cards

Question 1

first-line in maintain remission in ulcerative colitis patients with proctitis and proctosigmoiditis

Answer 1

Topical/PR aminosalicylate +/- PO aminosalicylate

Question 2

first line med for primary biliary cholangitis

Answer 2

ursodeoxycholic acid

Question 3

features of primary biliary cholangitis

Answer 3

IgM
Anti- antimitochondiral abs- M2 subtype
middle aged females

Question 4

Child Pugh classification

Question 5

mesalazine or sulfasalazine- which has the highest pancreatitis risk

Answer 5

Mesalazine

Question 6

Acute mng of variceal hemorrhage (double check with aus guidelines)

Answer 6

ABC
Correct clotting: FFP, vit K, platelet transfusions
Vasoactive agents: terlipressin, octreotide
PPX ABX
Endoscopy

Question 7

In pancreatic cancer, 3 different abdominal masses may be present:

Answer 7

hepatomegaly (metastases)
gallbladder (Courvoisier’s law)
epigastric mass (primary)

Question 8

What type of anaemia can sulphasalazine cause

Answer 8

Heinz body anaemia

Question 9

side effects of sulphasalazine

Answer 9

rashes, oligospermia, headache, Heinz body anaemia, megaloblastic anaemia, lung fibrosis

Question 10

side effects of mesalazine

Answer 10

GI upset, headache, agranulocytosis, pancreatitis*, interstitial nephritis

Question 11

what screenign tool is used to screen patients for malnutrition

Answer 11

MUST

Question 12

Definition of malnutrition

Answer 12

a Body Mass Index (BMI) of less than 18.5; or
unintentional weight loss greater than 10% within the last 3-6 months; or
a BMI of less than 20 and unintentional weight loss greater than 5% within the last 3-6 months

Question 13

complications of primary biliary cholangitis

Answer 13

cirrhosis-> portal HTN> ascites, variceal hemorrhage
Osteomalacia and osteoporosis
Increased risk of HCC

Question 14

investigations of choice in primary sclerosing cholangitis

Answer 14

magnetic resonance cholangiopancreatography (MRCP) is the diagnostic investigation of choice, showing multiple biliary strictures giving a ‘beaded’ appearance
endoscopic retrograde cholangiopancreatography (ERCP) was historically the gold-standard investigation but it has now been superceded by MRCP which carries a lower risk of complications such as pancreatitis. ERCP still has an important role for interventional procedures
p-ANCA may be positive
there is a limited role for liver biopsy, which may show fibrous, obliterative cholangitis often described as ‘onion skin’

Question 15

is h pylori eradication testing recommended for everyone?

Answer 15

NO- only if sympotms have not resovled

Question 16

early signs of hemochromatosisq

Answer 16

fatigue, erectile dysfunction, arthralgia

Question 17

LFT pattern for primary biliary cholangitis

Answer 17

ALP and ALT raised, ALP raised higher. Raised GGT

Question 18

LFT pattern for non alcoholic fatty liver disease

Answer 18

raised ALT, raised AST- slightly
Slightly raised GGT

Question 19

Which dietray substance is key to reduce in patients with ascites

Answer 19

Sodium

Question 20

Which condition is associated with gallstone development

Answer 20

Terminal ileitis from Crohns

Question 21

investigation of choice for suspected gastric cancer

Answer 21

Oesophago-gastro-duodenoscopy with biopsy

Question 22

what nail changes are associated in celiacs disease

Answer 22

koilonychia

Question 23

MOA of loperamide

Answer 23

Reduced gastric motility by stimulating opiod receptors

Question 24

most sensitive and specific lab finding for diagnosis of liver cirrhosis in those with chronic liver disease

Answer 24

Thrombocytopenia (platelet count <150,000 mm^3)

Question 25

crohns disease flare severity scoring system

Answer 25

Mild Ambulatory, tolerating oral fluid/food, no dehydration, no signs of pain Moderate Failing first-line treatment, low-grade fever, nausea and vomiting, weight loss, anaemia Severe Failing advanced treatment, shocked, obstruction, peritonitis, cachexia

Question 26

https://d32xxyeh8kfs8k.cloudfront.net/images_Passmedicine/xrb005.jpg

Answer 26

loss of haustral markings in the distal part of the bowel ('lead pipe colon'), consistent with ulcerative colitis.

Question 27

LFT pattern in pancreatic ca

Answer 27

raised bilirubin and ALP +signs of obstructive jaundice