gastrointestinal

Question 1

gingival hypertrophy -> gingivectomy/biting on own gums

Answer 1

side effect of calcium channel blockers or phenytoin

Question 2

bird beak appearance (and distended oesophagus)

Answer 2

achalasia

Question 3

grey turner’s(lumbar redness) and Cullen’s sign(umbilical redness) positive

Answer 3

acute pancreatitis

Question 4

causes of acute pancreatitis

Answer 4

I GET SMASHED
idiopathic, gallstones, ethanol, trauma, steroids, mumps, autoimmune, scorpion bites/stings, hyperlipidaemia/hypothermia/hypercalcaemia, ERCP, drugs

Question 5

murphy’s sign positive

Answer 5

cholecystitis

Question 6

pale stools, jaundice, abdo pain

Answer 6

biliary obstruction

Question 7

abdo distension, caput medusae, shifting dullness

Answer 7

portal hypertension + ascites

Question 8

pyoderma gangrenosum, erythema nodosum

Answer 8

Crohn’s/UC

Question 9

tinkling bowel sounds

Answer 9

bowel obstruction

Question 10

vesicular rash + weight loss

Answer 10

coeliac disease

Question 11

Virchow’s node (left supra-clavicular)

Answer 11

gastric cancer

Question 12

urea breath test

Answer 12

H.pylori

Question 13

13C breath test

Answer 13

bacterial overgrowth

Question 14

‘rice-water’ like stools

Answer 14

vibrio cholera

Question 15

primary biliary cirrhosis

Answer 15

presence of AMA(anti mitochondrial antibodies)

Question 16

autoimmune hepatitis

Answer 16

presence of ASMA(anti smooth muscle antibodies)

Question 17

alpha feto protein assay

Answer 17

hepatocellular carcinoma

Question 18

cobblestone mucosa; indication deep fissuring ulceration of mucosa

Answer 18

Crohn’s disease

Question 19

diuretics for ascites

Answer 19

spironolactone

Question 20

corkscrew oesophagus on barium swallow

Answer 20

diffuse oesophageal spasm

Question 21

severe abdo pain + D after raw milk

Answer 21

campylobacter

Question 22

Russell’s sign

Answer 22

self induced vomiting

Question 23

Mallory’s hyaline bodies

Answer 23

alcoholic liver disease(acute hepatitis) and chronic active hepatitis)

Question 24

crypt abscess/ cryptitis

Answer 24

inflammatory bowel ulcerative colitis

Question 25

onion skinning fibrosis, beading of bile ducts

Answer 25

primary sclerosing cholangitis

Question 26

'signet ring' cells seen on biopsy

Answer 26

linitis plastica- diffuse stomach cancer

Question 27

thumb printing on x ray commonly at splenic flexure

Answer 27

ischaemic colitis

Question 28

charcot's triad

Answer 28

fever, jaundice, abdominal pain secondary to acute cholangitis

Question 29

causes for abdominal mass

Answer 29

A CHEMICAL: AAA, crohn's, hernia, enlarged organ, malignancy, intussusception, cyst or abscess, appendicitis, lymphadenopathy

Question 30

causes for bowel obstruction

Answer 30

BATH VIPS: bolus, adhesions, tumour, hernia, volvulus, intussusception, pseudo-obstruction, stricture

Question 31

virchow's node

Answer 31

lymph node in left supra-clavicular fossa suggestive of gastric malignancy

Question 32

klebsiella pneumoniae

Answer 32

red currant jelly sputum, cavitating lesions in upper zone CXR

Question 33

E.coli 0157

Answer 33

bloody diarrhoea, fragmented RBCs, undercooked hamburgers, metallic green stool cultures

Question 34

salmonella typhi

Answer 34

red macules on body on examination

Question 35

salmonella enterididis

Answer 35

playing with turtles, undercooked chicken/ stale chicken

Question 36

shigella dysenteria

Answer 36

bloody diarrhoea, haemorrhagic mucosa with ulceration on distal colon

Question 37

vibrio cholerae

Answer 37

india, severe dehydration, watery diarrhoea

Question 38

campylobacter jejuni

Answer 38

unpasteurised/ raw milk, guillain Barre Syndrome

Question 39

how many muscles for jaw opening and closing?

Answer 39

1 for opening(lateral pterygoid), 3 for closing(temporalis, medial pterygoid, masseter)

Question 40

salivary glands?

Answer 40

parotid, submandibular, sublingual

Question 41

retroperitoneal organs?

Answer 41

SAD PUCKER: suprarenal(adrenal) glands, aorta & IVC, duodenum, pancreas, ureter, colon, kidney, esophagus, rectum

Question 42

which liver lobe is next to the gallbladder?

Answer 42

quadrate lobe

Question 43

what does the coronary ligament attach to?

Answer 43

diaphragm

Question 44

hepatomegaly with a history of malignancy?

Answer 44

think liver metastasis

Question 45

what is the most common cause of colovesical fistula?

Answer 45

diverticular disease

Question 46

LFT mnemonic

Answer 46

“Hepatocellular = ALT/AST, Cholestatic = ALP/GGT”

Question 47

which lobe is next to gallbladder?

Answer 47

quadrate lobe

Question 48

signs of liver failure?

Answer 48

RUQ pain -> shoulder tip pain jaundice pale stools, dark urine

Question 49

gilberts syndrome?

Answer 49

only bilirubin is raised

Question 50

paget's disease?

Answer 50

isolated high ALP ( paige only likes the ALPs)

Question 51

if ALP + GGT raised?

Answer 51

cholestasis(bile flow obstruction- PSC, PBC, gallstones)

Question 52

if all are deranged(ALP, GGT, AST, ALT)?

Answer 52

gallstone cholestasis- hepatocellular injury

Question 53

Alpha, beta, delta,...

Answer 53

so therefor g, i, s (alpha secretes glucagon, beta secretes insulin, delta secrete somatostatin)

Question 54

gallstones?

Answer 54

5 Fs- can be broken down into biliary cholic and acute cholecystitis

Question 55

acute cholecystitis?

Answer 55

murphy's sign positive, constant pain, less common then biliary colic

Question 56

ascending cholangitis?

Answer 56

bacterial infection typically E.coli charcot's triad reynold pentad: charcot's triad + confusion + hypotension

Question 57

what is strongly suggestive of acute alcoholic hepatitis?

Answer 57

a ratio of AST:ALT >3 and raised GGT

Question 58

acute pancreatitis?

Answer 58

serum amylase/lipase > 3x upper limit of normal management: fluid resuscitation

Question 59

primary biliary cholangitis?

Answer 59

positive AMA antibodies LFTs show cholestatic picture more common in women

Question 60

primary sclerosing cholangitis?

Answer 60

LFTs show cholestatic picture positive for pANCA