Quesmed Gastro

Question 1

What causes metaplasia in lower third of oesophagus?

Answer 1

Barrett’s oesophagus

Question 2

What causes abdominal pain, ascites and hepatomegaly?

Answer 2

Budd-chairs syndrome

Question 3

What causes tender hepatic edge and nausea and vomiting?

Answer 3

Inflammation of the liver, with acute hepatitis

Question 4

What causes lower back pain with ulceration in patient that is elderly and underweight?

Answer 4

Malnutrition

Question 5

Which type of murmur is in carcinoid syndrome?

Answer 5

Pulmonary stenosis and tricuspid regurg

Question 6

What can slow iron absorption?

Answer 6

Tannins in tea and coffee and polyphenols in peppermint tea

Question 7

How is a perforated peptic ulcer diagnosed?

Answer 7

Laparotomy

Question 8

Which IBD has crypt abscesses?

Answer 8

Ulcerative colitis

Question 9

When is arterial pH used in referral in hepatology?

Answer 9

Only for paracetamol induced liver transplant

Question 10

What is used in non paracetamol induced liver failure urgent referral?

Answer 10

Age under 10 years or over 40 years, 1 week from jaundice to encephalopathy, PT >50 seconds or bilirubin ≥300 μmol/L.

Question 11

What to give actively bleeding patients awaiting endoscopy?

Answer 11

Fresh frozen plasma if PT is over 1.5 normal limit

Question 12

What is the most common site of carcinoid tumours?

Answer 12

Appendix

Question 13

What are the alternative sites of carcinoid tumour?

Answer 13

Ileum, rectum and testis

Question 14

Which antiemetic is given for gastroparesis?

Answer 14

Metaclopramide

Question 15

Which groups are at risk of listeriai?

Answer 15

From dairy products in immunosuppressed patients like elderly, pregnant women

Question 16

Which sense is affected in coeliac disease?

Answer 16

Night blindness because of vitamin A malabsorption

Question 17

What is given for autoimmune hepatitis?

Answer 17

Prednisolone

Question 18

Which diabetic drug causes diarrhoea?

Answer 18

Metformin because of bile acid malabsorption

Question 19

What does increased echogenicity of Liver mean?

Answer 19

NAFLD

Question 20

What is the endoscopic surveillance for Barrett’s without dysplasia?

Answer 20

3-5 years

Question 21

What is the endoscopic surveillance for Barrett’s with dysplasia?

Answer 21

3-6 months

Question 22

What causes eosinophilic deposits in liver?

Answer 22

Drug induced hepatitis

Question 23

What causes granulomatous in bile ducts?

Answer 23

Primary biliary cirrhosis

Question 24

What IBD causes palpable bowel loops?

Answer 24

Crohn’s disease

Question 25

How should bisphosphonates be taken?

Answer 25

Full glass of water on empty stomach and stand for at least 30 minutes after taking

Question 26

What are the indications for TIPPS?

Answer 26

Refractory ascites to reduce portal hypertension

Question 27

Which antiemetic must be avoided in Parkinson’s?

Answer 27

Metaclopramide

Question 28

What is the maintenance for alcohol abstinence?

Answer 28

Acamprosate

Question 29

What causes flattening of mucosa of duodenum and scalloping of folds?

Answer 29

Coeliac disease

Question 30

What drink increases iron absorption?

Answer 30

Orange juice, ideal for haemochromatosis

Question 31

What is the criteria for the Glasgow score?

Answer 31

Glasgow Score - each of the following scores 1 point and a score of 3 or more predicts severe pancreatitis: * PaO2 < 8kPa * Age > 55 years * Neutrophils > 15 * Calcium < 2 * Renal i.e. Urea > 16 * Enzymes i.e. LDH > 600 or AST > 200 * Albumin < 32 * Sugar i.e. Glucose > 10 This should be calculated on admission and at 48 hours

Question 32

What to do for Glasgow score of more than 3?

Answer 32

Transfer to ICU for intensive monitoring and aggressive fluid resuscitation

Question 33

What does rice water stool indicate?

Answer 33

Vibrio cholerae which is treated with doxycycline

Question 34

What is the treatment of spontaneous bacterial peritonitis?

Answer 34

Ceftriaxone, Cefotaxime, or Ciprofloxacin

Question 35

In addition to bloody stools, what is essential for moderate flare classification in ulcerative colitis?

Answer 35

Pyrexia or tachycardia

Question 36

What does breast lump with fever and fluid filled mass indicate?

Answer 36

Lactational breast cyst from mastitis, so incise and drain

Question 37

What investigation for epigastric pain that is constant and weight loss?

Answer 37

Endoscopy due to gastric cancer or oesophageal risk.

Question 38

What are the serology tests for coeliac disease?

Answer 38

anti-tTG antibodies or anti-endomysial antibodies, are preferred

Question 39

How does peritoneal carcinoma affect SAAG?

Answer 39

It will be low

Question 40

What is the white cell count for ascites?

Answer 40

White cell count over 650 and neutrophil count over 250

Question 41

What does TIPS increase the risk of?

Answer 41

Diverts blood away from liver parenchyma which reduces breakdown of ammonia, which causes hepatic encephalopathy

Question 42

How is IBD diagnosed during a flare?

Answer 42

Flexible sigmoidoscopy

Question 43

What is the treatment of typhoid fever?

Answer 43

Cefotaxime

Question 44

What does 10 episodes of bloody diarrhoea in 24 hours and dehydration indicate?

Answer 44

Likely campylobacter jejuni infection.

Question 45

How is campylobacter treated?

Answer 45

Severe is treated with clarithromycin