Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gastrointestinal > Dyspepsia And GORD > Flashcards

Dyspepsia And GORD Flashcards

1
Q

Dyspepsia symptoms

A

Upper GI symtpoms
Upper abdominal pain/discomfort
Acid reflux, heartburn
Nausea and vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Dyspepsia is causes by

A

Increased acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How long do symptoms of dyspepsia last

A

Usually 4 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Lifestyle management of dyspepsia

A

Smoking cessation
Sleep with raised head of bed
Stress/anxiety management
Avoid spicy foods, alcohol
Weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Red flags of dyspepsia

These would require what management?

A

55+ with new onset or not responding to treatment

Bleeding
Dysphagia
Recurrent vomiting
Weight loss

ENDOSCOPY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe the 2 types of dyspepsia

A

Functional - symptoms present but no ulcers/ cause

Uninvestigated - symptoms present but not had an endoscopy yet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which drugs cause dyspepsia

A

Aspirin
NSAIDs
Alpha blockers
Beta blockers
CCB
Antimuscarinics
Bisphosphonates
Corticosteroids
Benzodiazepines
Nitrates
TCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How long can antacids/ alginates be used for

A

Short term use only

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Functional dyspepsia treatment

A

Lifestyle measure
Offer PPI/ H2 antagonist prn

Test for H.pylori and treat if present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Uninvestigated dyspepsia treatment

A

Test for H.pylori and treat if present, if not present:

Offer PPI or H2 antagonist for 4 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why do we leave a 2 week period between taking a PPI and testing for H.pylori

A

Washout period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Whats a washout period in dyspepsia

A

Leaving a 2 week interval between stopping PPI and testing for H.pylori

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

A patient has dyspepsia but is on NSAIDs, he cant stop these NSAIDs. What do you do

A

Switch to paracetamol or cox2 inhibitor

Or

Reduce dose and use long term PPI/H2 antagonist alongside

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Whats are examples of a Cox 2 inhibitor, what risk is associated with them

A

Etoricoxib
Celecoxib

Risk if CV events

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

In patients with uninvestigated dyspepsia unable to stop aspirin ……

A

Switch to alternative antiplatelet- clopidogrel, pyridamole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is GORD

A

Acid regurgitation/ heart burn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Red flags of GORD

What causes them

A

Chest pain
Cough
Wheezing
Asthma
Hoaresness of voice

Caused by acid moving to the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Complications of GORD

A

Barretts oesophagus
Oesophagus inflammation
Anaemia due to blood loss
Aspiration pneumonia
Stricture
Ulceration
Bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Treatment of GORD

A

PPI, anatacids, alginates, H2 antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Treatment of GORD in pregnancy

A

Lifestyle
Low sodium antacids, alginates
Omeprazole or ranitidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which PPI is the only safe one in pregnancy

A

Omeprazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When is Omeprazole used in GORD in pregnancy

A

Severe symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

GORD infants treatment <12 yrs and > 12 yrs

A

<12 yrs - change freq and volume of feed, use thickner

> 12 yrs - treat like adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

GORD counselling and patient advice

A

Eat small meals slowly and not at bedtime

Avoid precipitating factors

Sleep with head raised

Lose weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Which groups of patients would you avoid high sodium antacids

A

Pregnant
Hypertension
Liver or kidney failure
Sodium restricted diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which antacid would you avoid in a constipated patient

A

Aluminium containing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What antacid would you avoid in diarrhoea

A

Magnesium containing

28
Q

Which are more effective- liquid or tablet antacids

A

Liquid

29
Q

Can you give antacids with other medication

A

Leave 2 hrs between as can affect absorption if other meds and can damage enteric coating in some MR tabs

30
Q

Avoid sodium bicarbonate in those taking ……. Or have these conditions ……

A

Lithium

High BP, salt restricted diet, fluid retention

31
Q

Lithium and sodium bicarbonate interaction

A

Sodium bicarbonate reduces lithium concentration

32
Q

Which antacids provide quick relief (how long?) But its effects dont last long

A

SCAM

Sodium bicarbonate
Calcium bicarbonate
Aluminium hydroxide
Magnesium hydroxide

33
Q

What is low sodium content? Values

A

< 1mmol/ tablet or

10ml dose

34
Q

Which antacids have low sodium content

A

MAM

Co- magaldrox (MAALOX and mucogel)
Co- simalcite (altacite plus)

35
Q

What drugs are in co- magaldrox

A

Magnesium and aluminium

36
Q

What drugs are in co simalcite

A

Simethicone and hydrotalcite

37
Q

Which antacids have high sodium content

A

Sodium alginate with potassium bicarbonate- gaviscon advance

38
Q

Gaviscon advance and normal gaviscon difference

A

Gaviscon advance has double sodium

39
Q

PPI examples

A

Omeprazole
Esomeprazole
Lansoprazole

40
Q

Monitoring requirements for PPI

A

Monitor serum magnesium when using other drugs causing hypomagnesia or with digoxin

41
Q

PPI MHRA warning

A

May cause lupus (skin reactions)
- lesions on skin when exposed to sun

42
Q

A patient is on Omeprazole and develops lupus, what do you do?

