Gi System - Gastric Acid Disorder

Question 1

Urgent Referral for Dyspepsia/Gord?

Answer 1

Bleeding
Over 55
Weight loss unexplained

BOW

Question 2

Uninvestigated Dyspepsia treatment plan?

Answer 2

PPI for 4 weeks

If doesn’t work: H Pylori Test

Question 3

Investigated Functional Dyspepsia however cause not known?

Answer 3

Test for H Pylori

If not infected 4 weeks PPI or H2 antagonist

Question 4

H Pylori test?

Answer 4

Urea (13c) Breath Test
Or
Stool Helicobacter Antigen Test (SAT)

Question 5

When should PPI and Abx be stopped before a H pylori test?

Answer 5

PPI stopped 2 weeks before

Abx stopped 4 weeks before

Question 6

H Pylori treatment? Duration?

Answer 6

PPI Twice daily

Amoxicillin 1000mg BD

Clarithromycin 500mg BD
Metronidazole 400mg BD

7 days

Question 7

GORD - Gastro Oesphagul Reflux disease

What increases it from happening?

Answer 7

Fatty Foods
Pregnancy
Hernia
Family History
Stress/Anxiety
Obesity
Drugs
Smoking
Alcohol

Question 8

Drugs which can increase GORD?

Answer 8

CCB
Statins
ACE inhibitors
Nitrates

Question 9

Also cause Oesphagul irritations?

Answer 9

Bisphosphonates
TCAS
Corticosteroids
Benzos
Abx (Clindamycin and Tetracycline)

Question 10

Nitrates increase GORD how?

Answer 10

Loosens sphincter
Therefore more acid Reflux

Question 11

Uninvestigated GORD treatment?

Answer 11

4 weeks PPI

Question 12

How to treat confirmed GORD?

Answer 12

4-8 weeks of PPI

Question 13

Gord during Pregnancy? 3 steps?

Answer 13

• Dietary and lifestyle
• Antacids and Alginate
• Omeprazole or Ranitidine

Question 14

Magnesium containing antacids laxative or constipation effect?

Answer 14

Laxative effect

“L” next to “M” in alphabet

Question 15

Aluminium containing antacids laxative or constipation effect?

Answer 15

Constipating Effect

“C” next to “A” in alphabet

Question 16

Calcium containing Antacids affects reflux how?

Answer 16

Induces rebound acid secretion effect

Question 17

What increases viscosity of stomach contents to prevent acid bounce back?

Answer 17

Antacids + Alginate

Forms viscous gel Raft - floats on surface of stomach contents prevent acid bounce back

Question 18

Antacids and Hypertension & lithium interaction?

Answer 18

Due to sodium content

Contraindicates with Lithium/Hypertension

Hypernatraemia

Question 19

Low sodium antacid available?

Answer 19

Co-magaldrox

Question 20

Which drugs impair antacid absorption?

Answer 20

Bisphosphonates
Tetracyclines
Ciprofloxacin

Question 21

PPI MHRA warning?

Answer 21

Low risk of Subacute Cutaneous Lupus Erythematosus

(Which is an autoimmune disorder causing skin sores/rashes)

Question 22

PPI electrolyte imbalance and therefore risk of what condition occurring?

Answer 22

Hypomagnesaemia

Increasing Risk of Fractures/Osteoporosis

Question 23

PPi and C. difficile

Answer 23

Ppi increase risk of C Difficile

Question 24

Esomeprazole/Omeprazole with Clopidogrel?

Answer 24

Do not use together!

Use Lansoprazole instead

Question 25

PPI increase concentration of what high risk drugs?

Answer 25

Phenytoin
Methotrexate
Warfarin
Digoxin

Question 26

H2 Receptor antagonist and PPI can mask what condition?

Answer 26

Gastric Cancer

Question 27

H2 receptor antagonist interacts with what?

Answer 27

-Azoles & Antifungals

It reduces absorption of these drugs in the body