UKMLA Applied Knowledge Test (MSRA-style single best answer) · Gastroenterology, Renal, Urology and Endocrinology

Gastroenterology and hepatology

13 practice questions, each with the answer and an explanation.

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Random questions from this topic, one at a time. You see the answer and the explanation straight after each one.

All 13 questions

  1. Which test is first-line to screen for coeliac disease in an adult who is still eating gluten?
  2. A 24-year-old has bloody diarrhoea with continuous inflammation from the rectum proximally, crypt abscesses on biopsy and no perianal disease. Which is the most appropriate first-line treatment for a…
  3. A man has epigastric pain radiating to the back and vomiting after a heavy night of drinking. According to the usual diagnostic criteria, which finding is needed to confirm acute pancreatitis along wi…
  4. A 68-year-old has right upper quadrant pain, fever and jaundice, and is hypotensive and confused. Gallstones are seen on ultrasound with a dilated common bile duct. What is the most appropriate treatm…
  5. A patient's hepatitis B serology shows HBsAg negative, anti-HBc negative and anti-HBs positive. What is the correct interpretation?
  6. A patient with cirrhosis becomes confused, with a flapping tremor after a gastrointestinal bleed. What is the first-line treatment for hepatic encephalopathy?
  7. A patient with ascites and abdominal pain has an ascitic fluid neutrophil count above 250 cells per mm3. What is the diagnosis and treatment?
  8. A 45-year-old with dyspepsia tests positive for Helicobacter pylori. What is the usual eradication regimen in the UK?
  9. A 62-year-old man has painless, progressive difficulty swallowing solids and 6 kg weight loss. What is the most appropriate action?
  10. A middle-aged woman has fatigue, itching and a raised alkaline phosphatase. Antimitochondrial antibodies are positive. Which drug is used to slow the disease?
  11. Which laboratory pattern is most suggestive of alcohol-related liver disease rather than viral hepatitis?
  12. A man is admitted with haematemesis. His Glasgow-Blatchford score is 0. What does NICE suggest?
  13. A 28-year-old woman has abdominal pain relieved by defaecation, bloating and alternating bowel habit without red flag features. What is the most appropriate initial management?

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