Functional bowel disease

Question 1

Triad of IBS

Answer 1

Abdominal pain, bloating and abnormal bowel habits

Question 2

What reflex is exaggerated in IBS

Answer 2

gastro-colonic reflex

Question 3

Anti-Diarrhoeal used in IBS

Answer 3

loperamide

Question 4

laxative to avoid in IBS

Answer 4

lactulose

Question 5

Best drugs for IBS

Answer 5

antidepressants - TCA 10th dosage - good for diarrhoea

Question 6

Mechanism of 5HT drug in diarrhoea IBS

Answer 6

5HT3 antagonist - they have too much 5HT

Question 7

mechanism of 5HT drugs in constipation IBS

Answer 7

5HT4 agonist - they don’t have enough example - Renzapride

Question 8

What is Prucalopride

Answer 8

5HT4 agonist approved for IBS

Question 9

Anti spasmodic used in IBS

Answer 9

mebeverine

Question 10

Three gastro differentials for vomitting, diarrhoea and pyrexia

Answer 10

A. Infectious gastroenteritis – viral or bacterial
B. Inflammatory bowel disease
C. post-infectious IBS

Question 11

Sudden onset of diarrhoea

Answer 11

invective

Question 12

Blood in diarrhoea

Answer 12

dysentery and in inflammatory bowel disease

Question 13

Mucus in stools

Answer 13

IBD and IBS

Question 14

Complication of C Diff

Answer 14

pseudomembranous colitis which can lead to toxic megacolon and colonic perforation

Question 15

Treatment of C diff

Answer 15

ORAL vancomycin, metronidazole or fidaxomicin.

Question 16

Virus that gives young children diarrhoea

Answer 16

rotavirus

Question 17

Drugs that can casue diarrhoea

Answer 17

antibiotics, antiacids and anti-motility agents

Question 18

Managements of acute diarrhoea

Answer 18

fluids, fluids, fluids - ORS

Question 19

If diarrhoea lasts more than ten days what should you suspect?

Answer 19

parasitic causes

Question 20

Test for acute diarrhoea

Answer 20

stool culture

Question 21

If someone has been in hospital for more that how many days do you suspect nosocromial diarrhoea?

Answer 21

more than three days - suspect C diff

Question 22

Which ecoli causes a lot of acute diarrhoea?

Answer 22

E.coli H7:O157 (E 0157)

Question 23

Campylobacter treatment

Answer 23

macrolide

Question 24

Campylobacter transition

Answer 24

feocal oral

Question 25

Should you always treat campylobacter?

Answer 25

No, if bad macrolide or quinolone

Question 26

EHEC complications

Answer 26

heamolytic ureamic syndrome. Caused by shiga-like toxins. profuse bloody diarrhoea

Question 27

Does Salmonella cause dysentry?

Answer 27

Salmonella Typhi and paratyphi don’t

Question 28

Enteric fever cause

Answer 28

Salmonella typhi and paratyphi. constipation more common than diarrhoea - culture blood stool and urine

Question 29

UK type of shigella that is mild

Answer 29

S. sonnei

Question 30

E coli and shigella complications

Answer 30

Haemolytic ureamic syndrome and toxic megacolon

Question 31

Acid fast staining for

Answer 31

Mycobacteria i.e TB

Question 32

Endrocrine cause of diarrhoea

Answer 32

hyperthyroidism

Question 33

Malabsorption diarrhoea

Answer 33

Giardia lamblia. Fat and cysts in stools

Question 34

Giardia treatment

Answer 34

Metronidazole or tinidazole

Question 35

Cause of Ameobiasis

Answer 35

Entamoeba histolytica

Question 36

Abscess caused by entamoeba histolytica

Answer 36

Liver ameobiasis abscess

Question 37

Amoebiasis treatment

Answer 37

metronidazole and luminal cysticide

Question 38

Important differential for amoebiasis

Answer 38

IBD

Question 39

Chronic diarrhoea caused by parasites

Answer 39

schistosomiasis

Question 40

What disease to directly test for in someone with diarrhoea

Answer 40

HIV

Question 41

Stool test for IBD vs IBS

Answer 41

faecal calprotectin