Gastro/GI

Question 1

Cx of cirrhosis

Answer 1

CAVES

Coagulopathy
Ascites
Varices
Encephalopathy
SBP

Question 2

Five F’s of abdominal distension

Answer 2

Fluid 
Flatus
Feces
Fetus
Fat

Question 3

PBC presentation (jaundice occurs late)

Answer 3

PPBBCCS

Pruritus 
Pigmentation of face
Bones: osteoporosis, osteomalacia (reduced vit D)
Big organs: HSM
Cirrhosis and coagulopathy
Cholesterol up
Steatorrhoea

Question 4

Raised ALP (= alkaline phosphatase)

Answer 4

ALKPHOS

Any fracture
Liver damage
K for Kancer
Paget’s disease
HyperPTH
Osteomalacia
Surgery

Question 5

Causes of intrahepatic liver failure

Answer 5

3 C’s and 3 I’s

Chronic liver disease
Carcinoma
Congestive cardiac failure
Immunological (PBC/PSC and AIH)
Infiltrative (amyloid and myeloproliferative disorders)
Infectious (HBV and HCV)

Question 6

Signs of liver decompensation

Answer 6

3 A’s

Ascites
Asterixis
Altered mental state

Question 7

Rule of 2s for Meckel’s diverticulum

Answer 7

2 inches 
2 feet from the ileocaecal valve
2% of the population
Presents in first 2 years of life
2 types of epithelial tissue

Question 8

Hereditary haemocrhomatosis features

Answer 8

MEALS

Myocardial: dilated CM, Arrhyhtmias
Endocrine: Pancreas DM, Pituitary, Parathyroid
Arthritis
Liver: CLD
Skin: slate grey

Question 9

Wilson’s disease

Answer 9

CLANK

Cornea
- Kayser-Fleischer rings
Liver disease
Arhtiritis
Neurological
- Parkinsonism, psychos-s
Kidney 
- Fanconi’s syndrome

Question 10

Precipitants of portal hypertension

Answer 10

HEPATICS

Haemorrhage
Electorlytes ( low K, Na)
Poisons: diuretics, sedatives, anaethetics
Alcohol
Tumour: HCC
Infection: SBP, pneumonia, UTI, HDV
Constipation
Sugar

Question 11

Portal hypertension presentation

Answer 11

ACDCs

Asterixis, ataxia
Confusion
Dysarthria
Constructional apraxia
Seizure

Question 12

Portal htn signs

Answer 12

SAVE

Splenomegaly
Ascites
Varices
Enphalopathy

Question 13

Drug causes of gynaecomastia

Answer 13

Drug causes of gynaecomastia: SACKED

Spironolactone, 
alcohol, 
cimetidine, 
Ketoconazole
Estrogen
Digitalis

Question 14

Signs of Cirrhosis

Answer 14

Signs of Cirrhosis: ABCDE

Asterixis, ascites
Bruises
Clubbing
Dupuytren’s
Erythema

Question 15

Risk factors for pancreatic cancer

Answer 15

Risk factors for pancreatic cancer: SINED

Smoking 
Inflammation: chronic pancreatitis
Nutrition: high fat diet
EtOH
DM

Question 16

Acute Pancreatitis causes

Answer 16

Acute Pancreatitis causes: I GET SMASHED

Idiopathic
Gallstones
Ethanol
Trauma
Steroids
Mumps
Autoimmune
Scorpion sting
Hypercalcaemia
ERCP 
DRUGS

Question 17

Chronic pancreatitis causes

Answer 17

Chronic pancreatitis causes: AGITS

Alcohol
Genetic: CF, HH,
Immune: lymphoplasmacytic sclerosing pancreatitis
Triglycerides are raised
Structural: Pancreas divisum or obstruction by tumou

Question 18

Presentations of Coeliac Disease

Answer 18

Presentations of Coeliac Disease: GLIAD

GI malabsorption: carbs, fat, protein, haematinics, vitamins
Lymphoma and carcinoma
Immune associations: IgA def., T1DM, PBC
Anaemia
Dermatological: dermatitis herpetiformis

Question 19

Treatments of IBD

Answer 19

5-PC, 5-AI, CAMI

UC:
- 5-PC induction - 5-ASA, prednisolone, ciclosporin
- 5-AI maintenance - 5-ASA, Azathiprine, infliximab
CD:
- Corticosteroids, azathioprine, methotrexate, infliximab

