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1 General Practice > Gastroenterology > Flashcards

Gastroenterology Flashcards

1
Q

List two predisposing factors for IBS

A

History of GI infection
Genetic
Adverse childhood events or psych factors
female

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2
Q

What are the red flags for change in bowel habit?

A

> 50
rectal bleeding
weight loss
family history bowel/ovarian cancer
change in bowel habit

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3
Q

What is the three step process for diagnosing IBS?

A
  1. Suspect diagnosis- symptoms abdo pain, bloating, change in bowel habit for over 6 months
  2. Exclude other conditions
  3. Positive diagnostic criteria for IBS
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4
Q

List three investigations for change in bowel habit

A

FBC, coeliac, CRP
Faecal calprotectin
FIT- for those WITHOUT rectal bleeding
CA125

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5
Q

List two positive diagnostic criteria for IBS

A
  1. Abdo pain relieved by defaecation
  2. Change in stool frequency
  3. Altered stool passage- straining, urgency…
  4. Abdo bloating, distension, hardness
  5. Symptoms worsened by eating
  6. Passage of mucus
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6
Q

List the three types of IBS

A

IBS-D= diarrhoea predominant
IBS- C= constipation
IBS-mixed

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7
Q

List three options for the management of IBS

A

Lifestyle- diet and exercise
Antispasmodics for pain
Laxatives for constipation
Loperamide for diarrhoea
TCAs
SSRIs

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8
Q

Define dyspepsia

A

Describes range of symptoms= indigestion
Discomfort or pain in upper abdomen after eating or drinking

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9
Q

What does univestigated dyspepsia mean?

A

dyspepsia that has not been investigated with endocscopy

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10
Q

List three differentials for dyspepsia

A

Functional dyspepsia
OEsophagitis
Oesophageal ulcers
Benign oesophageal strictures
Gastric or duodenal ulcers
Oesophageal or gastric cancers

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11
Q

Patient who is on NSAIDs and omeprazole requires endocoscopy. How long before the endoscopy should they stop taking these medications for?

A

2 weeks before endoscope

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12
Q

List the red flags for urgent endoscopy investigation to rule out cancer

A

Upper abdo mass (Stomach cancer)
Dysphagia
>55 with weight loss and upper abdo pain/reflux/dyspepsia
Haematemesis

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13
Q

Patient has experienced significant weight loss but upper GI endoscopy is normal. Which diagnosis should you consider?

A

Pancreatic cancer- urgent CT if weight loss, >60, and diarrhoea, nausea/vomiting, abdo pain, back pain, new onset diabetes!!!!

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14
Q

List three options for management of uninvestigated dyspepsia

A

NSAIDs
Corticosteroids
Nitrates
Theophyllines
Bisphosphonates
Lifestyle

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15
Q

State three lifestyle changes to manage univestigated dyspepsia

A

weight loss
smoking cessation
reduce alcohol, chocolate, coffee
avoid fatty foods
have evening meal well before bed
raised the head of the bed

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16
Q

Patient with dyspepsia has tried lifestyle modifications and NSAIDs but dyspepsia is still present. What should you do now?

A

Trial PPI for 1 month

17
Q

There is no response to PPI treatment. What do you do now?

A

Test for H.pylori

18
Q

List two methods for investigating H.pylori

A

Carbon-13 urea breath test
Stool antigen test

19
Q

What is the H.pylori eradication regimen if person has not previously had antibiotics?

A

Clari or Met
Amox
Twice daily PPI

20
Q

Patient has to stop using PPI for 2 weeks prior to H. pylori testing. What can you offer them as an alternative?

A

H2 receptor blocker

21
Q

List two modifiable risk factors for bowel cancer

A

red meat and processed meat
obesity
alcohol
smoking

22
Q

List two non-modifiable risk factors for colon cancer

A

male
older age
family history
IBD
diabetes

23
Q

List one hereditary cancer that predisposes to bowel cancer

A

familial adenomatou polyposis FAP
hereditary non-polyposis colorectal cancer HNPCC

24
Q

List two contraindications/disadvantages of colonoscopy

A

Bowel prep may decomponsate certain groups of patients e.g. heart failure, renal failure
May cause decreased absoroption of antiepileptics
Bowel prep may need to be done in hospital

25
Q

If you are allergic to X then you cannot have CT colon

A

iodine

26
Q

List two advantages of CT colon over colonscopy

A

No sedation required, can pick up other abdo pathology
Sensitivity similar to colonoscopy

27
Q

List two drugs that are contrainidicated for colonscopy?

A

deydrating drugs e.g. diuretics
Drugs that are dangerous in hypokalaemia e.g. lithium, digoxin, steroids, carbamazepine

28
Q

What is the colon cancer screening programme in Scotland?

A

men and women aged 50-74 every 2 years. Self-administered FIT test kit

29
Q

Where are diverticulum typically located?

A

sigmoid colon

30
Q

List two drugs that should be avoided in diverticular disease

A

NSAIDs and opioids due to diverticular perforation risk

31
Q

When would you suspect acute diverticulitis?

A

fever, abdo pain in left lower quadrant, sudden change in bowel habbit, history of diverticular disease

32
Q

Which antibiotic for acute diverticulitis?

A

co-amoxiclav

33
Q

List three subtypes of diverticular disease

A

acute diverticulitis
diverticulosis
diverticular disease
complicated acute diverticulitis

34
Q

List two complications associated with acute diverticulitis

A

absecess
fistula
stricture
perforation
sepsis

1 General Practice (15 decks)

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