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Thera > GI part 2 > Flashcards

GI part 2 Flashcards

1
Q

what should you tell patients to avoid during and 48 hours post treatment with metroniddszole ?

A

ALCOHOL

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2
Q

how can you minimize the reoccurence of h.pylori?

A

stop taking nsaids, smoking, and minimize use of alcohol

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3
Q

when would you confirm eradication of h.pylori and how would you do it?

A

you would only do this in complicated: bleeding, perforated, structured patients or those with refractory ulcers

its not advised to test in someone who remains asymptomatic

follow up testing can be done ONE MONTH after stopping treatment

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4
Q

true or false

serology testing is NOT recommended for confirming the eradication of h.pylori infection as antibodies last for many many months

A

true

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5
Q

what is Quadruple therapy treatment for h.pylori?

A

PPI (lanzoprazole, exomeprazole - ZOLE)
bismuth subsalicylate (pepto)
metronidazole 250-500
tetracycline 500mg

OR

PPI
Metronidazole
Clarithromycin
Amoxicillin

10-14 days

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6
Q

what are the options for triple therapy?

A
  1. PPI
  2. Metronidazole
  3. Clarithromycin

OR

  1. PPI
  2. Clarithromycin
  3. amoxiciilin

14 days

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7
Q

How would you diagnose infant colic using ROME IV criteria

A

its a diagnosis of exclusion

infant less than 5 months of age with recurring prolonged episodes of crying irritability and fussiness that cant be explained

OR ANOTHER DEFINITION

Crying for more than 3 hours per day 3 days per week

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8
Q

What diagnostic tests would you order for infant colic?

A

its a dignosis of exclusion so you are ruling out redflags

No tests would be ordered on an infant who is gaining weight and has a normal physical exam

other wise consider urinalysis and stool for occult blood to rule out cow milk allergy

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9
Q

What pharm therapies are approvd for colic?

A
  1. sucrose
  2. Ovol
  3. Probiotics (BIogaia) SPECIFICALL THIS PROBIOTIC Lactobacillus reuteri
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10
Q

what are the side effects of long term use of PPI

A

c.diff
bone fractures
low vitamin levels
pneumonia

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11
Q

What tips would you reccomend to stop your PPI?

A
  1. diet and lifestyle
  2. lower your PPI dose for 2-4 weeks
  3. Stop your PPI and try antacids like tums PRN or H2
  4. use PPI PRN only
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12
Q

With Digoxin what medications can increase or decrease its levels?

A

Calcium channel blocker NifediPINE increases dig levels
Advil INCREASES dig levels
Zantac (H2 receptor) increases dig levels

Tums DECREASES dig levles

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13
Q

what high risk conditions required long term PPI use?

A

barrets esophagitis
Chronic oral corticosteroid or NSAID use
Grade C/D esophagitis
Documented GI bleet
Dual antiplatlet therapy with prior upper GI bleed

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14
Q

Are coticosteroids safe to use during pregnancy for treatment of IBD

A

yes as long as the pros out weigh the cons, in the first trimester it might be linked to clef lip, but it is still considered safe to use

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15
Q

is methotrexate safe to use during pregnancy for IBD treatment

A

no its teratogenic, stop 3-6 months prior to trying to conceive and do not use during breastfeeding

this is an immune modulator

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16
Q

A baby born to a other who is hep B carrier should start hep B immunizations at what age?

A

at birth

17
Q

sucessful treatment of H.pylori will result in ulcer healing and prevent the development of recurrent PUD ( in the absence of concomiant ASA or NSAID use)

A

true

18
Q

what non pharm techniques can you use to cope with an inconsolable baby crying during colic

A
  • use headphones as a distraction while staying close
  • put the baby in a safe place and take a few steps back for one minute
  • check the intensity of your emotions and stay calm
  • ensure that yourself and the baby are okay, NO pain NOT hungry
19
Q

what is a common side effect from a PPI

A

diarrhea

20
Q

what is a common side effect from H2 receptor antagonist

A

diarrhea
constipation
headache

21
Q

what instructions would you provide your patient regarding the use of a PPI administration?

A

food decreases its efficacy so take it on an empty stomach. They are taken on a daily basis, not as needed for heart burn

take on an empty stomach 1/2 to 1 hour before a meal

22
Q

who would you prescribe a prophylactic antibiotic treatment for travellers diarrhea?

A

only someone with comorbind disease

23
Q

when should an NP avoid prescribing an anticholinergic-antihistamin for nausea ?

A

in men with Bprostate hypertrophy! (BPH) it can worsen urinary retention

24
Q

what is the recommended treatment for mild hypovolemia

A

oral fluids like water,juices, and tea

suprisingly not electrolyte replacement products?

25
Q

what non antibiotic can a NP recommed to people who want to prevent travelers diarrhea

A

Pepto-bismol (suprisingly not the vaccine Dukarol)

26
Q

what is considered chronic hepatitis and which ones are usually the culprit?

A

Chronic viral hepatitis is greater than 6 months
often caused by Hepb and HepC

27
Q

What lab values would tell you if someone has ACUTE HEPATITIS B?

A

anti-HBc Igm would be positive (this finding represents an acute infection)

HBsAg (HBV surface antigen): this positive results indicates an acute or chronic HB infection

anti-HBc igM (positive) & HBsAG (POSITIVE) = acute hep b

28
Q

what lab values would differentiate acute hep b from chronic?

A

HBsAG (hep b surface antigen)
Anti-HBc total - appears when exposed and lasts for life, this will differentiate person who develop immunity from vaccination ( test would be negative) or prior infection (test would be positive)

HBsAg POSITIVE + anti-HBc total (POSITIVE)

29
Q

what lab values would tell you if someone has acute hep A?

A

anti-HAV igM (positive) this indicates acute infection

ps. anti-HAV IgG just represents immunity from vaccine or previous exposure to memorize the difference think

igM= MORNING !! you got it RIGHT THIS MORNING ITS ACUTE

30
Q

How would you differentiate acute hep c from chronic hep c

A

first off, its rare for hep C to even be identified acutley. There are two tests.

anti-HCV (antibody to hep C) - after an exposure it will be negative for up to 6 weeks, but then will remain positive for life.

HCV RNA- this indicates the start of an acute infection

in acute hep C you will have

anti-HCV negative
HCV RNA positive

in chronic HCV
anti-HCV positive
HCV RNA positive

Thera (6 decks)

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