random GI

Question 1

if you have haemochromotosis what cancer are you at increased risk o f

Answer 1

hepatocellular carcinoma

Question 2

most common cause of pneumonia in children

Answer 2

strep pneumonia

Question 3

giving aspirin to a child risks what syndrome

Answer 3

reyes

Question 3

in paracentesis why is Iv human albumin solution given

Answer 3

requires ‘albumin cover’ to reduce paracentesis induced circulatory dysfunction

Question 4

what should be given to patients before endoscopy with suspect varicela haemorrhage

Answer 4

antibitics and terlipressin

Question 5

investigation of choice for suspected bowel ischaemia

Answer 5

CT

Question 6

what is seen on biopsy in coeliac

Answer 6

villous atrophy
crypt hyperplasia
increase in intraepithelial lymphocytes
lamina propria infiltration with lymphocytes

Question 7

what should you suspect in a metabolic acidosis with low/ norm glucose

Answer 7

alcholic ketoacidosis

Question 8

how do you differentiate between Iron deficiency anaeia and anaemia of chronic disease

Answer 8

TIBC is high in IDA and low/norm in chronic disease

Question 9

what are norm fluis maintenance rates

Answer 9

25-30 ml/kg/d

Question 10

metabolic state in addisons - inc anion gap

Answer 10

hyperchloraemic metabolic acidosis

normal anion gap

Question 11

most common cause of large bowel obstruction

Answer 11

bowel cancer

Question 12

most common casue of peritonitis seocndary to peritoneal dialysisi

Answer 12

staph epidermidis

Question 13

serious complication of carbimazole

Answer 13

agranulocytosis

Question 14

in heel prick test in neonates what is raised to warrant further investigation for CF. what further investigation is next

Answer 14

immunoreactive trypsinogen

sweat test done after

Question 15

MOA of PPI

Answer 15

block K/H ATPase on parietal cell - reduced HCL production

Question 16

role og HCL in stomach

Answer 16

covert pepsinogen to pepsin

Question 17

treatment of diverticular disease

Answer 17

increase fibre in diet

Question 18

risk factors for diverticulosis

Answer 18

incresasing age
low fibre diet

Question 19

complications of diverticular disease

Answer 19

pericolic abscess
fistula- colonvaginal etc
perforation
haemorrhage
stricture
divertilulitis
diverticular phlegmon

Question 20

treatment of intra-abdominal spesis

Answer 20

amox
met
gent

Question 21

what type of organism is bacillu scereus

how long does infection take to resolve

Answer 21

gram positive rod- bacilli

24 hours

Question 22

what causes of gastroenteritis have a short incubation period of 1-6 hours

Answer 22

staph aureus and bacillus cereus

Question 23

how does shiga toxin work

Answer 23

binds to RBC’s to cause cells desth

Question 24

how does e.coli cause HUS

Answer 24

via verotxin (shiga-like toxin)

Question 25

what products cause e.coli posinoning

Answer 25

beef

Question 26

food poisoning from a deli counter is likely to be from what organism

Answer 26

shigella

Question 27

what gastroenteritis if from food at room temp

Answer 27

staph aureus

Question 28

muscles of levatori ani

Answer 28

puborectalis pubococcygeus ilio coccygeus

Question 29

what is the screening programme for rectal cancer

Answer 29

50-75yrs 2 yearly stoole sample

Question 30

difference between a subtotal coloectomy and a total abdominal colectomy

Answer 30

subtotal - leaves sigmoid and rectum total - leaves rectum

Question 31

complications of a stoma

Answer 31

pyschosocial skin irritation hernia constipation stenosis/obstruction retraction, prolapse granuloma - raised red lumps around high output - dehydration and malnutrition

Question 32

diagnosis and treatment of acute cholecystitis

Answer 32

dx - USS >4cm thickness HIDA scan TX - Iv ABX and cholecyst within 1 week

Question 33

diagnosis and treatment of pancreatitis

Answer 33

amylase 3x normal limit for dx or USS TX - fluid and analgesia view to surgery

Question 34

whats more common primary liver cancer or mets

Answer 34

mets

Question 35

most common liver tumour in a non cirrhotic patient

Answer 35

haemangioma

Question 36

liver lesion with central scar

Answer 36

focal nodular hyperplasia

Question 37

liver lesion assoc with the pill and steroids

Answer 37

hepatic adenoma

Question 38

liver lesion in echinococcus infection

Answer 38

hyatadid cyst

Question 39

pianless juandice with palpable mass

Answer 39

pancreatic cancer (courvoiseiers law)

Question 40

investigation of choice in pancreatic cancer and management

Answer 40

high resolution CT whipple

Question 41

investigation of choice in cholangiocarcinoma and main risk factor

Answer 41

PSC main risk factor MRI/MRCP

Question 42

3 main causes of bowel obstruction

Answer 42

Adhesions (small bowel) Hernias (small bowel) Malignancy (large bowel)

Question 43

normal diameters of bowel seen in obstruction

Answer 43

3 cm small bowel 6 cm colon 9 cm caecum

Question 44

initial bowel obstruction management

Answer 44

IV fluids NBM drip and suck

Question 45

treatment of ascending cholangitis

Answer 45

iv abx endoscopic retrograde cholangiopancreatography (ERCP) after 24-48 hours to relieve any obstruction

Question 46

pain worse followign meal

Answer 46

gastric ulcer chronic pancreatitis gallstones