GI Flashcards
How would you manage a patient with gastro-oesophageal reflux disease?
Lifestyle modifications eg weight loss. Antacids. H2 antagonist. PPIs. Surgery.
How would you manage a patient with gastritis or a peptic ulcer?
Eradicate H-pylori using triple therapy of PPI (lansoprazole), clarithromycin and amoxicillin.
Stop NSAIDS.
Lifestyle modifications eg weight loss, decreased alcohol consumption.
Endoscopy for bleeding ulcers and follow up for treated gastric ulcers.
H2 antagonists eg cimetidine.
PPIs eg omeprazole.
How would you manage a patient with coeliac disease?
Diet - cut out gluten.
How would you manage a patient with acute pancreatitis?
Analgesia.
Supportive treatment particularly fluid resuscitation.
What drugs are used to treat IBD (Crohn’s and UC)?
- Aminosalicylates eg sulfasalazine for flares and remission.
- Corticosteroids eg prednisolone for flares.
- Immunomodulators eg azathioprine for fistulae/maintenance of remission.
When would you use surgical treatment for a patient with Crohn’s disease?
Strictures/fistulas.
When would you use surgical treatment for a patient with ulcerative colitis?
Inflammation not settling, precancerous changes or toxic megacolon. Is curable with a colectomy.
How would you manage a patient wit acute gut ischaemia?
Urgent laparotomy within an hour and resection of the dead bowel.
How would you manage a patient with acute cholangitis?
Remove the gallstone by ERCP, sphincterotomy and stone extraction.
How would you manage a patient with campylobacter infection?
Supportive treatment including fluid rehydration.
Antibiotics for severe disease and with risk factors eg pregnant, elderly, immunocompromised - fluroquinolone or macrolide.
How would you manage a patient with cyclospora cayetanensis infection?
Supportive including fluid rehydration.
Trimethoprim-sulphamethoxazole orally 7-10 days.
Longer duration and high doses if immunocompromised.
How would you manage a patient with norovirus?
Supportive including fluid rehydration.
How would you manage a patient with a GI cancer?
Chemotherapy.
Radiotherapy.
Surgical resections.
How would you manage a patient with a hernia?
Conservative measures.
Surgery - only for symptomatic inguinal hernia. Can be open or laparoscopic suture repair or mesh insertion.
