Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GPhC Exam Revison > GI System > Flashcards

GI System Flashcards

1
Q

What is coeliac disease, including symptoms and treatment?

A

It is a chronic inflammatory disease involving the small intestine due to an adverse reaction to gluten.

Symptoms: bloating, abdominal pain, diarrhoea.

Treatment: strict gluten-free diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is diverculitis?

A

Small pouches developing in the lining of the stomach.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the treatment for diverticulitis?

A

High fibre diet if constipated
Antibiotics if signs of infection or immunocompromised
Anti-spasmodics e.g. mebeverine, propantheline, peppermint oil, hyoscine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What 2 conditions ar einvolved in inflammatory bowel disease?

A

Crohns disease
Ulcerative colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is ulcerative colitis?

A

Mucosal inflammation/ulcers present in the descending colon and near the rectum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Which drugs are contraindicated in ulcerative colitis, and what can they cause?

A

Anti-motility drugs, anti-spasmodics, loperamide and codeine
These can cause toxic megacolon and should be AVOIDED

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is proctitis and which form of drug is better used to treat it?

A

It is inflammation of the rectum, and suppositories are best used.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the 1s, 2nd and 3rd line treatment for acute mild-moderate ulcerative colitis?

A

1st: Topical aminosalicylate for 4 weeks.
2nd line: Add oral aminosalicylate if no benefit
3rd line: high dose aminosalicylate + topical steroid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the 1st and 2nd line treatment for moderate-severe ulcerative colitis?

A

1st: Oral steroid
2nd: monoclonal antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the initial treatment in acute severe ulcerative colitis?

A

IV steroid (hydrocortisone/methylprednisolone)
Alternatively can use IV ciclosporin but this is unlicensed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is remission maintained in UC?

A

Rectal aminosalicylate alone, or with oral form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which 2 drugs are unlicensed for use in a patient with 2+ acute flare ups of UC in 12 months?

A

Azathioprine and mercaptopurine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is crohns disease?

A

Flare up involving lesions all throughout the GI tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What complications can arise from crohns disease?

A

Fistulas
Malnutrition, anaemia
Colorectal cancer, small bowel cancers
Growth failure
Arthritis
Osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which 2 drugs can help with diarrhoea in crohns (not ulcerative colitis)?

A

Codeine, or loperamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is fistulating crohns disease?

A

Complication involving formation of fistulas between the intestine and adjacent structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the treatment for a first time acute flare up in crohns disease?

A

IV steroid (hydrocortisone, methylprednisolone, prednisolone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the alternative treatment options for an acute flare up of crohns disease/first presentation?

A

Budesonide
Aminosalicylate
They also have fewer side effects than steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the add on treatment if a patient has had more than 1 flare up in a year?

A

Azathioprine (unlicensed)
Mercaptopurine (unlicensed)
Methotrexate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which drugs are given to maintain remission in crohns disease?

A

Azathioprine, or mercaptopurine (not licensed)

After surgery: As above, or aminosalicylate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are some examples of aminosalicylates?

A

Mesalazine (Pentasa, Asacol, Octasa, Salofalk)
Sulfasalazine (Salazopyrin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Why should patients report any signs of unexpected bleeding/bruising/sore throat/fever with aminosalicylates?

A

Because they can cause blood disorders and blood dyscrasias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

When do blood disorders usually start with aminosalicylates?

A

Within 3-6 months of treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What colour can sulfasalazine cause bodily fluids to change into (including soft contact lenses)?

A

Yellow-orange

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How often should renal function be monitored with aminosalicylates?

A

Before starting treatment, at 3 months, then annually thereafter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which osmotic laxative interacts with mesalazine, and why?

A

Lactulose because it lowers the pH of the stool in the intestines which can effect the release of the active ingredient from E/R preps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is irritable bowel syndrome and who is most affected?

A

A common, chronic relapsing condition affecting 20-30year olds, commonly in women.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What can aggravate IBS?

A

Stress
Depression
Lack of fibres
Lack of sleep
Anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Which types of fibre are recommended in IBS related constipation?

A

Soluble fibres, e.g. isphagula husk, oats, bran

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Which type of sugar should be avoided in diarrhoea related IBS?

A

Sorbitol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the usual dose of mebeverine?

A

135-150mg TDS before 20min meals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Why isnt lactulose recommended in IBS?

A

Because it can cause bloating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are some examples of antispasmodics used in IBS?

A

Mebeverine
Peppermint oil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are examples of some antimuscurinics used in IBS?

A

Hyoscine butylbromide
Atropine
Propantheline
Dicycloverine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

When is linaclotide used in IBS?

