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OSCEs > GI > Flashcards

GI Flashcards

1
Q

What are the red flags for bowel cancer?

A

Blood in stools

Abdominal mass

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2
Q

What are the referral symptoms for vomiting? [6]

A

Severe abdominal pain
Weight loss
Blood in vomit
Vomiting in

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3
Q

What is the first line treatment for vomiting?

A 
ORT.
Antiemetics
- Prochloperazine (migraines)
- anti-histamines
- anticholinergics
Acupressure.
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4
Q

What antiemetic is no longer OTC?

A

Domperidone.

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5
Q

What are the referral symptoms for diarrhoea? [9]

A 
Change in bowel habit in over 50s.
Recent foreign travel.
Failed treatment. 
Unable to drink fluids.
Blood/mucus in stools.
Bouts of constipation 
Severe abdominal pain. 
Weight loss.
Symptoms lasting >2-3 days in children and elderly. 
24 hours diabetics.
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6
Q

How is diarrhoea treated?

A

ORT.

Anti-motility drugs.

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7
Q

Loperamide is what type of drug?

A

Anti-motility

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8
Q

What would bismuth be used to treat?

A

diarrhoea.

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9
Q

What advice should be given to those suffering from diarrhoea? [6]

A 
Drink plenty of clear fluids. 
Avoid very sugary drinks. 
Avoid milk and milky drinks. 
Eat if it does not exacerbate symptoms. 
Avoid contact with food until better/stay home from work. 
Maintain good hygiene.
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10
Q

Diabetics with diarrhoea lasting longer than how long should be referred?

A

24 hours.

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11
Q

Children/Elderly patients with diarrhoea lasting longer than how long should be referred?

A

2-3 days.

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12
Q

What are the alarm signs indicating a need for referral in those suffering from dyspepsia? [5]

A 
GI bleeding.
Difficulty swallowing
Unintentional weight loss
Abdominal swelling
Persistent vomiting
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13
Q

In what circumstances would you refer a patient with dyspepsia to the GP (other than the normal ones)?

A 
Long standing change in bowel habit. 
Pain which is debilitating or that wakes the patient in the night
Referred pain
Treatment failure
Indigestion with medicines.
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14
Q

What are some examples of antacids that could be recommended for the treatment of dyspepsia?

A

Rennies

Remegel

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15
Q

What are some examples of some alginates that could be recommended for the treatment of dyspepsia?

A

Gaviscon

Peptac

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16
Q

What OTC options are there in regards to PPI for heartburn?

A

Available OTC – omeprazole, pantoprazole and esomeprazole.
The treatment should not exceed 4 weeks without consulting a doctor.
If no symptom relief is obtained within 2 weeks of continuous treatment, the patient should be instructed to consult a doctor.

17
Q

What are the referral symptoms for constipation?

A

Blood in stool/tarry stools
Greater than 14 days duration with no identifiable cause.
Middle aged with sudden change in bowel habit with no identifiable cause.
Suspected depression
Weight loss.

18
Q

How is constipation managed?

A

First line is lifestyle advice.

Laxatives are used if needed.

19
Q

What can cause haemorrhoids?

A

Constipation and straining.
Chronic diarrhoea
Family history
Pregnancy, bowel tumours

20
Q

What are the referral symptoms for those with haemorrhoids? [6]

A

Abdominal pain
Blood in stools, unless sinister pathology has previously been ruled out.
fever
PAtients who have to reduce haemorrhoids manually.
Persistent change in bowel habit in middle aged patients.
Severe pain associated with defecation.

21
Q

How are haemorrhoids treated?

A

Lidocaine
Astringents: bismuth, zinc.
Anti-inflammatories such as hydrocortisone.
Protecterorants such as shark liver oil.

22
Q

When would an IBS patient be referred? [8]

A 
Blood in poo.
Children under 16. 
Patients over 45 with recent change in bowel habit. 
Patients with no history of IBS of no precipitating factors. 
Fever. 
Nausea and/or vomiting. 
Severe abdominal pain. 
Steatorrhoea.
23
Q

How is IBS treated?

A

Antiplasmodics:
Hyoscine - Buscopan
Mebeverine - colofac IBS
Peppermint oil - Colpermin IBS

Laxatives can be recommended, Ispaghula, but lactulose should be discouraged.

Anti-diarrhoeals - loperamide is first line.
Probiotics.

24
Q

What laxatives can be recommended for IBS?

A

Ispaghula NOT lactulose.

25
Q

When someone requests medication for an upset stomach what key information do we need? [4]

A

When did it start?
Is there any recent foreign travel? if yes: refer.
Are they able to keep down fluids? If no: refer.
Has the patient tried anything so far? if yes and treatment failure: refer.
Are there any warning signs present? blood etc.

26
Q

When counseling on how to manage an upset stomach what key information should be explained to the patient? [4]

A

How to take ORT: one to two sachets with 200-400ml water after each loose stool in addition to normal fluids.

Advice regarding hygiene to prevent transmission.

Use of appropriate anti-motility drug such as loperamide, two stat then one after every loose bowel movement, no more than 8 per day.

Inform GP if symptoms last for longer than 72 hours, or immediately if symptoms get worse.

27
Q

What immediate questions should you ask someone presenting with indigestion? [8]

A

How long have they had the symptoms for?
What are the symptoms? If stabbing pain: refer.
Have they recently lost weight unintentionally?
Any dark tarry stools? Blood?
Any difficulty swallowing?
Are the symptoms worse at night?
Are they on any other medications?
Are they otherwise healthy? good diet, good exercise?

28
Q

What questions should be asked to all patients regardless of complaint? [8]

A 
Who is the patient? 
Are they on any medications?
Are they on any OTC medicines?
Are they taking any herbal remedies?
Are they healthy?
Do they exercise?
Do they have any allergies?
Have they tried any other medication for their symptoms?
29
Q

How soon after treatment failure should a patient with constipation see the DR?

A

7 days if bulk forming.

3 days if stimulant.

30
Q

What specific questions should be asked to someone presenting with pain upon going number 2?

A

Have they suffered from haemorrhoids before?

Is there any bleeding present?

31
Q

Why would a patient request some colpermin capsules?

A

To treat IBS.

32
Q

What should be done if a patient presents with self-diagnosed IBS?

A

REFER

33
Q

What is the active ingredient of imodium melts?

A

Loperamide.

34
Q

What does anusol plus HC ointment contain?

A

Hydrocortisone, max 7 days use.

OSCEs (10 decks)

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