General/GI

Question 1

Most common causes of acute pancreatitis

Answer 1

alcohol or gallstones

Question 2

pathophysiology of acute pancreatitis

Answer 2

autodigestion of pancreatic tissue by the pancreatic enzymes leading to necrosis

Question 3

presentation on acute pancreatitis

Answer 3

severe epigastric pain
vomiting
epigastric tenderness, ileus, low grade fever

Question 4

diagnosis of acute pancreatitis

Answer 4

epigastric pain, vomiting
raised amylase
+lipase

Question 5

management of acute pancreatitis

Answer 5

fluid resus
analgesia
NBM
no abx!!
surgery

Question 6

complications of acute pancreatitis

Answer 6

necrosis of the pancreas
infection in necrotic area
abscess formation
acute peripancreatic fluid collections
pseudocysts
chronic pancreatitis

Question 7

management of chronic pancreatitis

Answer 7

creon
no alcohol
pain management
subcut insulin
ERCP stenting
surgery

Question 8

what is an anal fissure

Answer 8

longitudinal or elliptical tears of the squamous lining of the distal anal canal

Question 9

risk factors for anal fissures

Answer 9

constipation
IBD
STIs

Question 10

presentation of anal fissures

Answer 10

bright red, rectal bleeding

Question 11

most common location of anal fissure

Answer 11

posterior midline

Question 12

management of anal fissure

Answer 12

soften stool: high fibre, bulk forming laxative
lubricants
topical anaesthetics
analgesia
GTN for chronic anal fissure
surgery- sphincterotomy

Question 13

pathophysiology of appendicitis

Answer 13

pathogens get trapped due to obstruction (faecolith, lymphoid hyperplasia) -> gut organisms invading the appendix wall -> oedema, ischaemia +/- perforation

Question 14

presentation of appendicitis

Answer 14

periumbilical pain radiating to RIF
pain worse on coughing or moving
vomiting once or twice
mild pyrexia
anorexia

Question 15

what is mesenteric ischaemia

Answer 15

lack of blood flow through the mesenteric vessels supplying the intestines

Question 16

what does the foregut include

Answer 16

stomach, part of the duodenum, biliary system, liver, pancreas and spleen

Question 17

what is included in the midgut

Answer 17

distal part of the duodenum to the first half of the transverse colon

Question 18

what is included in the hindgut

Answer 18

second half of the transverse colon to the rectum

Question 19

blood supply of the foregut

Answer 19

coeliac artery

Question 20

blood supply of the midgut

Answer 20

superior mesenteric artery

Question 21

blood supply of hindgut

Answer 21

inferior mesenteric artery

Question 22

presentation of chronic mesenteric ischaemia

Answer 22

central colicky abdominal pain after eating
weight loss
abdominal bruit

Question 23

diagnosis of chronic mesenteric ischaemia

Answer 23

CT angiography

Question 24

what is ileus

Answer 24

condition affecting the small bowel where the normal peristalsis temporarily stops.

Question 25

causes of ileus

Answer 25

injury to the bowel handling of the bowel during surgery inflammation or infection electrolyte imbalance (hypokalaemia or hyponatraemia)

Question 26

presentation of ileus

Answer 26

vomiting (green bilious) abdominal distention diffuse abdominal pain absolute constipation and lack of flatulence absent bowel sounds