GI Quiz Flashcards
Ms. B comes into the pharmacy asking to speak to the pharmacist. She tells you her stools have been hard and pellet like. You can see that she may be pregnant and on questioning, you confirm that she is 7 months pregnant. She has tried to change her diet and drink more water but this has been ineffective. She has no other medical condition and on no other medication.
Which of the following is the most appropriate advice to give Ms. B?
A- Recommend the use of Senna tablets
B- Recommend the use of Pepto-Bismol
C- Recommend the use of Bisacodyl tablets
D- Recommend the use of milk of magnesia
E- Recommend the use of Lactulose
E- Recommend the use of lactulose
PeptoBismol and Milk of magnesia = for indigestion
Senna and bisacodyl are stimulant laxatives and should not be used in pregnancy
Mr. H is a 60-year-old man who takes Pantoprazole 20mg daily for dyspepsia. Mr. H undergoes a routine blood test which reveals abnormalities. A drug-related cause is suspected.
Which of the following results is likely to be caused by the Pantoprazole?
A- Hypernatraemia
B- Hypercalcaemia
C- Hyperglycaemia
D- Hypomagnesaemia – can occur 1 year after treatment.
E- Hyperuricaemia
D- Hypomagnesaemia
Measurement of serum-magnesium concentration should be considered prior to and during prolonged treatment with a PPI
Mrs P, a 40-year-old with a BMI of 28kg/m2 is admitted to your ward with bloating and severe upper abdominal pain at night. She has a history of dyspepsia. She was referred by her GP for an endoscopy which revealed gastritis and a small peptic ulcer.
Which one of the following medicines is contraindicated in women of childbearing age unless they use effective contraceptive measures?
A- Ranitidine
B- Esomeprazole
C- Misoprostol
D- Cimetidine
E- Sucralfate
C- Misoprostol
Should not be used in women of childbearing age unless pregnancy has been excluded
Has potent uterine stimulant : can induce abortion
Teratogenic risk in the first trimester
A patient has asked you for something to relieve their constipation. The laxative you offer to the patient works by drawing fluid from the body into the bowel.
Which of the following matches the description of the laxative being offered?
A- Bisacodyl tablets
B- Docusate sodium capsules
C- Isphagula husk granules
D- Macrogols
E- Senna tablets
D - Macrogols
These are osmotic laxatives
Mr C has been diagnosed with H. Pylori infection. He also takes Ciclosporin 100mg BD for a kidney transplant which he received 2 years ago.
Which of the following H. Pylori treatments would be the best option for him?
A- Esomeprazole 20mg BD, Amoxicillin 1g BD, Clarithromycin 500g BD for 7 days
B- Lansoprazole 30mg BD, Amoxicillin 1g BD, Metronidazole 400mg BD for 7 days
C- Omeprazole 20mg BD, Clarithromycin 250mg BD, Metronidazole 400mg TDS for 7 days
D- Lansoprazole 30mg BD, Clarithromycin 250mg BD, Metronidazole 400mg BD for 7 days
E- Omeprazole 20mg BD, Amoxicillin 1g BD, Clarithromycin 500mg BD for 7 days
B- Lansoprazole, Amoxicillin and Metronidazole
Clarithromycin and Ciclosporin have a SEVERE interaction
Clarithromycin increases the concentration of Ciclosporin
A 66-year-old man has been prescribed loperamide 2mg capsules for acute diarrhoea. The prescription states ‘to be taken as directed’ but the patient cannot recall how he was told to take them.
What is the maximum number of loperamide capsules this patient could take in ONE day?
A- 6
B- 8
C- 10
D- 12
E- 16
B- 8
Maximum dose in acute diarrhoea is 16mg in 24 hours
How should constipation be managed in pregnancy?
Lifestyle measures first line: increasing dietary fibre, fluid intake and activity
Bulk-forming laxatives are the first line option: ispaghula
Then add or switch to osmotic, such as lactulose
Mrs P is one of the patients on your oncology ward and has recently had her analgesia increased to Oxycontin (oxycodone MR) 20mg BD alongside OxyNorm (oxycodone) 5mg PRN. A few days later, upon inspecting her stool chart, you notice that she has not opened her bowels for the past 2 days. You discuss with the medical team and agree she needs a laxative.
Which of the following options would be most appropriate?
A- Lactulose 10mL BD PRN
B- Senna 15mg ON PRN
C- Lactulose 10mL BD and Senna 7.5mg-15mg ON PRN
D- Lactulose 10mL BD and Movicol (Macrogol powder) 1 sachet ON PRN
E- Mrs P should be referred for urgent bowel evacuation
C- Lactulose 10ml BD and Senna 7.5mg- 15mg ON PRN
Constipation in palliative care patients who are receiving opioids should be prevented with the regular administration of laxatives
What are common side effects of Cholestyramine?
- Constipation
- GI discomfort
- Headache
- Nausea
- Vomitting
Mr AS is started on Sulfasalazine 1g FOUR times a day for the initial treatment of active Crohn’s disease.
Which of the ADRs listed does Mr AS need to be counselled about?
A- Bradycardia
B - Sore throat
C- Haematuria
D- Myopathy
E- Drowsiness
B- Sore throat
BLOOD DISORDERS are linked to aminosalicylates so patients should report any sore throat, fever, bruising or malaise during treatment
Mrs P comes into the pharmacy with a prescription. She states she has just been to see the GP as she has been suffering from gastro acid reflux. She is currently trying to conceive with her partner.
Which of the following should the GP avoid prescribing?
A- Omeprazole
B- Pantoprazole
C- Ranitidine
D- Misoprostol
E- Cimetidine
D- Misoprostol
Potent uterine stimulant
Teratogenic risk in first trimester
A patient has been taking clindamycin for the past three days and has developed nausea and diarrhoea. They ask for your advice about what to do. They have been taking Clindamycin as prescribed: 450mg QDS. They still have four more days of treatment to go.
What is the most appropriate advice to give the patient?
A- They should continue with the treatment as usual
B- They should go to A&E immediately
C- They should see their GP to get an alternative medication
D- They should stop taking the Clindamycin immediately and go and get an urgent appointment with their doctor
E- They should take an over the counter medicine for the nausea and diarrhoea
D - They should stop taking the clindamycin immediately and go get an urgent appointment with their doctor
Antibiotic associated colitis
Which can be fatal
Which of the following drugs below is not associated with causing constipation?
A- Verapamil
B- Tramadol
C- Aluminium containing antacids
D- Magnesium containing antacids
D- Magnesium containing antacids
Alphabet : L and M are next to each other
L for Laxative
M for Magnesium
What advice is INCORRECT when a pregnant lady is constipated?
A- A bulk-forming laxative is the first choice during pregnancy if fibre supplements fail.
B- An osmotic laxative, such as lactulose, can also be used.
C- Bisacodyl or Senna may not be suitable if a stimulant effect is necessary.
D- Docusate sodium and glycerol suppositories can also be used.
C- Bisacodyl or Senna may not be suitable if a stimulant effect is necessary
These MAY be suitable but use of senna should be avoided near term or if there is a history of unstable pregnancy
