitis
PSC/cholangiocarcinoma
Pyoderma gangrenosum
Clubbing

Question 12

Extra intestinal abdo complications of Crohns?

Answer 12

Gallstones

Kidney stones

Question 13

Factors of severe Crohns? [according to Truelove and Witts scale]

Answer 13

Going to toilet more than 6 times a day
Blood in stool
Anaemia
Fever
High heart rate/tachycardia- over 90
ESR over thirty

Question 14

Budd Chiari syndrome?

Answer 14

Abdominalpain+ vomiting + Jaundice
Tender hepatomegaly+ ascites
Past Hx of recurrent miscarriages(grossly distended abdomen + dilated abdominal veins)

(obstruction to hepatic venous outflow),
occurs in hypercoagulative state or physical obstructione.g. tumour
(Causes; pregnancy, OCP, PNH + Linked to polycythaemiarubravera(JAK2)

Question 15

How do you treat ascites?

Answer 15

Tap/drain
Spirinolactone
Fluid restrict
Weigh daily

Question 16

Epidemiology of auto immune hepatitis?

Answer 16

Fat young Cushingoid women

Question 17

Which is only antobody seen if give Hep B vaccine

Answer 17

Anti Hb S

Question 18

Triggers that make Gilbert’s syndrome symptomatic

Answer 18

Fasting
Nicotinic acid
Unwell
Hot weather

Question 19

Dark urine and normal stools indicates which type of liver disease

Answer 19

Hepatic cause

Question 20

Drrugs that cause obstructive jaundice

Answer 20

Clavulanic acid
penicillin
erythromycin. 
oestrogen
chlorpromazine

Question 21

Difference between Gilbert’s and Crigler-Najjar

Answer 21

Crigler Najjar= no UDP glucuronyl transferase, Gilbert’s= reduced

Question 22

ALT > AST

Answer 22

Chronic liver disease

Question 23

AST > ALT

Answer 23

Cirrhosis or acute alcoholic ischemia

Question 24

Symptoms of perianal abscess?

Answer 24

Purulent discharge
Intense throbbing pain
Pruritus ani

Question 25

IBS treatment

Answer 25

Mebeverine/Buscopan

Question 26

Colonic polyps symptoms?

Answer 26

Painless bright red bleeding, normal abdo, DRE and protoscopy

Question 27

Colonic polyps symptoms?

Answer 27

Painless bright red PR bleeding, separate from stool, normal abdo, DRE and protoscopy

Question 28

Does E Coli cause bloody diarrhoea?

Answer 28

No

Question 29

External haemorrhoids

Answer 29

Below dentate line- lower third of anal canal | More prone to thrombosis

Question 30

External haemorrhoids

Answer 30

Below dentate line- lower third of anal canal More prone to thrombosis inferior rectal vein??

Question 31

Gold standard for mesenteric ischeamia?

Answer 31

Angiography

Question 32

Next step after oesophageal cancer has been confirmed with endoscopy?

Answer 32

CT- staging

Question 33

Pancreatitis?

Answer 33

IV fluids NG tube [Drip and suck] IV analgesia Urinary catheter- fluid balance Antibiotics

Question 34

Differentials for lower GI bleeding?

Answer 34

``` Infective colitis Ischemic colitis IBD- Inflammatory colitis Malignancy Diverticulitis ```