GI condition Treatments

Question 1

ascites

Answer 1

1. Reduce Dietary Sodium
2. If sodium is less than 125 then fluid restriction
3. Aldosterone antagonist diuretic - Spironolactone
4. Drainage - paracentesis (large volumes require albumin cover)
5. prophylactic antibiotics - ciprofloxacin
6. TIPS

Question 2

haemochromatosis

Answer 2

1. Venesection
2. Iron Chelator - desferrioxamine

Question 3

ruptured osophogeal varicies

Answer 3

Terlipressin & IV Ciprofloxacin

Question 4

osophogeal varicose prophylaxis

Answer 4

propanolol

Question 5

Hepatic encephalopathy

Answer 5

Lactulose & Rifaximin

Question 6

Acute alcohol withdrawal

Answer 6

Chlordiazepoxide (librium)

Question 7

Reduction of cravings in alcoholism

Answer 7

Acamprosate

Question 8

Prevention of Wernicke-Korsakoff syndrome in alcohol withdrawal patients

Answer 8

High dose Thiamine (vitamin B1) - Pabrinex

Question 9

Non-Alcoholic Fatty liver Disease

Answer 9

Weightloss

Question 10

Autoimmune Hepatitis

Answer 10

1. Prednisolone
2. Azathioprine
3. Vaccination against Hep A & B
4. Liver Transplant

Question 11

Wilsons Disease

Answer 11

Penicillamine

Question 12

Primary Biliary Cholangitis

Answer 12

1. Ursodeoxycholic acid
2. Cholestyramine
3. Fat Soluble Vitamins

Question 13

Primary Sclerosing Cholangitis

Answer 13

1. Liver Transplant
2. Cholestyramine (for pruritis)
3. Fat Soluble Vitamins

Question 14

Celiac Disease

Answer 14

Gluten Free Diet

Question 15

constipation

Answer 15

1. Bulk Forming Laxative - fybogel (ispaghula husk)
2. Osmotic Laxative - Macrogol / Lactulose

Question 16

Crohns Inducing Remission

Answer 16

1. Oral / Topical / IV Steroids - Prednisolone
2. 5-ASA - mesalazine
   +/- azathioprine / mercaptopurine

Question 17

Crohns Maintaining Remission

Answer 17

1. Mercaptopurine / Azathioprine
2. Methotrexate

Question 18

Refractory / fistulating Chrohns Disease

Answer 18

Infliximab

Question 19

Isolated Peri-anal Crohns Disease

Answer 19

Metronidazole

Question 20

Complex Peri-anal Fistula Crohns

Answer 20

Draining Seton

Question 21

Peri-anal abscess management Crohns

Answer 21

Incision and drainage with antibiotic therapy

Question 22

Achalasia

Answer 22

1. Pneumatic Balloon Dilation
2. Heller cardiomyotomy
3. intra-sphincteric injection of botulinum toxin

Question 23

Alcoholic Hepatitis

Answer 23

1. Prednisolone
2. Pentoxyphilline

Question 24

C.diff - 1st infection

Answer 24

1. Oral vancomycin
2. Oral fidaxomicin
3. Oral Vancomycin & IV metronidazole

Question 25

C.diff - repeat infection

Answer 25

oral fidaxomicin

Question 26

C.diff - life threatening

Answer 26

Oral vancomycin & IV metronidazole

Question 27

Pernicious anemia

Answer 27

IM B12 replacement (Hydroxycobalamin)

Question 28

Bile acid malabsorption

Answer 28

BILE ACID SEQUESTRANTS = CHOLESTYRAMINE

Question 29

Pancreatic Cancer

Answer 29

1. Whipple Resection
2. Adjuvent chemotherapy
3. ERCP with stenting - for palliative care and relief of symptoms

Question 30

H.pylori Eradication

Answer 30

1. PPI + amoxicillin + (clarithromycin / metronidazole)

Question 31

small bowel overgrowth syndrome

Answer 31

Rifaximin

Question 32

Patients with dyspepsia (indigestion)

Answer 32

1. Review medications for possible causes of the dyspepsia
2. Lifestyle advice
3. Trial of full dose PPI for 1 month / ‘test and treat’ approach for H. pylori

Question 33

Barrett’s Osophagus

Answer 33

1. High dose PPI
2. Metaplasia –> endoscopic surveillance with biopsies every 3-5 years
3. Dysplasia –> endoscopic intervention

Question 34

Carcinoid Syndrome Management

Answer 34

• Somatostatin analogues –> OCREOTIDE
• for the diarrhoea - cyproheptadine