Gastroenterology

Question 1

Differentials for chronic diarrhoea in the young

Answer 1

Coeliac, IBD (UC/Crohn’s), IBS, throtoxicosis

Question 2

Tests for IBD

Answer 2

Colonscopy, inflammatory markers in FBC

Question 3

Histological signs of Crohn’s

Answer 3

Skip lesions, cobble-stone appearance, transmural inflammation

Question 4

Endoscopic signs of UC

Answer 4

No skip lesions (continuous inflammation extending from the rectum to large bowel)

Question 5

Which area is most commonly affected by Crohn’s

Answer 5

Terminal ileum

Question 6

Extraintestinal Crohn’s features

Answer 6

Mouth ulcers, iritis/episcleritis, erythema nodosum, large joint arthritis / ankylosing spondylitis

Question 7

Longterm complications of Crohn’s

Answer 7

Peri-anal fistula, bowel perforation

Question 8

Causes of upper GI bleed

Answer 8

Mallory-Weiss tear, variceal bleed, oesophageal trauma, cancer, peptic ulcer

Question 9

Drugs that may contribute to upper GI bleed

Answer 9

NSAIDs, anticoagulants, aspirin, steroids

Question 10

Investigation for upper GI bleed

Answer 10

Urgent OGD endoscopy

Question 11

What disease is associated with variceal bleed and how?

Answer 11

Liver cirrhosis - portal vein hypertension

Question 12

Endoscopic treatment of a variceal bleed

Answer 12

Banding of varices, adrenaline,

Question 13

Dyspepsia differentials

Answer 13

Peptic ulcer, GORD, oesophagitis

Question 14

Upper GI malignancy symptoms

Answer 14

Weightloss, dysphagia, anaemia, haematamesis / malaena

Question 15

Risk factors for peptic ulcer disease

Answer 15

NSAIDs, smoking, stress, H Pylori, renal failure

Question 16

H pylori eradication program

Answer 16

> 2 weeks of 2 different Abx + PPI

Question 17

What’s used to investigate peptic ulcer perforation, what would be seen?

Answer 17

Erect CXR, free air under diaphragm (pneumoperitoneum)

Question 18

Excessive gastrin and ulceration is caused by which condition

Answer 18

Zollinger-Ellison syndrome