Gastroenterology 1

Question 1

Entecavir or Tenofovir in osteoporotic patients?

Entecavir side effect?

Answer 1

Use Entecavir (guanoside analogue inhibitor)
Tenofovir can cause fanconi syndrome - RTA II - low Ca

Lactic acidosis

Question 2

What factors is protective against hepatotoxicity?

Answer 2

Acute alcohol ingestion

Hypophosphatemia

Question 3

Most sensitive screening tool for hemachromatosis?

Answer 3

High Transferrin saturation levels

Question 4

Most common mode of transmission for Hep B?

Answer 4

Vertical transmission

Question 5

Commonest Hepatitis C genotype in Australia?

Answer 5

Genotype 1

Question 6

Entecavir or Tenofovir in decompensated cirrhosis?

Answer 6

Entecavir

Question 7

Extraintestinal manifestations independent of IBD activity

Answer 7

Ankylosing spondylitis
Uveitis
PSC
Pyoderma Gangrenosum
Kidney,gall stones

Question 8

Extraintestinal manifestations dependent of IBD activity

Answer 8

ALONE - very dependent
Large joint arthritis
Oral ulcers
Nodosum erythema
Episcleritis

Question 9

Ratio of transmission in clinical setting from known source
Hep B
Hep C
HIV

Answer 9

Hep B 1 : 3
Hep C 1 : 30
HIV 1 : 300

Question 10

False negative results for Hep C examples?

Answer 10

Diabetes
Previous transplant
Contracted virus within 6 weeks ago

Question 11

Acute rejection of liver transplant - what normally do you see?

Answer 11

Obstructive LFT picture

Question 12

When to test for Hep C antibodies after childbirth?

Answer 12

> 1 year after childbirth - if not false positive

Question 13

What high transferrin levels highly specific for hematochromatosis?

Answer 13

Men > 60%

Women > 50%

Question 14

Difference of hemochromatosis and iron transfusional overload?

Answer 14

Hemachromatosis - iron deposited in parenchymal cells first = ferritin normal

Iron transfusional overload - iron deposited in reticuloendothelial cells = ferritin high

Ferritin ( iron storage)

Question 15

AST > ALT ratio = > 1 - what cause?
AST > ALT ratio = > 2 - what cause?
AST > ALT ratio = > 4 - what cause?

Answer 15

> 1 = NAFLD/ non-alcoholic cirrhosis eg. Hep C
2 = Alcoholic liver disease/ HCC
4 = Wilson’s disease

Question 16

ALT is found primarily where?

AST is found primarily where?

Answer 16

ALT = liver = hepatocellular injury

AST = enterocytes/ skeletal muscle

Question 17

Alcoholic liver disease has AST > ALT ratio of > 2 and what else?

Answer 17

Elevated gamma-glutamyl transpeptidase

Question 18

Contraindication to using Azathioprine?

Answer 18

Pancreatitis

Serum-like sickness

Question 19

Azathioprine long term side effect?

Answer 19

Non-melanoma skin cancer

Lymphoma

Question 20

Contraindication to using Infliximab?

Answer 20

Melanoma

TB!

Question 21

Vanishing bile duct syndrome - commonest drug that cause it?

Answer 21

Chlorpromazine

Question 22

Gilbert syndrome pathogenesis?

Answer 22

Lack of glucuranyltransferase ( conjugates bilirubin)

Question 23

Hyperglycemia causes what lung issue?

Answer 23

Pulmonary oedema - increase osmotic gradient

Question 24

Why malnourished patient gets infection?

Answer 24

Low T cells

Low IgA

Question 25

Islet B cells release what form of insulin in ER what happens? In Golgi what happens?

Answer 25

preproinsulin ER = pre to proinsulin Golgi = proinsulin to insulin + C-peptide

Question 26

How calcium activates insulin?

Answer 26

CREB - calcium responsive element binding protein

Question 27

Commonest antibodies in T1DM?

Answer 27

GAD antibodies in islet cells

Question 28

Diabetic type that has higher inheritance rate?

Answer 28

T2DM - monozygotic twins

Question 29

Fats good for DM?

Answer 29

Fats unsaturated - Mono, poly fats (FUMAP)

Question 30

Budesonide absorbed where?

Answer 30

Large intestine only

Question 31

Hep C with cirrhosis duration of treament?

Answer 31

12 weeks ( without cirrhosis = 8 weeks)