Gastroenterological

Question 1

Probiotic

Answer 1

Live miorrganism

1. Affect Pattern recognition receptor: work like immunoglobulin, a key innate immune system
2. Prevent pathogen colonization

Question 2

Lactulose intolerance

S&S
Physio

Answer 2

Lack of lactase–> increase lactose –> more carbon for bacteria

S&S: crampy pain, bloating, osmotic diarrhea

Question 3

Diarrhea type

Answer 3

Osmotic

Secretory: excessive mucosal secretion (toxins, tumours)

Motility: surgical

Question 4

H. Pylori

Answer 4

We all have H. Pylori. It cause problem for some people. Not all H. Pylori colonization causes problems

H. Pylori produces urease–> urease can cause pneumonia–> that’s why we can detect in breath test

Question 5

Peptic ulcer disease

Physio
Common cause
Type?

Answer 5

Mucosal destruction–> ulceration: lack of mucous batteri + acid

Loss plasma proteins–> loss albumin–> attract water–> mucosa edema

Common cause of PUD: NSAID, H. Pylori

Duodenal ulcer: pain relieved by food

Question 6

IBD

Major S&S
Types

Answer 6

Ulcerative colitis: surface lesion, rectum up
Crohn disease: deep skipped lesion. All GI tract: worse prognosis. (2/3 develops complication that need surgery)

Major S&S for both: weight loss, bloody diarrhea/ constipation, fever, abdominal pain

Therapy goal:
1. Control inflammation
2. Replace nutritional loss
3. Blood transfusion is needed

• control diarrhea agents should be used with caution

Question 7

IBS’s key feature

Etiology

Answer 7

Relief ed by bowel movement
Change of stool frequency or consistency

Cause: many theories, but not conclusive

Question 8

Celiac disease

Cause
S&S

Answer 8

Gluten intolerance
Genetic, autoimmune, inflamatory disorder of small intestine: HLA-DQ2, or 8

S&S: steatorrhea, wt loss, diarrhea, abd pain

Question 9

Saliva contains

Answer 9

IgA: prevent infection
Mucin: lubricant
Amylase: enzyme helps with carb digestion in mouth & stomach

Question 10

GERD treatment

Answer 10

Pantoprazole 40mg OD Q AM x 4 weeks, then reassess

Question 11

IBS diagnostic test and treatment

Answer 11

Diagnostic test: must exclude celiac disease

Treatment:

Diarrhea: soluable fibre, FODMAP, probiotic, amitriptyline 10mg Q HS

Constipation: soluable fibre, exercise, increase fluid intake, linaclotide 290mcg OD

Bloating: Buscopan 10-20mg TID