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PY6040 > Dyspepsia and Haemorrhoids > Flashcards

Dyspepsia and Haemorrhoids Flashcards

1
Q

Dyspepsia

A
  • Indigestion

- Concerns upper GIT

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2
Q

Rome IV criteria of dyspepsia

A
  1. prolonged persistence of food in stomach (postpranial fullness)
  2. early satiation (unable to eat full meal/full after eating small amount)
  3. epigastric pain
  4. epigastric burning
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3
Q

Symptoms of dyspepsia

A
  • Upper abdominal pain
  • Heartburn
  • Acid reflux
  • Bloating
  • Belching (burping)
  • Flatulence
  • Intolerant to some foods
  • Symptoms fluctuate
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4
Q

Aetiology of dyspepsia

A
  • smoking
  • alcohol
  • obesity
  • pregnancy
  • lifestyle (lack of exercise/diet/stress)
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5
Q

When to refer for dyspepsia

A
  • Signs of bleeding
  • dysphagia (swallowing difficulty)
  • unintended weight loss
  • persistent vomiting
  • iron deficiency anaemia
  • epigastric mass
    2 WEEK REFERAL RULE
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6
Q

Lifestyle measures

A
  1. Lose weight
  2. Stop smoking
  3. Reduce alcohol intake
  4. Avoid fatty foods and caffiene
  5. Raise head when sleeping
  6. Avoid tight fitting clothes
  7. Leave atleast 2 hours between eating and bedtime
  8. Dealing with stress
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7
Q

Alginates

A

GAVISCON

  • Forms raft on stomach contents
  • Protects gastric mucosa
  • Symptomatic relief from reflux
  • Gaviscon exacerbates hypertension so Gaviscon advanced is recommended as it has reduced salt and Cl-
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8
Q

Antacids

A

RENNIE AND TUMS

  • Neutralise stomach acid
  • Fast acting (1 hour)
  • Impair absorption of other drugs
  • Aluminium = constipation
  • Magnesium = diarrhoea
  • Use in combination to reduce effects
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9
Q

H2RA and PPI

A
  1. H2RA
    - Block H2R in parietal cell
    - fast acting (1 hr)
  2. PPI
    - Use lowest effective dose
    - Blocks H+ K+ ATPase
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10
Q

GORD in children

A
  • Sphincter muscles are not mature and prevent backflow of feed
  • Food and acid mixes
  • Irritates lining of GI making it sore
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11
Q

Symptoms of GORD in children

A

Spitting up/regurgitation of food, abdominal pain, general crankiness, frequent chest infection from inhaling stomach contents into lungs, surface of oesophagus becomes inflamed leading to scarring and narrowing

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12
Q

Gaviscon Sachets

A
  • Thickens food
  • Physical barrier to food coming back
  • Simethicone forms raft on top of food

BREAST FEEDING:

  • Mix sachet with 5ml of boiled and cooled water
  • Add another 10ml of boiled and cooled water
  • Give halfway through feeding

BOTTLE FEEDING:
- Mix sachet with 115ml of milk

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13
Q

Domperidone

A
  • For when nothing else works
  • Arrhythmias - ST elevation prolonged
  • Baseline ECG
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14
Q

What is haemorrhoids?

A
  • Swellings that develop inside and around the anal canal
  • Bleeding is common
    INTERNAL:
  • 2-3cm inside anus
  • Often painless
    EXTERNAL:
  • Lower part of anal canal
  • Painful
    Examined by GP using proctoscopy or two fingers by feeling around the area
  • Common due to ageing, during/after pregnancy, prolonged straining, genetic factors
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15
Q

Symptoms of haemorrhoids

A
  • Bleeding on defecation
  • Pain/discomfort
  • Pruritus(Itch)/tender lumps around anus
  • Mucus discharge
  • Feeling of incomplete defecation
  • Partial inconsistence
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16
Q

When to refer for haemorrhoids

A
  • No response to OTC
  • Longer than 3 weeks
  • Excessive bleeding with changes in bowel habits/weight loss
  • Blood in stools
17
Q

Lifestyle measures for haemorrhoids

A
  • Increase dietary fibre
  • Increase fluid intake
  • Good hygeine
  • Avoid straining
  • Suitable pain relief i.e. paracetamol
18
Q

AnuSol

A

Topical

  • Zinc oxide, Allatoin, Balsalm of Peru
  • Emollient and protective properties
  • Prevent local irritation
19
Q

Local Anaesthetics

A
  • Lidocaine, Cinchocaine, Proctadesyl
  • Alleviates pain, itching and burning
  • Use max for 5 days - can cause sensitisation of perianal skin
20
Q

Topical corticosteroids

A

Hydrocortisone, AnuSol HC

  • Reduces inflammation
  • Alleviates pain
  • Use max for 7 days
21
Q

Astringent agents

A

Bismuth oxide and witch hazel

  • Proteins are precipitated into the skin
  • Forms a protective layer
  • Reduces inflammation and irritation
22
Q

Bulk forming laxative

A

Fybogel, Ispahgu

23
Q

Injection sclerotherapy

A
  • Phenol oil injected into submucosa of rectum
  • Causes collapse inducing fibrotic reaction
  • Atrophy of haemarrhoid
24
Q

Rubber band ligation

A
  • Strangles haemarrhoid
  • No perfusion of blood to haemarrhoid
  • Necrosis/death
25
Q

Surgery

A
  • Haemarrhoidectomy

- Stapled haemarrhoidectomy

PY6040 (23 decks)

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