GI

Question 1

How is anion gap calculated?

Answer 1

(Na+ + K+) - (Cl- + HCO3-)

Question 2

What is the normal Anion gap value?

Answer 2

10-18mmol/l

Question 3

What are some causes of a Normal Anion Gap Metabolic acidosis?

Answer 3

Normal Anion Gap = (hyperchloraemic metabolic acidosis)
- GI bicarbonate loss e.g Diarrhoea
- Renal tubular acidosis
- Addisons disease

Question 4

What are some causes of a Raised Anion Gap Metabolic Acidosis?

Answer 4

• Lactate (Shock, Sepsis, hypoxia)
• Ketones (diabetic Ketoacidosis, Alcohol)
• Urate (renal Failure)
• Acid poisoning (Salicylates, methanol)

Question 5

What is the investigation of choice for Pancreatic Cancer?

Answer 5

High-Resolution CT abdomen.

Question 6

What medication is used to treat Campylobacter Jejuni?

Answer 6

Usually a self limiting however, may need treatment with Clarythromycin in severe cases or in Immunocompromised Patients.

Question 7

What does the PANCREAS pneumonic stand for?
(its for helping to identify risk of Severe acute pancreatitis)

Answer 7

P - PaO2 <8kPa
A - Age >55-years-old
N - Neutrophilia: WCC >15x10(9)/L
C - Calcium <2 mmol/L
R - Renal function: Urea >16 mmol/L
E - Enzymes: LDH >600iu/L; AST >200iu/L
A - Albumin <32g/L (serum)
S - Sugar: blood glucose >10 mmol/L

Question 8

What should be done with an Abdominal Aortic Aneurysm of 3-4.4cm?

Answer 8

Rescan every 12 months

Question 9

What should be done with an Abdominal Aortic Aneurysm of <3 cm?

Answer 9

No further Action

Question 10

What should be done with an Abdominal Aortic Aneurysm of 4.5-5.4 cm?

Answer 10

Rescan every 3 months

Question 11

What should be done with an Abdominal Aortic Aneurysm of => 5.5cm?

Answer 11

Refer within 2 weeks to vascular surgery for probable intervention.

Question 12

What are some indications of a High rupture risk AAA?

Answer 12

Symptomatic AAA have a high rupture risk and should undergo EVAR.