GI Disorders

Question 1

What is treatment of H.Pylori?

Answer 1

Clarithromycin Triple - PPI + Amox or Metro + Clarithromycin (14 days), efficacy affected by previous macrolide exposure.

Bismuth Quad- PPI + Bismuth + Metro + Tetra. 1st line, pcn allergy, previous macrolide or failure of triple. 10-14 days of treatment.

Question 2

Subtypes of hepatic encephalopathy?

Answer 2

A- acute liver failure, B- portosystemic bypass or shunting, C- cirrhosis.

Question 3

What do you titrate lactulose to in hepatic encephalopathy?

Answer 3

2-4 loose bms/day

Question 4

How to treat ascites?

Answer 4

Loop diuretic + spironolactone (40/100). Monitor weight (lose 1 kg/day edema and 0.5 kg/day furosemide) and electrolytes

Question 5

How to treat variceal bleeding?

Answer 5

Fluids, ocreotide IV, antibiotic.

Question 6

How to treat SBP?

Answer 6

3rd gen cephalosporin (cefotaxime or ceftriaxone)

Question 7

How often does hepatitis B become chronic?

Answer 7

5-10% of adults, 20-50% of children <5 years old, 90% of neonates