A

Reduce or stop (reversible when PPI stopped)

43
Q

Hypomagnasaemia symptoms

A

Convulsions
Muscle pain/ weakness

44
Q

PPI cautions

A

MC GOLF

magnesium (causes hypomagnesia)
Cancer (masks symptoms)
GI infections - c.diff risk increased
Osteoporosis (maintain vit D and calcium)
Lupus
Fractures

45
Q

Omeprazole interactions

A

AVOID CLOE
Clopidogrel interacts with omeprazole and esomeprazole - they decrease clopidogrels efficency

Decreases METHOTREXATE clearance- use with caution or avoid

Digoxin- monitor magnesium

46
Q

Which PPI can u use in breastfeeding

A

All but with caution

47
Q

H.pylori symptoms

A

Burning pain in stomach

48
Q

Tests used to diagnose h.pylori

A

Stool antigen test

Urea 13C- most common

49
Q

Washout periods of h.pylori prevent false negatives, explain this

A

Wait 4 weeks after stopping antibx before getting tested

Wait 2 weeks after stopping PPI before getting tested

50
Q

Duration of antibx treatment for h.pylori

A

7 days - 1st and 2nd line

10 days - 3rd line

51
Q

Treatment used for h.pylori in non penicillin allergy

A

Triple therapy for 7 days otherwise refer

  1. PPI + amoxicillin + metronidazole or clarithromycin
  2. PPI + amoxicillin + tetracycline (if metro or clarithromycin recently used)
  3. PPI + bismuth + 2 antibx not used before or with rifabutin or furazolidone
52
Q

Treatment for H.pylori in penicillin allergy

A
  1. PPI + metronidazole + clarithromycin
  2. PPI + metronidazole + tetracycline + bismuth (if clarithromycin recently used)
  3. PPI + metronidazole + levofloxacin

All used for 7 days each

53
Q

What is bismuth subsalicylate

A

Anti diarrhoeal drug

54
Q

Rifabutin and furazolidone are…..

Used in…..

A

Antibiotics used in h.pylori

55
Q

Clarithromycin + ciclosporin interaction

A

Increases concentration of ciclosporin

56
Q

Cimetidine and phenytoin interaction

A

Increases concentration of phenytoin

57
Q

PPI doses in H.pylori

A

Omeprazole 20-40mg BD

rabeprazole 20mg BD

Esomeprazole 20mg BD

lansoprazole 30mg BD

Pantoprazole 40mg BD

58
Q

GI protectors and chelators protect …..

Describe an example

A

Protect stomach lining

Sucralfate is a chelate. It contains sucrose and aluminium and is given late (bedtime).
Given 1hr before meal or enteral feeds

59
Q

Sucralfate - be careful in which patients and why

A

Intensive care as they can cause bezoar formation which is a solid indigestible mass which blocks enteral feeding tubes

60
Q

Whats a bezoar formation

A

Solid indigestible mass

61
Q

H2 receptor antagonist examples

A

Ranitidine
Famotidine
Cimetidine

62
Q

H2 receptor antagonist MOA

A

Heal gastric/ duodenal ulcers
Relieves GORD symptoms

63
Q

Avoid H2 receptor antagonists in which syndrome

What is it and what can be given as an alternative

A

Zollinger ellisone syndrome (stomach tumour causing increased acid)

PPI more effective

64
Q

Which h2 receptor antagonist is safe in pregnancy

A

Ranitidine

Famotidine and cimetidine- avoid unless essential and benefit outweighs risk

65
Q

H2 receptor antagonist caution!!

A

Masks symptoms of GI cancer

66
Q

SE of h2 receptor antagonist

A

Diarrhoea
Constipation
Dizziness
Headaches
Myalgia
Fatigue

67
Q

What is misoprostol
Indication
Caution

A

Synthetic prostaglandin analogue
- helps heal duodenal and gastric ulcers

Caution in child bearing women, exclude pregnancy and ensure contraception is in place - teratogenic

Gastrointestinal (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions