GASTROENTEROLOGY MRCP COMPREHENSIVE EXAM
QUESTIONS WITH DETAILED VERIFIED AND 100%
ACCURATE ANSWERS BRAND NEW EXAM ALREADY
GRADED A+ PASS
Crohn's vs. Ulcerative Colitis Ans✓✓✓Crohn's: Entire GI tract (mouth
ulcers to anus- perianal disease) may be involved.
Skip lesions.
Full thickness of bowel wall.
Gall stones + Oxalate Renal Stones
UC: Colon only. Bloody diarrhea.
Toxic megacolon.
Continuous lesions
PSC
Uveitis
Crohn's vs. Ulcerative Colitis Histology Ans✓✓✓CD: Deep ulcers,
skip: cobblestone appearance
UC: Crypt accesses, pseudopolyps, goblet cell depletion
No inflammation beyond submucosa
Crohn's: radiograph Ans✓✓✓Small Bowel Enema
Kantor's string sign
,rose thorn strictures
fistulae
ulcerative colitis radiograph Ans✓✓✓Barium Enema
Loss of haustrations
drainpipe colon
Crohn's investigations Ans✓✓✓CRP +ve, anemia,
Decreased Vit D, B12
Increased focal calprotectin
Crohn's treatment Ans✓✓✓goal: remission.
1. Glucocorticoids
2. 5 ASA Drugs
3. Azathioprine alternative: Methotrexate
4. Infliximab - refractory or fistulating
Crohns + perianal ulcers Mx Ans✓✓✓Isolated peri-anal disease:
Metronidazole
Crohn's: Maintaining remission Ans✓✓✓1. Stop smoking
2. 1st line: Azathioprine
3. 2nd line: Methotrexate
,4. If previous surgery: 5 ASA
T/F? Mouth ulcers can occur in Coeliac disease, but not Crohn's disease
Ans✓✓✓false can be seen in both
Before giving Azathioprine or Mercaptopurine Ans✓✓✓Thiopurine
methyltransferase (TPMT) activity
Ulcerative Colitis Treatment Ans✓✓✓1. 5-ASA preparations (e.g.,
mesalamine), 6-mercaptopurine,
2. Oral Steroids (fail to respond to ASA at least 4 weeks)
3. Sevre Colitis: iv steroids
Ulcerative Colitis Maintaining Remission Ans✓✓✓1. Oral ASA -
mesalazine
2. Azathioprine
3. MTX not recommended
Ulcerative colitis most commonly affected site Ans✓✓✓Rectum
Which disease has inflammation restricted to mucosa & submucosa? UC
or Crohn's. Where does the inflammation occur in the other one?
Ans✓✓✓UC has inflamm restricted to mucosa & submucosa.
Crohn's goes through to the serosa
, Sulphasalazine side effects Ans✓✓✓rashes, oligospermia and infertility
in men, headache,
Heinz body anaemia, megaloblastic anaemia
SJ Syndrome
cholestasis
pulmonary fibrosis
Mesalazine (delayed) side effects Ans✓✓✓Avoid side effects seen in
Sulphasalazine but still associated with side effects such as GI upset,
headache, agranulocytosis, pancreatitis, interstitial nephritis
Crigler-Najjar syndrome type I Ans✓✓✓* Symptoms: baby develops
persistent, marked jaundice after birth.
Lab Values: *Elevated unconjugated bilirubin.* Pathophysiology:
*Absent UDP-glucuronyl transferase. * Treatment: *Plasmapheresis and
phototherapy.
Unconjugated hyperbilirubinemia Ans✓✓✓Criggler-Najjar, Gilbert
Conjugated hyperbilirubinemia Ans✓✓✓Rotor
Dubin-Johnson (black liver)
QUESTIONS WITH DETAILED VERIFIED AND 100%
ACCURATE ANSWERS BRAND NEW EXAM ALREADY
GRADED A+ PASS
Crohn's vs. Ulcerative Colitis Ans✓✓✓Crohn's: Entire GI tract (mouth
ulcers to anus- perianal disease) may be involved.
Skip lesions.
Full thickness of bowel wall.
Gall stones + Oxalate Renal Stones
UC: Colon only. Bloody diarrhea.
Toxic megacolon.
Continuous lesions
PSC
Uveitis
Crohn's vs. Ulcerative Colitis Histology Ans✓✓✓CD: Deep ulcers,
skip: cobblestone appearance
UC: Crypt accesses, pseudopolyps, goblet cell depletion
No inflammation beyond submucosa
Crohn's: radiograph Ans✓✓✓Small Bowel Enema
Kantor's string sign
,rose thorn strictures
fistulae
ulcerative colitis radiograph Ans✓✓✓Barium Enema
Loss of haustrations
drainpipe colon
Crohn's investigations Ans✓✓✓CRP +ve, anemia,
Decreased Vit D, B12
Increased focal calprotectin
Crohn's treatment Ans✓✓✓goal: remission.
1. Glucocorticoids
2. 5 ASA Drugs
3. Azathioprine alternative: Methotrexate
4. Infliximab - refractory or fistulating
Crohns + perianal ulcers Mx Ans✓✓✓Isolated peri-anal disease:
Metronidazole
Crohn's: Maintaining remission Ans✓✓✓1. Stop smoking
2. 1st line: Azathioprine
3. 2nd line: Methotrexate
,4. If previous surgery: 5 ASA
T/F? Mouth ulcers can occur in Coeliac disease, but not Crohn's disease
Ans✓✓✓false can be seen in both
Before giving Azathioprine or Mercaptopurine Ans✓✓✓Thiopurine
methyltransferase (TPMT) activity
Ulcerative Colitis Treatment Ans✓✓✓1. 5-ASA preparations (e.g.,
mesalamine), 6-mercaptopurine,
2. Oral Steroids (fail to respond to ASA at least 4 weeks)
3. Sevre Colitis: iv steroids
Ulcerative Colitis Maintaining Remission Ans✓✓✓1. Oral ASA -
mesalazine
2. Azathioprine
3. MTX not recommended
Ulcerative colitis most commonly affected site Ans✓✓✓Rectum
Which disease has inflammation restricted to mucosa & submucosa? UC
or Crohn's. Where does the inflammation occur in the other one?
Ans✓✓✓UC has inflamm restricted to mucosa & submucosa.
Crohn's goes through to the serosa
, Sulphasalazine side effects Ans✓✓✓rashes, oligospermia and infertility
in men, headache,
Heinz body anaemia, megaloblastic anaemia
SJ Syndrome
cholestasis
pulmonary fibrosis
Mesalazine (delayed) side effects Ans✓✓✓Avoid side effects seen in
Sulphasalazine but still associated with side effects such as GI upset,
headache, agranulocytosis, pancreatitis, interstitial nephritis
Crigler-Najjar syndrome type I Ans✓✓✓* Symptoms: baby develops
persistent, marked jaundice after birth.
Lab Values: *Elevated unconjugated bilirubin.* Pathophysiology:
*Absent UDP-glucuronyl transferase. * Treatment: *Plasmapheresis and
phototherapy.
Unconjugated hyperbilirubinemia Ans✓✓✓Criggler-Najjar, Gilbert
Conjugated hyperbilirubinemia Ans✓✓✓Rotor
Dubin-Johnson (black liver)
