Week 7

Question 1

How many units are in a large glass of wine?

Answer 1

3.5

Question 2

How many units are in a vodka shot?

Answer 2

1 unit

Question 3

How many units are in a regular pint of beer?

Answer 3

2

Question 4

Man aged 60 presents with haemetemysis, haemetegelsia, a raised urea and dysphagia. He has a diet low in fibre, smokes and upon investigation has an infection with H. Pylori. Diagnosis?

Answer 4

Gastric ulcer

Gastric cancer

Question 5

Man is diagnosed with squamous cell carcinoma. Treatment?

Answer 5

Sensitive to radiotherapy and chemotherapy

Question 6

Man is diagnosed with adenocarcinoma what is the treatment?

Answer 6

Chemotherapy then surgical resection

Question 7

You suspect gastric cancer, investigation?

Answer 7

Endoscope
PET scan (mainly to see if metastasised)

Question 8

What are the four types of diarrhoea?

Answer 8

Secretory
Hypermobility
Osmotic
Exudative/inflammatory

Question 9

What can cause secretory diarrhoea?

Answer 9

Cholera by stimulating CTFR that secretes Cl- ions into lumen causing sodium and water to follow

Question 10

What condition causes hypermobility diarrhoea?

Answer 10

Coeliac disease

Reduced transit time causing malabsorption and diarrhoea

Question 11

What condition can cause osmotic diarrhoea?

Answer 11

Glucose/ galactose malabsorption syndrome

Due to defective ion transport causing solutes in lumen to fail to be broken down meaning it is hypertonic and water will flow into it.

Question 12

What can cause exudative (inflammatory) diarrhoea?

Answer 12

Crohns, ulcerative colitis, E.coli, infective colitis

Question 13

What can cause pseudomembraneous colitis?

Answer 13

C. Difficile infection

Can be secondary to antibiotic use

Question 14

Define acute liver disease

Answer 14

Rapid development of hepatic dysfunction without prior liver disease lasting less than 6 months

Question 15

What two vessels supply the liver?

Answer 15

Hepatic artery

Hepatic portal vein

Question 16

Women presents with an itch secondary to primary biliary cirrhosis, what do you prescribe?

Answer 16

Uresodeoxycholic acid

Question 17

Young women presents with rapid onset of jaundice and encephalopathy. You discover she has overdosed on paracetamol. Treatment?

Answer 17

N- Acetylcysteine which is then broken down into glutathione that neutralises the toxic metabolites of paracetamol

Question 18

What is fulminant hepatic failure?

Answer 18

Rapid development of acute liver injury with severe impairemnt of synthetic function and hepatic encephalopathy in patients without previous liver disease

Question 19

What is FRAMES used for?

Answer 19

A guideline for delivering a brief intervention of alcohol

Question 20

What does the F in frames stand for?

Answer 20

Feedback about personal risk of impairment

Question 21

What does the R in frames stand for?

Answer 21

Responsibility; emphasis on personal responsibility to change

Question 22

What does the A in frames stand for?

Answer 22

Advice to cut down or abstain from drinking

Question 23

What does the M in frames stand for?

Answer 23

Menu of options for making changes and setting targets. How confident about his change on a scale of 1-10. What would makeyou feel more confident?

Question 24

What does the E in frames stand for?

Answer 24

Empathetic interviewing; listening reflectively without trying to persuade or confront

Question 25

What does the S in frames stand for?

Answer 25

Self-efficacy and interviewing style that promotes peoples belief in their ability to change

Question 26

What is the weekly recommendation for alcohol consumption?

Answer 26

14 units a week spread evenly over 3 days or more with two non-drinking days

Question 27

What are some alcohol screening tools?

Answer 27

FAST; asking about drinking habits | AUDIT

Question 28

Female aged 41 presents with worsening pain in the right upper quadrant, it radiates to the back and shoulder. She gets nausea and indigestion simultaneously. She is also obese with a high fat diet. Likely diagnosis?

Answer 28

Gall stones 5F’s (forty, female, fat diet, fat (obese), fetus)

Question 29

When diagnosing for gallstones, what is the best investigation?

Answer 29

Ultrasound CT can give good picture of other organs too HIDA; nuclear medicine looking at gallbladder mobility

Question 30

Women presents with known gallstones now with jaundice, is itchy, nauseated and has abnormal LFTS. Diagnosis and treatment?

Answer 30

Gallstone blocking common bile duct. ERCP to remove gallstones

Question 31

What can blocking the ampulla of vater cause?

Answer 31

Acute pancreatitis by pancreatic enzymes backlogging into the pancreas causing inflammation

Question 32

What is the cause of a gallstone ileus?

Answer 32

A large gallstone erroding the wall of the gallbladder and entering the duodenum to then block the ileum

Question 33

What must a bacteria be inorder to be multi-drug resistant?

Answer 33

Resistant to at least one drug in 3 different antibiotic categories