Mrcp Part 2 - Gastroenterology

Front 1

Bacterial overgrowth

Back 1

Small bowel diverticulae

B12 malabsorption - causes subacute cord degeneration

Folate excess as bacteria synthesise folate

Front 2

Small intestine dilation + oedema + fluid secretion which dilutes barium during its passage through small intestine

Back 2

Tropical sprue

Coeliac disease

Olmesartan-associated enteropathy

Scleroderma

Hypoalbuminemia

Anasarca

Front 3

Lymphocytic colitis

Back 3

One type of microscopic colitis. The other being collagenous colitis

Can co-exist with other colitis

Associated with long term NSAID, PPI, SSRI

Lymphocytic infiltrate on colonic bx

Treatment: budesonide

Front 4

Gardner's syndrome

Back 4

Autosomal dominant

Multiple intestinal polyps

Osteomas

Soft tissue tumour (epidermoid cysts, fibromas, lipomas)

Front 5

Hep B

Back 5

Compensated liver

- first line: peginterferon

- second line: tenofovir

Decompensated liver

- first line: tenofovir

Front 6

Autoimmune hepatitis

Back 6

Front 7

Fatty liver of pregnancy Vs cholestatis of pregnancy

Back 7

Fatty liver is associated with constitutional symptoms

Front 8

Bile acid malabsorption

Back 8

14C glycolate test

Previous ileal resection

Front 9

Calcification on AXR

Back 9

Hydatid disease

Porcelain gallbladder

Front 10

Whipple's disease

Back 10

Systemic disease caused by Tropheryma whippeli

Middle-aged European white men

Migratory arthralgia of large joints

Arthritis

Intermittent diarrhoea

Colicky abdo pain

CNS sx eg disinhibition

Periodic acid Schiff (PAS) stain positive on jejunal bx

1yr cotrimoxizole/tetracycline

Front 11

Budd chiari

Back 11

Think APLS

Raised APTT but normal PT

Front 12

UC

Back 12

pANCA

Hypoalbuminaemia

Crypt abscess

Front 13

Achalasia

Back 13

Nifedipine/ISDN

Botox

Front 14

Coeliac disease

Back 14

Associated with T-cell lymphoma (raised viscosity)

Anti-endomysial

Front 15

PBC

Back 15

Middle aged women

Itching

AMA

High ALP

High IgM

UDCA

Front 16

Hydatid disease

Back 16

Echinococcus granulosis

Percutaneous aspiration (PAIR procedure)

Albendazole

Front 17

Neuroendocrine tumour

Back 17

Carcinoid (ileum, appendix)

Pancreatic endocrine tumour (different from exocrine tumour eg adenocarcinoma)

Front 18

Carcinoid tumour

Back 18

Serotonin

Substance P

Front 19

Pancreatic endocrine tumour

Back 19

Front 20

CMV colitis

Back 20

Associated with UC treated with immunosuppressant

Inclusion bodies on biopsy

Treat with ganciclovir

Front 21

Wilson's disease

Back 21

Trientene/penicillamine/zinc supplement

ATP7B gene faulty - H1069Q mutation most common in Caucasian, whereas R778L is more common in China

PRNP gene variant may delay onset

Front 22

FMF

Back 22

Recurrent acute abdomen (normal laparotomy)

Treatment: colchicine

Front 23

Cowden syndrome (PTEN defect)

Back 23

Hamartomatous polyps

Oral mucosal papilloma

Palmoplantar keratosis

Trichilemmomas

Associated with breast and thyroid disorder

Front 24

Schistosomiasis (Mansoni)

Back 24

Periportal fibrosis

Front 25

Toxic megacolon

Back 25

IV ciclosporin

Front 26

Colonoscopy interval for familial syndromes

Back 26

1 year - high risk patients (5 or more adenomas less than 10mm, or 3 or more adenomas larger than 10mm)

3 years - intermediate risk (3-4 adenomas less than 10mm, or 1-2 adenomas larger than 10mm)

5 years - low risk

Front 27

FAP Vs HNPCC

Back 27

Front 28

Haemochromatosis

Back 28

Bronze diabetes

Genetics

HFE gene - C282Y mutation most common in white population, followed by H63D