Gastroenterology Flashcards
Ulcerative colitis Mx - Severe
> 6 stools/ day + systemic features (pyrexia, tachycardia, anaemia)
Admission for IV steroids
Ulcerative colitis Mx - Mild to Mod
4-6 stools/ day no systemic upset
1st - Topical (rectal) aminosalicylate - Mesalazine
2nd - If no improvement after 4 weeks to add PO Mesalazine
Ulcerative colitis Mx following severe relapse or >2 exacerbations/ year
PO Azathioprine
PO mercaptopurine
C Diff Mx
1st - PO Vanc 10/7
2nd - PO Fidaxomicin
3rd - PO Vanc +/- IV Metro
Drugs causing Cholestasis (raised BR, ALP)
Flucloxacillin, Co-Amox, Erythromycin
COCP
Anabolic steroids
Gliclazide
Prochlorperazine
Drugs causes Hepatitis (raised ALT)
Paracetmol
Sodium valproate
Anti TB meds
Statins
Alcohol
Amiodarone
Methyldopa
Nitrofurantoin
Drugs causing Liver Cirrhosis
methotrexate
methyldopa
amiodarone
Hemochromatosis monitoring
Ferritin and Transferrin saturation
PPI side effects
HypoMag
HypoNat
Osteoporosis - risk of fractures
Microscopic colitis
C. Diff
Variceal Bleeding prophylaxis in community
Propranolol
Hepatitis B immunisation biochemistry
Anti Hep B POS
All other negative
Current Hepatitis B infection biochemistry
Hep B surface Antigen (HBsAg) Pos
Previous Hepatitis B infection biochemistry, NOT a carrier
Anti-HBc POS
HBsAg neg
Anti-HBs POS
Previous Hepatitis B infection biochemistry, current carrier
Anti-HBc POS
HBsAg POS
Alcohol dependence screening tool
AUDIT
Screening for hemochromatosis
general population - Transferrin saturation
family members +ve - HFE genetic testing
Haemochromotosis biochemistry
transferrin sats raised
ferritin raised
TIBC low
Coeliac disease in infants Fx
chronic diarrhoea
bloating
failure to thrive
Waterlow score is for…
Bed sores
MUST score is for…
Malnutrition
H Pylori Ix
1st - Stool ANITGEN or Urea breath test
Must be off (before testing):
Abx 4 for weeks
PPI 2 for weeks
Causes of C Diff
Clindamycin
Cefalexin
Broad spec Abx - Co-Amox
PPIs
H Pylori Mx
PPI
Clarithromycin
Amoxicillin or Metronidazole
Risk factors for Crohns disease (relapse)
Smoking
COCP
NSAIDs
Appendicectomy (soon after, risk reduces after 5 years)
Infective gastroenteritis
H Pylori association
Peptic ulcer disease (duodenal > gastric)
gastric ca
B cell lymphoma MALT
2WW oesophageal ca criteria
dysphagia
> 55 + weight loss +
upper abdo pain
reflux
dyspepsia
Ulcerative colitis remission medication
1st - Top (rectal) aminosalicylate +/- PO aminosalicylate eg mesalazine
Non urgent referral for endoscopy
haematemesis (stable)
> 55 AND
treatment resistant dyspepsia
upper abdo pain and anaemia
raised platelet count with GI symptoms
IBS Mx
1st - anti spasmodics - Hyoscine/ mebeverine; loperamide for diarrhoea and laxatives for constipation. Lactulose should be avoided.
2nd - TCA (amitryptline)
3rd - SSRI
4th Linaclotide
UGIB initial scoring system
Glasgow Blatchford - stratifies risk of UGIB
Rockall - requires endoscopy results, therefore not initial screening tool - for prognosis after diagnosis
