Gastro 2

Question 1

what is affected in PSC

Answer 1

the bile ducts

Question 2

what condition is PSC associated with

Answer 2

ulcerative colitis

Question 3

what LFT is most raised in PSC

Answer 3

ALP

Question 4

PSC autoantibody

Answer 4

none are specific

Question 5

PSC diagnostic test

Answer 5

MRCP

Question 6

PSC mx

Answer 6

strictures can be dilated with ERCP

colestyramine for pruritus

replace fat soluble vitamins

Question 7

what cancer does PSC increase risk of

Answer 7

cholangiocarcinoma

Question 8

what is IgG4 related sclerosing cholangitis

Answer 8

similar to PSC but responds to steroids

associated with autoimmune pancreatitis

Question 9

main risk factor for hepatocellular carcinoma

Answer 9

cirrhosis

due to NAFLD, ALD, hep b, hep c

Question 10

how is screening in liver cirrhosis patients for hepatocellular carcinoma carried out

Answer 10

ultrasound
alpha fetoprotein

Question 11

hepatocellular carcinoma marker

Answer 11

alpha fetoprotein

Question 12

what histological type of cancer are cholangiocarcinomas

Answer 12

adenocarcinomas

Question 13

tumor marker for cholangiocarcinoma

Answer 13

ca 19-9

Question 14

liver transplant scar

Answer 14

roof top (along costal margin) or mercedes benz (along costal margin and midline)

Question 15

what type of cell is the oesophagus lined with

Answer 15

squamous epithelium

Question 16

what type of cell is the stomach lined with

Answer 16

columnar epithelium

Question 17

red flags for 2WW upper GI endoscopy

Answer 17

anyone with dysphagia
above 55
mass
anaemia
weight loss
upper abdo pain

Question 18

when does dysphagia warrant a 2WW referral

Answer 18

always
anyone, any age with new dysphagia refer them

Question 19

what is a hiatus hernia

Answer 19

when a portion of the stomach shifts up through the diaphragm

Question 20

what surgery is done for reflux

Answer 20

laparoscopic fundoplication

Question 21

what type of bacteria is h pylori

Answer 21

gram negative aerobic

Question 22

what medication needs to be stopped before h pylori testing and for how long

Answer 22

stop PPI 2 weeks before

Question 23

h pylori eradication therapy

Answer 23

PPI
amoxicillin
clarithromycin

for 7 days

Question 24

what is zollinger ellinson syndrome

Answer 24

duodenal or pancreatic tumors produce gastrin causing excessive dyspepsia, dairrhoea and peptic ulcers

Question 25

what is zollinger ellinson syndrome associated with

Answer 25

MEN 1

Question 26

what medications increase risk of bleeding from a peptic ulcer

Answer 26

NSAIDs aspirin anticoagulants SSRIs steorids

Question 27

peptic ulcers encompass

Answer 27

gastric ulcers duodenal ulcers

Question 28

changes in weight in gastric vs duodenal ulcer

Answer 28

gastric ulcer- weight loss due to fear of eating causing pain duodenal ulcer- weight remains stable or higher

Question 29

signs of upper GI bleed

Answer 29

haematemesis coffee ground vomit melaena low Hb

Question 30

complications of peptic ulcers

Answer 30

bleeding perforation gastric outlet obstruction- due to scarring and strictures

Question 31

peptic ulcer mx

Answer 31

stop exacerbating/ causative medications h pylori eradication PPIs

Question 32

sources of upper GI bleed

Answer 32

varices cancer peptic ulcers mallory weiss tear

Question 33

mallory weiss tear is a tear in the

Answer 33

oesophageal mucosa

Question 34

what score is used to determine risk of upper GI bleed

Answer 34

glasgow blatchford score

Question 35

what score is used after endoscopy to assess risk of rebleeding from upper GI bleed

Answer 35

rockall

Question 36

when should an endoscopy be done for upper GI bleed

Answer 36

within 24 hrs immediately is emergency

Question 37

what is difference between G+S and xmatch

Answer 37

G+S= a sample of patients blood is saved for matching and the blood group is checked xmatch= units of blood are tested to check compatibility and kept ready in the fridge

Question 38

what platelet level are platelets given

Answer 38

<50

Question 39

when is PPI used in upper GI bleed

Answer 39

AFTER endoscopy, not before

Question 40

what site is most affected in crohns

Answer 40

terminal ileum

Question 41

conditions associated with IBD

Answer 41

erythema nodosum pyoderma gangrenosum enteropathic arthritis PSC red eye eg anterior uveitis, scleritis, episcleritis

Question 42

mild.moderate UC mx

Answer 42

aminosalicylate 1st line corticosteroids 2nd line

Question 43

maintaing remission UC first line

Answer 43

oral aminosalicylate rectal mesalazine

Question 44

surgeries for UC

Answer 44

ileostomy- end of small bowel is brought to skin and stoma created j pouch- ileum is made into a pouch and attached to rectum

Question 45

maintaining remission in crohns

Answer 45

azathioprine mercatopurine both 1st line methotrexate if those not suitable

Question 46

how is pain sometimes improved in IBS

Answer 46

after opening bowels

Question 47

how is pain sometimes worsened in IBS

Answer 47

after eating

Question 48

what must you rule out in someone with bloating

Answer 48

ovarian cancer- non specific sx

Question 49

ovarian cancer tumor marker

Answer 49

ca125

Question 50

how long do you have to have sx for IBS diagnosis

Answer 50

6 months

Question 51

IBS medication used for diarrhoea

Answer 51

loperamide

Question 52

IBS medication used for constipation

Answer 52

ispaghula husk

Question 53

in IBS do not use what medication for constipation

Answer 53

lactulose- can cause constipation

Question 54

new T1DM patients are tested fr what autoimmune conditions even if there are no sx

Answer 54

thyroid disease coeliacs

Question 55

coealiac disease autoantibodies

Answer 55

anti TTG anti endomysial anti DGP

Question 56

what part of the bowel is most affected in coeliacs

Answer 56

jejunum

Question 57

HLA associations in coeliacs

Answer 57

HLA DQ2 HLA DQ8

Question 58

deficiencies in coeliacs

Answer 58

iron b12 folate

Question 59

biopsy findings in coeliacs

Answer 59

crypt hyperplasia villous atrophy

Question 60

cancers associated with coeliacs

Answer 60

EATL NHL small bowel adenocarcinoma