A

When different laxatives have not worked and constipation has been present for 12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Which class of drug is unlicensed for use in abdominal pain/discomfort in IBS?

A

TCAs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Why are ER/MR preparations not suitable for patients with short bowel syndrome? What is suitable instead?

A

Because no sufficient drug release would be present.

Uncoated, soluble tablets are preferred.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

When do you refer a patient who presents with constipation?

A

New onset in >50 years
Anaemic
Abdominal pain present
Unexplained weight loss
Blood present in stool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

How do stimulant laxatives work?

A

They stimulate the muscles lining the gut, aiding in defecation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are some examples of stimulants?

A

Senna
Bisacodyl
Glycerol suppositories
Co-danthramer
Sodium picosulfate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

When are stimulants taken during the day?

A

Usually at night

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

How long should stimulants max. be used?

A

1 week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Which stimulant laxative is only used in terminally ill patients, and why ?

A

Dantron (co-danthramer), because it is genotoxic and carcinogenic

44
Q

Which stimulant laxative has the quickest onset of action?

A

Glycerol suppositories (within 15-20mins)

45
Q

What are some examples of stool-softners?

A

Liquid paraffin
Docusate (can also be classed as a stimulant)

46
Q

Why is liquid paraffin not recommended anymore as a laxative?

A

Because it can cause side effects like anal seepage, malabsorption of fat soluble vitamins, and lipoid pneumonia

47
Q

How do osmotic laxatives work, and what are some examples of it?

A

They increase the water content of stools making them easier to pass

Can include: lactulose, macragol

48
Q

Can osmotics be used in pregnancy?

A

Yes

49
Q

What is the onset of action for osmotics?

A

2-3 days

50
Q

What is the mechanism of action of bulk-forming laxatives?

A

They work by increasing faecal mass to stimulate peristalsis

51
Q

Can bulk-forming laxatives be used in pregnancy?

A

Yes

52
Q

What is the duration of action of bulk-forming laxatives?

A

2-3 days for full effect

53
Q

Why should patients taking bulk-forming laxatives be told to drink plenty of water?

A

To avoid gut obstruction

54
Q

What are some examples of bulk-forming laxatives?

A

Isphagula husk (fybogel)
Methylcellulose
Sterculia

55
Q

Which laxative is only given to women if >2 laxatives have not worked?

A

Prucalopride, or lubiprostone

56
Q

Which laxatives are given for opioid-induced constipation?

A

Stimulant + osmotic

57
Q

What is the 1st and 2nd line options for constipation in children?

A

1st line: osmotics (macragol)
2nd line: add simulant, or faecal softener

58
Q

What are the 1st and 2nd line laxative options for constipation in pregnancy/breastfeeding?

A

1st: bulk-forming
2nd line: osmotics

REMEMBER TO AVOID STIMULANTS IN PREGNANCY

59
Q

What are the red flag symptoms involved with diarrhoea?

A

Unexplained weight loss
Rectal bleeding
Persistent diarrhoea

60
Q

What is the 1st line treatment option for diarrhoea?

A

ORT (dioralyte)
Must maintain good hydration with it

61
Q

What are other treatment options used for diarrhoea?

A

Loperamide
Codeine

62
Q

How does loperamide work?

A

Binds to opioid receptors in the GIT to prolong duration of intestinal transit

63
Q

At what age should loperamide not be used?

A

<12 years old

64
Q

What is the max. number of loperamide capsules that can be taken in a day?

A

8 capsules

65
Q

What complications can arise if someone abuses/overdoses on loperamide?

A

QT prolongation
Cardiac arrest

66
Q

Which drug is given to reverse opioid induced toxicity?

A

Naloxone

67
Q

Which conditions can cause dyspepsia?

A

Indigestion
GORD
Gastritis
Gastric/duodenal ulcers

68
Q

How do antacids and alginates work?

A

Antacids: neutralise pH of acid in stomach

Alginates: form a viscous gel on top of stomach to prevent reflux

69
Q

Which antacids have low sodium preparations?

A

Mucogel (co-magaldrox)
Altacite Plus

70
Q

What are some examples of drugs that can interact with antacids, and hence should be taken 2h apart?

A

Tetracylines
Quinolones
Bisphosphonates
Levothyroxine
Rifampicin
Gabapentin

71
Q

How do PPIs work?

A

They block the hydrogen-potassium ATPase pump of the gastric parietal cell

72
Q

Which PPI is the safest in pregnancy?

A

Omeprazole

73
Q

What are some long-term complications that can arise with PPIs?

A

Increased risk of osteoporosis
Increased risk of C.difficile
Vitamin B12 deficiency
Rare cases of lupus

74
Q

What can occur if PPIs have been used for >1 year?

