wednesday 17th

Question 1

causes of metabolic alkalosis

Answer 1

hypokalaemia
loop diuretics
hyperaldosteronism
cushings
vomiting
liquorice

Question 2

casues of a metabolic acidosis with raised anion gap

Answer 2

K- ketones: DKA, Alcohol
U- urate : renal failure
L - actate- sepsis, shock , hypoxia, metformin
T - toxins : salicylic,methanol

Question 3

causes of a hyperchloreamic metabolic acidosis

Answer 3

addisons
diarrhoea
renal tubular acidosis
ureterosigmoidostomy

Question 4

side effects of 5-ASA drugs

Answer 4

mesalazine - agranulocytosis, pancreatitis, headache
sulfa- oligospermia, headache, lung fibrosis

Question 5

when shoudl prophylactic abx for SBP be offered? what one?

Answer 5

if ascitic protein <15g/l or had an episode of SBP
cipro

Question 6

what neutrophil count is diagnostic of SBP

Answer 6

> 250

Question 7

management of SBP

Answer 7

IV cefotaxime

Question 8

symptoms of SBP

Answer 8

ascites, fever, pain

Question 9

IX for budd chairir

Answer 9

USS with dopple flow

Question 10

what hormones do renal cell carcinomas produce

Answer 10

EP, PTH, ACTH

Question 11

what investigations should be done in a newly diagnosed cirrhotic patient

Answer 11

endoscopy for varices
USS for HCC(+AFP)

Question 12

serum and urine osmolality findings in. SIADH

Answer 12

low serum osmol
high urine osmol - dumping all sodium

Question 13

sodium high or low in diabetes insipidus

Answer 13

hypernatraemia

Question 14

serum and urine osmolalities in SIADH vs DI

Answer 14

SIADH - low serum osmol , high urine osmol
DI- high serum osmol, low urine osmol

Question 15

antibodies in addisons

Answer 15

anti-21-hydroxylase

Question 16

when do you measure cortisol in a short synachten test- what is a normal result

Answer 16

before giving and after 30 mins - normally cortisol should double

Question 17

most common cause of hyperaldosteronism

Answer 17

bilateral idiopathic adrenal hyperplasia

Question 18

what test can differentiate between bilat idio adrenal hyperplasia and adrenal adenoma causing conns

Answer 18

adrenal venous sampling

Question 19

first adn seconds investigatin in hyperaldosetrone

Answer 19

renin:aldosterone ration
high res CT following to find cause

Question 20

rhyme for remebering reflex spinal levels

Answer 20

1,2 buckle my shoe 3,4 kick the door 5,6 pick up sticks 7,8 shut the gate

Question 21

becks triad for cardiac tamponade

Answer 21

Distant heart sounds
Distended jugular veins
Decreased arterial pressure (low BP)

Question 22

drugs that potentiate warfarin eg. CYP450 inhib

Answer 22

ODEVICES

Omeprazole
Disulfiram
Erythromycin
Valproate
Isoniazid
Ciprofloxacin/Cimetidine
Ethanol (acute intoxication)
Sulphonamides

Question 23

drugs that decrease warfarin activity eg CYP450 inducers

Answer 23

PC BRAS

Phenytoin
Carbamazepine
Barbiturates
Rifampicin
Alcohol (chronically)
Sulphonylureas

Question 24

what diameter is bad sign for melanoma

Answer 24

> 6mm

Question 25

treatment of mild - mod UC proctitis

Answer 25

rectal 5-asa rectal 5-asa and oral 5asa rectal and oral 5asa + oral steroid

Question 26

remission therapy in UC

Answer 26

5-asa either rectally or orally

Question 27

maintenance therapy in UC if >2 exacerbations in a year

Answer 27

oral mercaptpurine or azathioprine

Question 28

mangement of chrons - lifestyle, inducing remission adn maintenance

Answer 28

lifestyle - STOP SMOKING inducing - steroids maintain oral azathio or mercaptopurine

Question 29

what cancers are most assoc with UC and Crohns respectively

Answer 29

UC - colorectal cancer Crohns - small bowel

Question 30

difference between low anterior resection and an abdominoperoneal resection

Answer 30

rectum removed in both anal canal left in anterior resection

Question 31

if you have a rectal cancer causing obstruction what is surgical tx

Answer 31

defunctioning loop colostomy

Question 32

treatment of colorectal caner obstruction

Answer 32

stent or resection

Question 33

lymphatic drainage above and below pectinate line

Answer 33

above - iliac below - inguinal

Question 34

symptoms of diverticulosis

Answer 34

pr bleed altered bowel habit abdo pain bloating

Question 35

abx for diverticulitis

Answer 35

co-amoxiclav

Question 36

complications of diverticulosis

Answer 36

Diverticulitis Haemorrhage fistula Perforation abscess diverticular phlegmon

Question 37

investigations in diverticular disease

Answer 37

FBC CRP erect CXR AXR CT?

Question 38

management of thrombosed haemorrhoids

Answer 38

if <72 hrs - excise if >72 hours - stool softeners analgesia

Question 39

initial mangement of bowel obstruction

Answer 39

NBM IV fluids nasogastric tube with free drainage

Question 40

what i sleft in subtotal colectomy

Answer 40

sigmoid and rectum

Question 41

what is worse with eating duodenal or gastric

Answer 41

gastric

Question 42

what inscision is used for an open cholecystectomy

Answer 42

kocher

Question 43

what inscion is used for a liver trasnplant

Answer 43

mercedes benz

Question 44

what inscions is used for a kidney transplant and where is it

Answer 44

LIF rutherford -morrison inscion

Question 45

how do you check NG placement

Answer 45

aspiration and pH