GI Conditions

Question 1

Aetiology steatosis and steatohepatitis

Answer 1

Alcohol, metabolic syndrome, starvation, steroids

Question 2

Features of steatohepatitis

Answer 2

Fatigue, malaise, RUQ pain
AST/ALT may be raised, ALT higher in NASH, AST in alcoholic
More likely to progress to cirrhosis

Question 3

What is cirrhosis?

Answer 3

Hepatic fibrosis, nodular disorganisation, protal hypertension and ultimatley hepatic failure

Question 4

Aetiology cirrhosis?

Answer 4

Alcohol, chronic hep B/C, NASH, NAFLD

Question 5

Symptoms and signs cirrhosis

Answer 5

Fatigue, anorexia, nausea, weight loss, ascites, variceal haemorrhage

Question 6

Management cirrhosis

Answer 6

Zinc supplements, cholestyramie, consider bisphosphonates

Question 7

Complications cirrhosis

Answer 7

Hypersplenism, Vitamin deficiency, synthetic failure, anaemia, thrombocytopenia, coagulopathy, DIC, encephalopathy

Question 8

Ascites aetiology

Answer 8

Cirrhosis, GI/ovarian cancer, lymphoma, chronic hf, nephrotic syndrome, pancreatitis

Question 9

Management ascites

Answer 9

Low salt, spironolactone, paracentesis

Question 10

Symptoms of primary biliary cirrhosis

Answer 10

Asymptomatic, fatigue, pruritis, RUQ pain

Question 11

Investigations PBC

Answer 11

High ESR, Bilirubin, hyperlipidaemia, AMA, IgM, ANA

Question 12

Management PBC

Answer 12

UDCA, DMARDS, liver transplant

Question 13

Primary sclerosing cholangitis features

Answer 13

Autoimmune inflammatory fibrosis of extra-hepatic bile ducts
Men < 35, underlying IBD

Question 14

PSC investigations

Answer 14

p-ANCA, IgG, IgM, USS, ERCP, MRCP

Question 15

Management PSC

Answer 15

Liver transplant only life-prolonging treatment

Avoid alcohol

Question 16

Features coeliac disease

Answer 16

Autoimmune inflammation triggered by gluten

Question 17

Symptoms coeliac

Answer 17

Anaemia, abdo discomfort, diarrhoea, mouth ulcers, angular stomatits

Question 18

Associations for coeliac

Answer 18

Subfertility, miscarriage, low birth weight, dermatitis herpetiformis

Question 19

Investigations coeliac

Answer 19

anti-tTGA/anti-endomysial antibodies; undetectable after 6m gluten free
Duodenal biopsy gold standard

Question 20

management coeliac

Answer 20

Gluten free diet, consider vaccinations, bisphosphonates

Question 21

Complications coeliac

Answer 21

Osteoporosis, malnutrition, hyposplenism, lactose intolerance

Question 22

Pathogens causing gastroenteritis

Answer 22

Norovirus, campylobacter, E. coli, salmonella, shigella

Question 23

Risk for GORD

Answer 23

High intra-abdominal pressure, smoking, alcohol, coffee, obesity, hiatus hernia

Question 24

Alarm symptoms GORD

Answer 24

Dysphagia, weight loss, anaemia, vomiting, age >55, FH, Melaena

Question 25

Management GORD

Answer 25

PPI for 1-2months

Question 26

Peptic ulcer causes

Answer 26

H. pylori associated, NSAIDs, smoking, alcohol, steroids, stress, bile reflux

Question 27

Symptoms peptic ulcers

Answer 27

Epigastric pain, night waking, nausea, belching, bloating

Question 28

Investigation PU

Answer 28

FBC, H.pylori testing

Question 29

Management PU

Answer 29

PPI if NSAID induced

Eradication therapy for H. pylori

Question 30

Features crohn’s disease

Answer 30

Cobblestone colon, skip lesions, granulomas, affects any part of GI tract most commonly ileum, girls aged 15-30, smoking major risk/exacerbating factor

Question 31

Symptoms crohns disease

Answer 31

diarrhoea (mucus > blood), weight loss, abdominal pain, malaise, anorexia, mouth ulcers, perianal lesions, clubbing, ankylosing spondylitis, renal stone

Question 32

Investigations crohns disease

Answer 32

ASCA, high CRP in active disease, stool culture, ileocolonoscopy

Question 33

Treatment crohns disease

Answer 33

smoking cessation, metronidazole if fistulating, PPI if gastric
Prednisolone, IV hydrocortisone, azathiprine, infliximab

Question 34

Features UC

Answer 34

Pseudopolyps, thin ulcers, crypt abscess, distal disease

Question 35

Symptoms and signs UC

Answer 35

Bloody diarrhoea, weight loss, abdo pain, tenesmus, urgency, mouth ulcers

Question 36

Investigations UC

Answer 36

p-ANCA, magnesium, albumin, sigmoidoscopy/colonoscopy

Question 37

Treatment UC

Answer 37

Mesalazine - maintenance

Surgery