Gi Flashcards
What are the causes of coeliac disease?
An adverse reaction to gluten a dietary protein found in cereals or wheat, barley and rye
What are the symptoms of coeliac disease?
Diary of the more pain and bloating higher risk of malabsorption of key nutrients
What is the treatment of coeliac disease?
Strict long life, gluten-free diet, assess risk for osteoporosis and treat bone, disease, vitamin and mineral supplements Valley medical assessment
What is diverticula’s disease?
Small bulges or pockets, develop in the lining of the intestine
What is diverticulitis?
Diverticulitis is when the pocket become inflamed or infected
What is ulcerative colitis?
Mucosal inflammation , and ulcers restricted to colon and rectum
What are the symptoms of ulcerative colitis?
, bloody diarrhoea, abdominal pain, urgent, need to defecate acute flareups
What are the long-term complications of ulcerative colitis?
Colorectal , cancer, secondary osteoporosis, vte, toxic megacolon
Why is loperamide and codeine contra indicated in ulcerative colitis?
Avoid antimotility drugs as can increase the risk of toxic megacolon
What is the treatment of ulcerative colitis
Aminosalicylate or prednisolone, monoclonal antibodies, rectal, corticosteroid
Maintaining remission in ulcerative colitis
Aminosalicates, corticosteroids have too many side-effects 
Are single daily dose, more effective than multiple daily doses for aminosalicylate for ulcerative colitis
Single daily dose are more affective than multiple daily doses, but have more side-effects
When would you add in oral azathiopurine or mercaptopurine ne in ulcerative colitis.
If there are two or more acute flareups in 12 months that require systemic cortical steroids, or if remission is not maintained by aminosalicylate or acute severe flareup
What is Crohn’s disease?
Inflammation of the GI tract from mouth to anus
What are the symptoms of Crohn’s disease?
Abdominal pain and diarrhoea, rectal bleeding weight loss, low-grade, fever and fatigue
What are the complications of Crohn’s disease?
Interest to intestinal structures, abscess, Vistula, malnutrition anaemia
What is the lifestyle advice for Crohn’s disease?
Advice on high-fibre diet, smoking sensation reduces the risk of the lips. Loperamide or codeine, treat diarrhoea, but not in colitis.
Which drugs affect the immune system
Azathioprine cyclosporine meracaptopurine methotrexate monoclonal antibodies
And what is the mode of action of aminosalicylic?
Reduce cytokinin free radical formation on inhibit, prostaglandin synthesis
Side affects of an aminosalicylates
Blood dyscrasias report, unexplained, bleeding, bruising, sore throat and fever nephrotoxicity monitoring of function. Salsalate hypertensity itching and hives. Yellow and orange bodily. contact lenses. Maybe stained
Interactions with lactulose and mesalazine
Lactulose lowers PH in the intestine prevents sufficient release in active ingredients in enteric-coated or modified release preparations
What are the symptoms of IBS?
Lower abdominal pain, bloating, alternating between constipation and diarrhoea, aggravated by stress, depression and anxiety lack of dietary fibre, commonly affects young adult between 20 to 30 years
What is IBS aggravated by?
Stress, depression, anxiety, lack of dietary fibre
What are antispasmodics used for?
GI spasms alverine mebervine peppermint oil
Is lactulose recommended in IBS
Not recommended causes bloating
What is short, bowel syndrome?
Characterised by malabsorption, following expensive is action of the small bowel
What are the consequences of short bowel syndrome?
Malabsorption and malnutrition deficiency of vitamin B-12, DENK essential fatty acid think
What is another consequence of short bowl syndrome
Higher doses of warfarin oral contraceptives and talk soon or give IV modified release formulations I’m not suitable soluble tablets are more suitable. Liquid formulations may be suitable dependent on the excipients and osmolality
What are the red flag symptoms for constipation?
New onset conspire to know for 50 years anaemia abdominal pain unexplained weight loss
Examples of bulk forming laxatives
Isphagula husk methylcellulose?
What is the drug action of bulk forming laxative?
Swells in the gut to increase faecal mass to stimulate peristalsis works within 24 hours. It takes 2 to 3 days for full effect.
What the counselling points for bulk forming laxatives
maintain adequate fluid risk of gut obstruction, drink with plenty of water, and not immediately before bed contains potent. Allergens can cause hypersensitivity reactions.
Examples of osmotic laxative
Macrogol lactulose
What is the drug action for osmotic?
Increase is water in: by drawing fluid from the colon or retains fluid administrated with works within 2 to 3 days, 48 hours for lactulose
What are the side effects for osmotic?
Discomfort, flatulence, cramps, and nausea
Examples of stimulant laxative
Bisxadoyl sodium picosulfate senna
How long should you stimulant laxative for?
For short-term use one week
What is the drug action for stimulant laxative?
Increases intestinal motility by irritate in the gut lining
Side affects of a stimulant laxative
Abdominal cramps senna colours urine, yellow brown hypokalaemia diarrhoea
Counselling points for stimulant laxative
Take at night to pass stool in the morning, moiston suppositories with water before use
Which stimulant laxative is genotoxic, and carcinogenic
Dantron Carciogenic used in terminally ill patients colours urine red local irritation. Avoid prolonged contact with skin in incontinent patience.
Example of faecal softener
Liquid paraffin
Side effects of faecal softeners
Anal seepage, liquid pneumonia, disease of GI tract malabsorption of vitamins, A D, E,NK and Folic acid
What is recommended if to laxatives from different classes have been tried the highest tolerated recommend us for at least six months
Consider prucalopride ( WOMEN ONLY) or lubiprostone
Why is prucalopride only used in women
It was only effective in women. In addition to its cardiovascular harms may cause depression and suicidal ideation. 
