GIT Investigations

Question 1

What are the 2 most important investigations with any patient?

Answer 1

History

Examination

Question 2

What bedside investigations should be done?

Answer 2

BMI 
Pulse
ECG 
Capillary glucose 
Urinalyssis

Question 3

What does capillary glucose investigate?

Answer 3

Diabetes

High blood glucose

Question 4

What score must be carried out for malabsorptive patients?

Answer 4

MUST

Question 5

Why should an ECG be carried out for abdominal patients?

Answer 5

Distinguish between upper abdomen or chest pain

Question 6

What is stool analysed for?

Answer 6

FOBT
Stool culture
Faecal calcprotectin
Faecal Elastase

Question 7

What is FOB?

Answer 7

Blood in the bowels

Question 8

When is stool culture particularly important?

Answer 8

For diarrhoea

Question 9

When is faecal calcprotectin important?

Answer 9

Inflammatory signs e.g IBD

Question 10

When is faecal elastase important to test for?

Answer 10

Investigations of pancreatic insufficiency/malabsorption

Question 11

What LFT should be carried out?

Answer 11

Bilirubin 
Aminotransferases ALT/ALT 
Alkaline Phosphatase/ALP
Gamma GT 
Albumin 
Prothrombin time 
Creatinine 
Platelet count

Question 12

What are aminotransferases?

Answer 12

Enzymes used in breaking down proteins
ALT
AST

Question 13

What result suggests problem with aminotransferases?

Answer 13

Elevated aminotransferases

Excess levels are leaked into blood stream when hepatocytes are damaged

Question 14

What is alkaline phosphatase?

Answer 14

Enzyme present in cells lining biliary ducts

Question 15

What results suggest pathology with alkaline phosphatase?

Answer 15

Elevated levels

Question 16

What is Gamma GT?

Answer 16

Non-specific liver enzyme

Question 17

When is Gamma GT elevated?

Answer 17

In alcohol abuse

Question 18

What do low levels of albumin suggest?

Answer 18

Chronic liver disease

Question 19

What can elevated CRP suggest?

Answer 19

Inflammation

Generally high in Crohns disease

Question 20

Why should WBC be checked for?

Answer 20

Inflammation

Question 21

In blood analysis what should be checked fro in hepatic screens?

Answer 21

HBC and HCV serology 
Autoantibodies
Immunoglobulins 
Ferritin 
Alpha 1 antitrypsin 
Alpha fetoprotein

Question 22

What does alpha fetoprotein suggest?

Answer 22

Cancer bio marker

Question 23

What is a urea breath test used to test for?

Answer 23

H/pylori

Question 24

What does an UGIE examine?

Answer 24

Oesophagus to duodenum

Question 25

Why is fasting required for UGIE?

Answer 25

To ensure no food gets in the way of camera view

Question 26

What does UGIE allow for?

Answer 26

Biopsy and therapeutic intervention

Question 27

Give example of therapeutic intervention that can be carried out with UGIE

Answer 27

Oesophageal stenting | Pyloric stenting

Question 28

Give an example of diagnostic technique that can be carried out with UGIE

Answer 28

Biopsy

Question 29

What are some risks from UGIE?

Answer 29

Aspiration Perforation Haemorrhage

Question 30

What does colonoscopy investigate?

Answer 30

Rectum to caecum

Question 31

What does colonoscopy allow for?

Answer 31

Biopsy and polypectomy

Question 32

What is polypectomy?

Answer 32

Removal of polyps

Question 33

What are the risk fo colonoscopy?

Answer 33

Perforation Hameorrhage Renal impairment

Question 34

What is ERCP?

Answer 34

Endoscopic retrograde cholangio-pancreatography

Question 35

What does ERCP allow visualisation of?

Answer 35

Ampulla Biliary system Pancreatic ducts

Question 36

What are the risks of ERCP?

Answer 36

``` Pancreatitis Haemorrhage Perforation Infection Mortality ```

Question 37

What is endoscopic ultrasound used for?

Answer 37

Diagnosis and staging

Question 38

What does EUS allow for?

Answer 38

Diagnosis Staging Biopsy Cyst Drainage

Question 39

Where are RBC broken down?

Answer 39

Spleen

Question 40

What does increased creatinine suggest?

Answer 40

Renal impairment | Decreased eGFR

Question 41

Where is albumin made?

Answer 41

Liver

Question 42

Why can hypoalbuminaemia lead to oedema?

Answer 42

As oncotic pressure extravascular space>intravascular space

Question 43

Which antibodies are measured in coeliac serology?

Answer 43

Tissue transglutaminase

Question 44

What is oesophageal pH manometry used to detect?

Answer 44

Motility of GIT Level of acid exposure Records acid levels

Question 45

In which cancers if alpha fetoprotein normally found?

Answer 45

Liver | Non-sematomous

Question 46

What is ERCP a major risk factor for?

Answer 46

Pancreatitis

Question 47

Why is a colonoscopy and endoscopy diagnostic?

Answer 47

Because biopsies can be taken