Gastroenterology and Renal Disorders Flashcards
What type of medication eliminates formed acid?
Antacids
What are the 2 functions of medication for upper GI disease?
Eliminate formed acid
Reduce acid secretion
What medications reduce acid secretion?
H2 receptor blockers
Proton pump inhibitors
What are some examples of antacids?
Gaviscon
Rennie
How do H2 receptor antagonists work?
Reduce acid production by stopping histamine activation
What are the 2 most common H2 receptor antagonists?
Cimetidine
Ranitidine
What are some common proton pump inhibitors?
Omeprazole
Lansoprazole
Pantoprazole
How are GI diseases investigated?
Endoscopy
Capsule with camera
What is dysphagia?
External compression
What is GORD
“heartburn”
What 3 things cause GORD?
Defective lover oesophageal sphincter
Impaired lower clearing
Impaired gastric emptying
GORD sings and symptoms?
Worse lying down
Dysphagia
GI bleeding
What is hiatus hernia?
Upper part of the stomach bulges through an opening in the diaphragm
GORD management
Stop smoking
Lose weight
Medication - Antacids, H2 blockers and PPIs
Increase GI mobility and gastric emptying
What is peptic ulcer disease (PUD)
Any site affected by excess acid production
What does helicobacter pylori effect?
lower part of the stomach antrum
What shape if the bacterium causing helicobacter pylori?
Spiral
What can helicobacter pylori cause?
Ulcers and inflammation
How to manage helicobacter pylori?
Triple therapy
What is triple therapy?
2 antibiotics - 1 proton pump inhibitor
What antibiotics is used in triple therapy?
Amoxycillin
Metronidazole
What proton pump inhibitor is used in triple therapy?
Omeprazole
PUD signs and symptoms
Worse before and after food
Worse at night
Usually no physical signs
How is PUD investigated?
Endoscopy
Radiology
Faecal occult blood test
What is coeliac disease?
Sensitivity to a-gliaden component gluten
What causes coeliac disease?
Genetic susceptibility
Environmental trigger
Consumption of gluten
What effects does coeliac disease have?
Oral ulceration
Growth failure
What are some common symptoms of coeliac disease?
Weight loss
weakness
Oral aphthae
Tongue papillary loss
Coeliac disease investigations
Autoantibody test
Jejunal biopsy
Faecal fat
Haematinics
What does oral aphthous ulcers indicate in relation to coeliac disease?
malabsorption
What is pernicious anaemia?
Disease caused by vitamin B12 deficiency
How to treat a vitamin B12 deficiency?
Diet
Injections
What age groups are most commonly inflammatory bowel disease?
15-25
50-80
What causes IBD?
Food intolerance
Persisting infection
Smoking
Genetics
What are 2 common IBDs?
Ulcerative colitis
Crohns disease
What gender is more commonly affected by crohns?
Male
What gender is most commonly affects by Ulc Col?
Female
Disease continuous
Rectum always involved
Anal fissures 25%
Ileum involved 10%
Vascular
What IBD is this?
Ulcerative Colitis
Discontinuous
Rectum involved 50%
Anal fissures 75%
Ileum involved 30%
Non vascular
What IBD is this?
Crohns disease
Mucosal, vascular, mucosal abscesses are microscopic features of what IBD?
Ulcerative colitis
Transmural, oedematous, granulomas are microscopic features of what IBD?
Crohns disease
IBD treatment
Systemic steroids
Local steroids
Anti inflammatory drugs
Orofacial granulomatosis is a symptom of what?
Crohns disease
What does orofacial granulomatosis do?
Causes lip and oral swelling from increased capillary leakage
Second main type of cancer causing death in Scotland?
Bowel cancer
Bowel cancer symptoms
Commonly none
Anaemia
Rectal blood loss
How is bowel cancer staged?
Dukes classification
What is dukes classification
A - Submucosal
B - Muscularies
C - Lymph nodes
D - Liver
Bowel cancer treatment
Surgery
Hepatic metastases
Radiotherapy
Chemotherpy
What is FIT test?
All adults in Scotland from age 50 send faecal ample by post
What happens if FIT test comes back postive?
Endoscopy
What are 3 most common urinary tract diseases?
Urinary tract infection
Urinary tract obstruction
Urinary tract malignancy
Who is UTIs most common in?
Women
What bacteria is most commonly found in UTIs?
E. coli
What factors can lead to a UTI?
Poor bladder emptying
Low urinary flow rates
UTI symptoms
Dysuria
Urinary frequency
Cloudy urine
What can happen is urine is infected?
Cystitis
Renal infection
Prostate infection
UTI treatment
Increase fluid intake
Antibiotics
What antibiotics are given for a UTI?
Trimethoprim
Amoxycillin
What is prostatits?
Inflammation of the prostate
What is benign prostatic hypertrophy?
Hyperplasia of the prostate
What is prostatic cancer?
Adenocarcinoma
Benign prostatic hypertrophy is common
True or False?
True - 80% men over 80
Symptoms of BPH?
Slow stream
Frequency
Urgency
Treatment for BPH?
Drugs
Surgery
What drugs are used for BPH?
a-blocking drugs
Anticholinergic
Diuretics
What surgery is there for BPH?
TURP
RALP
What age does prostate cancer become more common?
After 45
Prostate cancer screening?
PSA blood tests
mpMRI
Prostate cancer treatment?
Surgery
Radiotherapy
Hormone treatment
What are the 2 types of renal stones?
Radiopaque - calcium and oxalate
Non radiopaque - uric acid
How are renal stones treated?
Lithotripsy
Dentistry and renal dislysis
Treat after haemodialysis sessions
Do not use the dialysis shunt
No heroic treatment plans
Dentistry and renal transplant
Normal renal function at first but may reduce with time
Immune suppressants
Drugs to be aware of in relation to renal transplant
Prednisolone
Azathioprine
Tacrolimus
Cyclosporin
Due to renal transplant patients are at an increased cancer risk - what should you be aware of when examining?
Oral mucosal lesions
What are the main problems with renal transplant?
Rejection
Immunosuppression
High cardiovascular mortality
Osteoporosis risk
What is an inherited bleeding disorder?
An acquired defect which affects the coagulation of the blood
What is an inherited bleeding disorder?
An acquired defect which affects the coagulation of the blood
What 3 things can an inherited bleeding disorder?
Coagulation cascade
Platelets
A combined deficiency
Where might you carry out dental treatment if it will cause bleeding?
Hospital
What LA injections are considered safe in someone with bleeding disorder?
Buccal infiltration
Intraligamentary
Intra-papillary
What LA injections are considered dangerous in someone with a bleeding disorder?
IDB
Lingual infiltration
After a severe extraction how long should a patient with a bleeding disorder be monitered?
Overnight
After a mild extraction how long should a patient with a bleeding disorder be monitored?
2-3 hours after
If platelet count is below 100x10/L what treatment would you do?
Primary care treatment
If platelet count is below 50x10/L wat treatment would you do?
Hospital treatment
If platelet count is above 500x10/L what treatment would you do?
Either primary or hospital