Question 20

Carcinoid Tumour

Answer 20

FIVE-HT

Flushing: paroxysmal, upper body and with or without wheals
Intestinal: diarrhoea
Valve fibrosis: TR and PS
whEEze: bronchoconstriction
Hepatic involvement: bypassed 1st pass metabolism
Tryptophan deficiency: pellagra (3Ds)
- Pellagra:
- Diarrhoea
- Dermatitis
- Dementia

Question 21

Haematemesis causes

Answer 21

Haematemesis: VINTAGE

Varices
Inflammation: oesophag-/gastr-itis or PUD (duodenal)
Neoplasia: oesophageal or gastric
Trauma: Mallory-Weiss tear (mucosal tear due to vomiting)
Boerhaave’s: full thickness tear 2cm proximal to LOS
Angiodysplasia and vascular anomalies: angiodysplasia, hereditary haemoragic telangectasia, Dieulafoy lesion (rupture of a large arteriole in stomach/bowel)
General bleeding: anticoagulants and chronic renal failure
Epistaxis

Question 22

Rectal bleeding

Answer 22

DRIPPING arse

Diverticulae
Rectal: haemorrhoids
Infection: camply, shige, E. coli, C, diff, amoebiasis 
Polyps
Inflammation: UC and Crohn's
Neoplasia
Gastric Upper Bleeding 
Angio: ischaemic colitis, HHT, angiodysplasia

Question 23

Alcoholism screening tool

Answer 23

Alcoholism screening tool: CAGE

Felt you should Cut down?
People Annoyed you by criticising your drinking?
Guilty feeling about your drinking?
Eye opener needed?

Question 24

Causes of liver failure

Answer 24

Causes of liver failure: VADAM
Viral
EtOH
Drugs
Autoimmune (PBC, PSC, AIH)
Metabolic

Question 25

Risk factors for cholecystitis

Answer 25

5 F’s ``` Fat Female Forty Fertile Fair ```

Question 26

Glasgow score for acute pancreatitis

Answer 26

Glasgow score for acute pancreatitis: PANCREAS ``` PaO2 <6 Age >55 Neutrophils > 15 Calcium < 2 Urea > 16 Enzyme < 600 Albumin < 32 Sugar > 10 ```

Question 27

Release of enzymes in pancreatitis

Answer 27

Release of enzymes in pancreatitis: English Premier League Elastases Proteases Lipases

Question 28

Causes of Splenomegaly

Answer 28

Causes of Splenomegaly: MILD ``` Myeloproliferative - CML Infiltrative - Gaucher disease (deposition of glucocerebroside in cells of the macrophage-monocyte system) Lymphopriolferative - CLL Developing world - Malaria - Visceral Leishmaniasis ```

Question 29

Causes of massive splenomegaly

Answer 29

Causes of massive splenomegaly: MMM Malaria CML Myelofibrosis and visceral leishmaniasis

Question 30

Causes of constipation

Answer 30

Causes of constipation: OPENED IT ``` Obstruction Pain Anal fissure Proctalgia fugax Endocrine/electrolytes Hypothyroidism Reduced calcium, hypokalaemia, uraemia Neuro MS Myelopathy Cauda Equina Elderly Diet/dehydration IBS Toxins Opioids Anti-MAch ```

Question 31

ALARM symptoms

Answer 31

ALARM symptoms ``` Anaemia Loss of wt. Anorexia Recent onset of progressive symptoms Melaena or haematemesis Swallowing difficulty ```

Question 32

ABCD of alcoholism

Answer 32

Ascitic tap B12 vitaimins Chlordiazepoxide Dietary requirements

Question 33

Child-Pugh classification for grading of cirrhosis

Answer 33

``` Albumin Bilirubin Coagulopathy Distension (ascites) Encephalopathy ```

Question 34

Causes for vomiting

Answer 34

ABCDEFGHI ``` AKI Brain (raised ICP) Cardiac (MI) DKA Ears Foreign substance Gravidity HyperCa2+/hyperNa Infection ```

Question 35

Indications for splenectomy

Answer 35

HI RAT ``` Hyperslepnism/HS ITP Rupture AIHA Trauma ```

Question 36

Differentials fo bilateral enlarged kidneys

Answer 36

``` Differentials fo bilateral enlarged kidneys: ABBA ADPKD Bilateral RCC (5%) Bilateral cysts (VHL) Amyloidosis ```