GI System

Question 1

Define IBD

Answer 1

Crohn’s disease - effects any part of GI tract
Ulcerative colitis - limited to colon

Question 2

What is the indication of Aminosalicylates

Answer 2

Treatment of acute attack or maintenance of remission in UC or Crohns

Question 3

What is the mechanism of aminosalicylates

Answer 3

Prevent leukocyte recruitment into the bowel wall

Question 4

What are the main side effects of aminosalicylates

Answer 4

Blood disorders - report unexplained bleeding, bruising, purpura, sore throat, fever or malaise
Perform blood count and stop immediately if suspected

Question 5

Give two examples of aminosalicylates

Answer 5

sulfasalazine, mesalazine

Question 6

What population is IBD most prevalent?

Answer 6

20-30y/o women

Question 7

What are common symptoms of IBS

Answer 7

Abdo pain, discomfort, passage of mucus, bloating

Question 8

What non-pharm options are there for IBD?

Answer 8

High fibre diet
Exercise

Question 9

Give examples of 2 antispasmodics

Answer 9

Mebeverine , peppermint oil

Question 10

Give examples of two antimuscarinics used in IBS

Answer 10

Hyoscine, dicycloverine

Question 11

When should antispasmodics be avoided

Answer 11

Paralytic ileus

Question 12

Which antimuscarinic used in IBS is poorly absorbed in the GI tract

Answer 12

Hyoscine

Question 13

What patients should Metoclopramide be avoided in

Answer 13

Under 20 yers old or elderly, Parkinson’s patients
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Question 14

What commonly precedes C.diff infection

Answer 14

Antibiotic therapy with ampicillin, amoxicillin, co-amoxiclav, second and third gen cephalosporins, clindamycin and quinolones

Question 15

What are the treatment options in c.diff infections?

Answer 15

Metronidazole
Vancomycin

Question 16

What is the preferred treatment for pregnant women with IBD?

Answer 16

Prednisolone or hydrocortisone

Question 17

Give an example of a bulk forming laxative

Answer 17

Ispahula husk

Question 18

Give two examples of osmotic laxitives

Answer 18

Lactulose
Macrogol

Question 19

Give three examples of stimulant laxatives

Answer 19

Senna
Bisacodyl
Glycerol

Question 20

What is the main aim of treating diarrhoea

Answer 20

Reverse fluid and electrolyte depletion

Question 21

What are the high risk populations in terms of diarrhoea

Answer 21

Infants, frail and elderly

Question 22

What are treatment options for diarrhoea

Answer 22

Oral rehydration
Antimotility (loperamide)

Question 23

When are antimotility drugs used

Answer 23

In uncomplicated diarrhoea in those over 3 years old

Question 24

What can be used for prophylaxis of travelers diarrhoea

Answer 24

Ciprofloxacin, although not routinely recommended

Question 25

What is dyspepsia

Answer 25

Upper abdo pain, bloating and nausea

Question 26

What are the alarm symptoms of dyspepsia

Answer 26

Bleeding, dysphagia, recurrent vomiting, weight loss

Question 27

What patients with dyspepsia should be referred

Answer 27

Over 55 with new-onset

Question 28

What are the treatment options for dyspepsia

Answer 28

Antacids, PPIs, H2 receptor agonists

Question 29

What are problems concerning two antacids that should be considered

Answer 29

Magnesium induce diarrhoea
Aluminium induce constipation
Long term use of calcium can cause hypercalcaemia and alkalosis