Which laxative , should you avoid in opioid induced constipation?
Avoid bulk forming laxatives
What is the treatment for chronic constipation?
Macrogol
What is the first line for constipation in pregnancy?
Bulk forming if fibre supplements fail, osmotic, bisacodyl or senna avoid in history of unstable pregnancy, can stimulate uterine contractions docusate a glycerol suppositories can be used
What should be used for constipation in
breastfeeding
Bulk forming lactulose or Macrogol
What are the red flags for diarrhoea?
Unexplained weight loss, rectal, bleeding, persistent diarrhoea, recent travel or antibiotics
First line treatment for diarrhoea
Oral rehydration therapy replaces electrolyte every depletion
What is the mode of action off loperamide ?
Pro long is the duration of intestinal transit by binding to opioid receptors
What is the age restriction for loperamide?
Not recommended for children under 12 years
What is the door search for loperamide?
Initially 4MG, then 2MG for up to 5 days, take a dose after each loose stool, maximum 16 mg a day
What is the antidote for loperamide ?
Naloxone, patient must be monitored for 48 hours after possible, CNS depression
When is loperamide contraindicated?
Active ulcerative colitis conditions were there is no gut motility conditions were abdominal. Distension develops acoid in bloody diarrhoea or inflammatory diarrhoea.
What is dyspepsia?
Group of upper abdominal symptoms, fullness, bloating, belching, and nausea 
When do you urgently refer dyspepsia?
Anaemia loss of weight anorexia recently changed unexplained dyspepsia and 55 over Melania blood in stool

What is the treatment for univestigated dyspepsia?
Antacid PPI for four weeks if symptoms persist 4 weeks after then hpylori test if there is no response to PPI
What is the treatment for investigated functional dyspepsia?
H.pylori test ppi
What are the low-sodium preparations?
Maalox and mucogel
How to antacids
Take after each main meal and a bedtime, impaired absorption of jokes with a two hour gap damages into recordings, hide sodium content, avoid in hypertension heart, liver, or kidney failure of fluid retention. Avoid in sodium restricted diet.
What is the mode of action of PPO?
Inhibit gastric acid secretion by blocking hydrogen ATP of the gastric parietal cell
Which PPI safe in pregnancy?
Omeprazole
Cautionary an advisory labels for PPIs
Take this medicine as whole do not take indigestion remedies two hours before can mask the symptoms of gastric cancer increased risk of fractures and risk of osteoporosis. Increased risk of GI infection C.difficlr
What is the MHRA advice for PPI?
Very low risk of subacute cutaneous, lupus erythematoaus avoid sun, exposure, hypomagnesium, ( predispose to digoxin, toxicity, )
fractures, rebound, acid, secretion, abdominal pain, constipation diarrhoea
Interactions with omeprazole
Clopidogrel , reduced antiplatelet effect methotrexate decrease clearance of methotrexate
What is the mode of action of H2 receptor antagonist?
Reduces gastric acid secretion by blocking H2 receptors in the gastric parietal cell it is antisecretory drug
What are the
examples of H2 receptor antagonist?
Misoprostol synthetic prostaglandin analog, tetragenic in pregnancy, diarrhoea, diarrhoea is common occasionally be severe and require withdrawal
Sucrfate can cause bezoar formation, one hour before meals, one hour between internal feeds
Treatment for H.pylori.
One week triple therapy, PPI, twice daily and cliffs, Romana, saying on amoxicillin or metronidazole
H., pylori diagnosis
C urea breath test kits do not test within four weeks of anti bacterial or two weeks with anti secretary drug
Antimuscarinic side-effects
Tachycardia pupil dilation, reduce bronchial, secretions, angle-closure, glaucoma confusion
MHRA, warning, with hyoscine butylbromide
Risk of serious adverse effects in patients with underlying cardiac disease, contraindicated in tachycardia patients and have a resuscitation question equipment readily available
How long should professions with corticosteroids be useful for haemorrhoids?
Maximum seven days
When did take pancreatin?
Pan create an is an activated by gastric acid take with meals or snacks or immediately before or after food. Enter enter quarters profession deliver hi pancreatin levels do not mix with excessively hot food or drinks is in activated by eight mix with food or liquids. Do not keep for more than one hour.
H.ployri treatment for patient on ciclosporin
Amoxicillin lanso metro
*** CLAITHROMYCIN INTERACTION BETWEEN CICLOSPORIN **
What is bismuth oxide
An astringent
What can PPI increase the risk
Fractures GI infections mask the symptoms of gastric cancer risk of osteoporosis
constipation treatment
Spc is boss
FOCHOS
short duration of pregnancy, chronic
Faecal opioid children
What do you remember for the doses for H. pylori?
First and second line 7 days treatment 3rd line 10 days treatment. Doses are given us twice daily.
What can occur with misoprostol
Diarrhoea
H.pylori main symptom
Pain improved after food
Cimetidine adverse effects
Erectile dysfunction gynaecomastia hallucinations
What do antacids do
Neutralises stomach acid
What do alignates do
Forms a raft on top of the stomach contents to prevent reflux
Breastfeeding and constipation
Bulk forming lactulose macrogol
Sean or bisacodyl
What can sorbitol cause
Pain and diarrhoea
Which part of the GI tract is affected by diverticular disease
Large intestine
