Gastrointestinal, Hepatic and Renal Disorders
Gastroenterology
Know GERD (alarm features, PPI trial, endoscopy indications), peptic ulcer disease (H. pylori testing/eradication), irritable bowel syndrome (Rome criteria, red flags), inflammatory bowel disease (distinguish Crohn vs UC), and coeliac disease (serology, duodenal biopsy).
Liver
Interpret liver enzymes: hepatocellular (ALT/AST) vs cholestatic (ALP/GGT). Know viral hepatitis serology (HBsAg, anti-HBc IgM, anti-HBs; HCV antibody/RNA), cirrhosis (Child–Pugh, MELD, varices, ascites, SBP), and drug-induced liver injury. NAFLD/MASLD is increasingly common with obesity and diabetes.
Renal
- AKI: KDIGO staging (creatinine, urine output); pre-renal vs intrinsic vs post-renal.
- CKD: eGFR and albuminuria categories (KDIGO heat map); complications - anaemia, CKD-MBD, acidosis.
- Urinalysis: haematuria, proteinuria, casts; nephritic vs nephrotic syndromes.
Traps
- Using single creatinine without baseline to diagnose AKI.
- Missing post-renal obstruction (bladder scan, catheter) in AKI.
- Confusing cholestatic with hepatocellular patterns.
- Ignoring red-flag GI symptoms (weight loss, dysphagia, anaemia) in IBS.
Worked rule
AKI with rising creatinine and low urine output: check volume status, medications (NSAIDs, ACEi), bladder scan, urinalysis, and electrolytes before imaging.