Diarrhoea & GORD

Question 1

Is this secretory or osmotic diarrhoea: Mod stool volume, drha stops in response to fasting, stool osmolality may be increase.

Answer 1

Osmotic

Question 2

Is this secretory or osmotic diarrhoea: V large volume, drha continues in response to fasting, stool osmolality normal.

Answer 2

Secretory

Question 3

45 yo man with pain in abdomen, through to back, worse when hungry. Symptoms persist for few weeks then settle for months.

Answer 3

Peptic ulcer possible

Question 4

These cells in the antrum of the stomach produce gastrin

Answer 4

G cells (G & D cells = “get down” ie in antrum of stomach)

Question 5

These cells in the antrum of the stomach produce somatostatin

Answer 5

D cells (G & D cells = “get down” ie in antrum of stomach)

Question 6

What should not be prescribed to a woman of child bearing age

Answer 6

Misoprostol (prostaglandin)

Question 7

Increased risk of C. difficile infection, osteoporosis fractures and community aquired pneumonia are assoc with long term use of what medication

Answer 7

PPIs e.g. omeprazole

Question 8

H2 receptor antagonists (Ranitidine, Cimetidine, Nizatidine etc.) are required in High dose for what syndrome

Answer 8

Zollinger Ellison

Question 9

Domperidone and metclopramide are what type of drugs

Answer 9

Gastric stimulanst - incr peristalsis in sm intestine

Question 10

Cimetidine (H2 receptor antagonist) INHIBITS what enzyme

Answer 10

CYP450

Question 11

What would you add to antibiotic regime to eradicate H pylori

Answer 11

Omeprazole (PPI)

Question 12

Ranitidine is MOSTLY excreted via kidneys or liver?

Answer 12

Kidneys

Question 13

Omeprazole is MOSTLY excreted by kidneys or liver?

Answer 13

Liver

Question 14

Omeprazole can increase the effects of what drug?

Answer 14

Warfarin

Question 15

These cells in the body/ fundus of the stomach secrete gastric acid, which converts pepsinogen to pepsin

Answer 15

Parietal cells (think, high in stomach - fundus)

Question 16

Crypts of lieberkuhn in sm. intestine - what type of cells are produced

Answer 16

Stem cells - replace epithelial cells

Question 17

Goblet cells - produce what mainly

Answer 17

Mucus

Question 18

Three tests for H pylori infection (non endoscopic)

Answer 18

1. Serology - H pylori IgG antibodies
2. Urea Breath Test - (only perform 2 wks after stopping PPIs)
3. Stool antigen test (Paeds)

Question 19

What cell changes (metaplasia) occur in Barrett’s oesophagus (possible after prolonged GORD)

Answer 19

Oesophageal squamous cells become columnar epipthelium similar to stomach.

Question 20

Chief cells located where and produce what

Answer 20

Body / fundus of stomach - produce pepsinogen (which is converted to pepsin by gastric acid)

Question 21

Which cells in the duodenum produce secretin in response to incr. acidity when stomach chyme enters gut.

Answer 21

S cells

Question 22

4 fat soluble vitamins

Answer 22

A D E K

Question 23

Where is Vit B12 absorbed

Answer 23

Distal ileum (needs Intrinsic Factor prod by stomach)

Question 24

Where are Iron, Calcium, Mg and Zn absorbed

Answer 24

Duodenum

Question 25

Other than Vits A D E K, what else is absorbed in Jejenum

Answer 25

Glucose, AAs & peptides, Folate (and some Calcium)

Question 26

Which clotting factors are Vit K dependant (4)

Answer 26

2, 7, 9, 10