A

Hypomagnasaemia

75
Q

Which 2 drugs must always be avoided with omeprazole?

A

Clopidogrel and methotrexate

76
Q

What are some examples of H2RA antagonists?

A

Cimetidine
Famotidine
Ranitidine

77
Q

Which H2RA antagonist is safest in pregnancy?

A

Ranitidine

78
Q

What are some common causes of peptic ulcer disease?

A

NSAIDs
SSRIs
Steroids
H.Pylori
Poor lifestyle

79
Q

What are the different diagnostic tests used to diagnose H.Pylori?

A

Urea 13c breath test
Stool helicobacter antigen test (SAT)
laboratory based serology

80
Q

What is the treatment for H.pylori?

A

ALWAYS TRIPLE THERAPY
PAC, PAM, OR PMC

  1. Amoxicillin 1g BD 7/7
  2. Clarithromycin 500mg BD 7/7
  3. Lansoprazole 30mg BD 7/7
  4. Metronidazole 400mg BD 7/7
81
Q

How can NSAID-induced ulcers be treated?

A

Withdraw NSAID, or gradually lower dose
Switch to COX-2 inhibitor
Add PPI/H2RA antagonist/misoprostol

82
Q

What is the treatment for confirmed GORD?

A
  1. Antacids/alginates
  2. PPI for 4-6 weeks, or H2RA antagonist
83
Q

When should the urea 13C breath test NOT be done for H.pylori?

A

Within 2 weeks of starting PPI, or 4 weeks within antibacterial treatment

This can lead to a false negative

84
Q

What are some examples of antimuscurinic side effects?

A

Dry mouth
Constipation
Blurred vision
Tachycardia
Urinary retention
Angular-closure glaucoma
Confusion in elderly

85
Q

Are antimuscurinics used in urinary retention or incontinence?

A

They are used in urinary incontinence

86
Q

Why should peppermint oil capsules be swallowed whole?

A

To avoid side effects e.g. local irritation of mouth/oesophagus

87
Q

What is cholestasis?

A

Impaired or disrupted bile formation/flow

88
Q

What are the symptoms of liver disorders?

A

Fatigue
Dark urine
Pale stools
Itchy skin
Signs of fat-soluble decifiency

89
Q

What is the treatment of cholestasis?

A

Colestyramine for itchy skin
Ursodeoxycholic acid used as alternative
Rifampicin (unlicensed)

90
Q

Which biomarker is not specific to the liver, but can also indicate cholesasis/tumour in the liver?

A

ALP

91
Q

What can cause high GGT levels in the liver?

A

Alcohol
Enzyme inducing drugs

92
Q

What can high AST/ALT levels indicate?

A

Acute liver damage

93
Q

What is ascites and how is it treated?

A

It is high sodium/water retention and hepatic portal hypertension.

Treatment: b-blockers, spironolactone, furosemide, lower sodium/water intake

94
Q

How is hepatic encephalopathy treated?

A

Lactulose + neomycin 4g OD

95
Q

What is given to correct any vitamin B/C deficiency?

A

Pabrinex

96
Q

What should a patients BMI be to consider giving orlistat?

A

> 30kg/m squared, or >28kg/m squared + risk factors

97
Q

When should orlistat be discontinued?

A

If patient has not lost >5% of body weight in 12 weeks

98
Q

What are the fat-soluble vitamins which orlistat can deplete?

A

A, D, E and K

99
Q

Which GLP-1 agonists are also used for aid in weight loss?

A

Semaglutide (victoza)
Liraglutide (ozempic, wegovy)

100
Q

What are anal fissures?

A

A tear or ulcer in the lining of the anal canal, leading to bright red blood in stool

101
Q

What is the treatment for acute anal fissures?

A

Bulk-forming or osmotic laxatives
Topical use of lidocaine
Analgesics

102
Q

What is given for chronic anal fissures?

A

GTN rectal ointment (unlicensed)

103
Q

What are haemorrhoids?

A

Swelling of anal mucosa found inside or outside of anus which can be itchy and painful

104
Q

What is the treatment of haemorrhoids?

A

As anal fissures, PLUS (max. 7 days):

Xyloproct: lidocaine + hydrocortisone
Proctosedyl: cinchocaine + hydrocortisone

105
Q

Which enzymes are included in pancreatin?

A

Lipase
Amylase
Protease

106
Q

How are pancreatin capsules (creon) taken?

A

With meals/snacks
Granules can be mixed with slightly acidic liquid or food (e.g. apple juice)

GPhC Exam Revison (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions