Passmed Gastro

Question 1

What should be suspected in intense abdominal pain, bloating and fever with recent history of ascites?

Answer 1

SBP confirmed by paracentesis
-> neutrophil count will be over 250

Question 2

What kind of sexual dysfunction is caused by haemochromatosis?

Answer 2

Hypgonadotrophic hypogonadism

Question 3

Which chromosome is affected i Wilson;s?

Answer 3

Chromosome o 13

Question 4

Which renal pathology is Wilson’s associated with?

Answer 4

Renal tubular acidosis in FeNO in syndrome, associated with type 1

Question 5

What marker is associatd with priamry sclerosing cholangitis?

Answer 5

P-ANCA

Question 6

What h part of the brain is affected in Wilson;s?

Answer 6

Basal ganglia in the putamen and globus pallidus which causes a tremor

Question 7

What is shellfish associated with?

Answer 7

Hepatitis A

Question 8

What should be given with large volume paracentesis?

Answer 8

IV albumin solution

Question 9

What to give for severe alcoholic hepatitis?

Answer 9

Prednisolone

Question 10

What is the madder;s discriminat function?

Answer 10

Used to assess glucocorticoid therapy benefit in acute alcoholic hepatitis based on PT time and biliurubin concentration

Question 11

Which medications are a risk for C.DIFF?

Answer 11

PPIs
Cephalopsporins like clindaymcin

Question 12

How often do patients with coeliac have vaccines?

Answer 12

Pneumococcal vaccine every 5 years
Yearly influenza

Question 13

Which foods are gluten-free?

Answer 13

Maize in corn
Rice
Potatoes

Question 14

How to differentiate upper and lower GI bleed?

Answer 14

High urea in upper GI bleed

Question 15

What do carcinoid tumours produce other than serotonin?

Answer 15

If present in the lungs, they produce ACHTH and cause bruising, moon face and central fat. At high concentrations cortisol will act as a minealocorticoid and cause hypokaelmia and hypernatraemia

Question 16

What is the management of ow grade dysplasia in Barrett’s?

Answer 16

Radiofrequency ablation

Question 17

When is endoscopic mucosal resection idnicated?

Answer 17

High grade dysplasia
Visible lesions, or nodules

Question 18

How is alcohlic ketoacidosis managed?

Answer 18

0.9% saline and thiamine

Question 19

What is the most common symptom of Crohn’s disease in children?

Answer 19

abdominal pain

Question 20

What is first line for diarrhoea in IBS?

Answer 20

Loperamide

Question 21

What should be adminstered before endoscopic band ligation?

Answer 21

Terlipressin and prophylactic antiboic

Question 22

When is Propanolol given in variceal bleed?

Answer 22

AFTER band ligation along with PPI if caused by ulcer

Question 23

What is the prophylaxis of ascites?

Answer 23

Ciprofloxacin

Question 24

What is the criteria for severe UC?

Answer 24

6 stools per day and at least one of:
Heart rate greater than 90
Anaemia
ESR 30 or more
Temp greater than 37.8

Question 25

What causes abdominal pain, ascites and TENDER hepatomegaly?

Answer 25

Budd-chari syndrome

Question 26

What causes bowel obstruction with brown and blue maculae’s on buccaneers mucosa?

Answer 26

Pouts-Jegher’s syndrome

Question 27

What is a key feature of Crohn’s ?

Answer 27

Abdominal mass palpable in right iliac fossa due to inflammation and thickening of abomdinal wall or strictures or abscesses

Question 28

What to do when treating h.pylori if symptoms have resolved?

Answer 28

Reassure and monitor as no further actin is required

Question 29

What investigation assesses diseasease activity in IBD?

Answer 29

Flexible sigmoidoscopyscopy with biopsy

Question 30

What should be avoidedd investigations in UC?

Answer 30

Colonoscopy

Question 31

What is an indicator of life threatening C.diff infection?

Answer 31

partial or complete ileus, toxic megacolon, or CT evidence of severe disease

Question 32

What is AMA?

Answer 32

Antimitochondrial antibody associated with priamry biliary cholangitis

Question 33

What causes swallowing of saliva to be more difficult?

Answer 33

Globus pharyngis which is sensation of lump in the throat, relieved by swallowing food and drink

Question 34

What causes eelvated ALT and AST in thousands and cold extremities ith poor capillary refill?

Answer 34

Ischaemic hepatitis secondary to sepsis or Hypovolemia from blood loss

Question 35

What causes Murphy’s sign and fever?

Answer 35

Acute cholecystitis

Question 36

What causes persist dull ache in right upper quadrant with history of heart failure and ALT raised?

Answer 36

Congestive hepatomegaly

Question 37

What does pernicious anaemia increase the risk of?

Answer 37

Gastric carcinoma

Question 38

When is methotrexate used to induce remission?

Answer 38

In Crohn’s

Question 39

What is used to induce remission in IBD other than azathriopine?

Answer 39

Mercaptopurine

Question 40

Which type of murmur is present in carcinoid?

Answer 40

Systolic murmur and bronchospasm

Question 41

What causes skin to appear grey?

Answer 41

Haemochromatosis

Question 42

Most common organism in ascites fluid

Answer 42

E.col

Question 43

What will iron study show in haemochromatosis?

Answer 43

Raised transferrin saturation and ferritin, with low TIBC

Question 44

What does painless jaundice idnicate?

Answer 44

Pancreatic cancer with obstructive picture

Question 45

What investigation is used to monitor for complaications in patients with coeliac disease?

Answer 45

DEXA scan

Question 46

Which type of IBD is associated with absence of oral ulcers and perianal disease?

Answer 46

Ulcerative colitisw

Answer 47

Wh

Question 48

What is given for even mild symptoms of withdrawal?

Answer 48

Chlordiazepoxide, including for high risk

Question 49

What is given to reduce the risk of developing Werincke’s?

Answer 49

IV pabrinex which contains thiamine

Question 50

How is

Question 51

What does CA 125 indicate?

Answer 51

Ovarian cancer Peritoneal cancer

Question 52

What to suspect in patient with signs of chronic liver disease and history of COPD?

Answer 52

Alpha 1 antitrypsin deficiency from tuberculosis

Question 53

What is the management of dermatitis herpetiform?

Answer 53

Dapsone

Question 54

What does pain relieved by defaecation indicate?

Answer 54

IBS

Question 55

What is the key investigation for IBS?

Answer 55

Tissue trans glutaminase antibody