Gastrointestinal

Question 1

Gingival hypertrophy which is caused by gingivectomy (bitting on own gums) is a common side a effect of which class of drugs?

Answer 1

Calcium channel blockers

Or phenytoin

Question 2

There’s a bird beak appearance on an X-ray. What is this a sign of in the upper GI tract and what is it a sign of in the lower GI tract?

Answer 2

Upper GI tract - Achalasia
Lower GI tract - Bowel obstruction

Achalasia is a condition that affects the nerves and muscles of the oesophagus, mainly at the lower end.

Question 3

What is grey turner’s sign?

Answer 3

Lumbar redness

Question 4

What is Cullen’s sign?

Answer 4

Umbilical redness

Question 5

What are grey turner’s and Cullen’s sign indicative of?

Answer 5

Acute pancreatitis

Question 6

What is Murphy’s sign?

Answer 6

The inspiration arrest that occurs upon palpating of the right upper quadrant during a deep breath.

Question 7

What is Murphy’s sign indicative of?

Answer 7

Cholecystitis

Question 8

A patient comes in with the pale stools, jaundice and abdominal pain. What is the most likely diagnosis?

Answer 8

Biliary obstruction

Question 9

A patient comes in with abdominal distension, caput Medusa’s and shifting dullness. What are his most likely diagnoses?

Answer 9

Portal hypertension

Ascites

Question 10

A patient comes in with pyoderma gangrenosum and erythema nodosum. Which diseases are part of your differential diagnosis?

Answer 10

Ulcerative colitis and Crohn’s disease

Question 11

A patient has tinkling bowel sounds. What is the most likely cause?

Answer 11

Bowel obstruction

Question 12

A patient comes in with a history of weight loss and a vesicular rash. What is the likely cause of this?

Answer 12

Coeliac disease

Question 13

What is Virchow’s node (swollen left supra-clavicular node) a sign of?

Answer 13

Gastric cancer

Question 14

What is the urea breath test used for?

Answer 14

H pylori diagnosis

Question 15

What is the 14C urea breath test used for?

Answer 15

To test for bacterial overgrowth (of H.pylori)

Question 16

A patient comes in with rice water like stools. What organism is likely to be affecting this patient?

Answer 16

Vibrio cholera

Question 17

A patient has presence of AMA (anti mitochondrial antibodies). What is this a sign of?

Answer 17

Primary biliary cirrhosis

Question 18

A patient had the presence of ASMA (anti smooth muscle antibodies). What is this a sign of?

Answer 18

Autoimmune hepatitis

Question 19

A patient’s alpha fetoprotein assay (AFP) test shows high levels of AFP. What is this likely to indicate?

Answer 19

Hepatocellular carcinoma (or teratoma)

Question 20

What is a cobblestone mucosa?

Answer 20

Deep fissuring ulceration of mucosa

Question 21

What is a cobblestone mucosa indicative of?

Answer 21

Crohn’s disease

Question 22

Which diuretic is prescribed for ascites (cause by cirrhosis)?

Answer 22

Spirolactone

Question 23

What is a corkscrew oesophagus on a barium swallow indicative of?

Answer 23

Diffuse oesophageal spasm

Question 24

A patient comes in with severe abdominal pain as well as diarrhoea and vomiting after drinking raw milk. Which organism is likely affecting him?

Answer 24

Campylobacter

Question 25

What is Russell’s sign indicative of?

Answer 25

Self induced vomiting

Question 26

What are Mallory’s hyaline bodies indicative of?

Answer 26

Alcoholic liver disease (acute hepatitis) or Chronic active hepatitis

Question 27

What are crypt abscesses a sign of?

Answer 27

IBS or Crohn’s disease

Question 28

A patient’s pathology report shows onion skinning fibrosis and heading of the bile duct. What is the most likely diagnosis?

Answer 28

Primary sclerosing cholangitis

Question 29

Signet ring cells are seen on a biopsy. What is this a sign of?

Answer 29

Diffuse stomach cancer

Question 30

There’s thumb printing on an X-ray at the splenic flexure. What is this indicative of?

Answer 30

Ischemic colitis

Question 31

What is Charcot’s triad?

Answer 31

Fever, jaundice and abdominal pain secondary to cholelithiasis

Question 32

What is Charcot’s triad a sign of?

Answer 32

Acute cholangitis

Question 33

What are some causes of an abdominal mass?

Answer 33

A - Abdominal aortic aneurysm ``` C - Crohn’s disease H - Hernia E - Enlarged organ M - Malignancy I - Intersusception C - Cyst or abscess A - Appendicitis L - Lymphadenopathy ```

Question 34

What are some causes for bowel obstruction?

Answer 34

B - Bolus A - Adhesions T - Tumour H - Hernia V - Volvulus I - Intersusception P - Pseudo obstruction S - Stricture

Question 35

What is the side effect of spironolactone?

Answer 35

Gynaecomastia

Question 36

What is a common oral disease in people with Crohn’s?

Answer 36

Stomatitis gangrenosum

Question 37

What is Barrett’s oesophagus characterized by?

Answer 37

Replacement of oesophageal stratified epithelium by simple columnar epithelium with goblet cells

Question 38

What are the three stages of Dukes classification?

Answer 38

A - Confined to the bowel wall B - Local spread outwith the bowel wall C - Lymph node metastases

Question 39

What are some causes of liver disease?

Answer 39

``` A - Autoimmune B - Hepatitis B C - Hepatitis C D - Drugs such as paracetamol E - Ethanol F - Fatty liver disease G - Growth H - Haemodynamic e.g. congestive heart failure I - Infiltration e.g. haemochromatosis or Infective ```

Question 40

How can you remember that AST levels increase in alcoholic liver disease?

Answer 40

wASTed

Question 41

What are some causes of abdominal distension?

Answer 41

``` Fat Firth’s Flatus Faeces Fluid Fucking massive tumour ```