GI system

Question 1

Which aminosalicylate requires LFT every month for the first 3 months?

Answer 1

Sulfasalazine

Question 2

Which laxative should be avoided in opioid induced constipation?

Answer 2

Bulk forming

Question 3

What 2 conditions must loperamide be avoided in?

Answer 3

Bloody and inflammatory diarrhoea

Question 4

What BMI is considered obese?

Answer 4

> 30kg/m2

Question 5

Which group of drug may cause an increased risk of GI infections?

Answer 5

PPIs so lansoprazole ect, review if pt has C.Diff infection

Question 6

What conditions do you have to use hyoscine in caution with?

Answer 6

Cardiac: the injection can cause tachycardia, hypotension, and anaphylaxis (more likely death if those with CHD). It is contraindicated in tachycardia

Question 7

Which aminosalicylate can cause Haematological abnormalities in the first 3-6 months?

Answer 7

Sulfasalazine so obvs you want a FBC initally and then every months for at least 3 months

Question 8

Which aminosalicylate can stain soft contact lenses?

Answer 8

Sulfasalazine

Question 9

What pain relief class should be avoided in diverticulitis disease?

Answer 9

NSAIDs and opioids as they can increase risk of diverticular perforation

Question 10

What is 1st line for short term constipation?

Answer 10

Bulk forming laxative e.g. ispagula husk
If stools hard and difficult to pass despite bulk forming= + or switch to osmotic such as lactulose or macrogol
If stools soft and difficult to pass despite bulk laxative= + a stimulant laxative

Question 11

What are PPIs associated with although its very rare?

Answer 11

Subacute cutaneous lupus, watch for lesion that develop on sun exposed skin and joint pain.

Also associated with: Increased risk of GI infections, osteoporosis (take vit D and calcium) and hiding symptoms of gastric cancer