GIT Assessment Flashcards
A patient being treated for gastric ulcer complains of black stools and blackening of his tongue. Which of the following would most likely be responsible?
- Colloidal bismuth
- Omeprazole
- Clarithromycin
- Sodium bicarbonate
- Misoprostol
4
A stool surfactant agent
Docusate
Potencies of Antiemetic Drugs: Substituted benzamide
High
Emetic potential of Anticancer Drugs: Methotrexate
Mild
A 33-year old woman came for consultation due to recurrent hypogastric pain associated with constipation,
with hard and narrow stools, the past 4 months. She also complains of always feeling bloated and of having flatulence. Investigation revealed no organic cause and led to the diagnosis of irritable bowel syndrome. Which of the following is inappropriate for the management of this patient?
- Doxepin (tricyclic antidepressant)
- Lubipristone
- Methylcellulose
- High-fiber diet and avoidance of carbonated beverages
- Alosetron
Alosetron
Emetic potential of Anticancer Drugs: Cisplatin
Strong
A patient with gastric ulcer is currently taking pantoprazole. You decided to give another agent to protect the
ulcer bed. This drug binds to the affected site and acts as a physiochemical barrier.
Sucralfate
This is a prokinetic agent that may be used to treat gastroparesis in diabetic patients. However, long-term use may cause symptoms of parkinsonism.
Metoclopramide
Potencies of Antiemetic Drugs: Corticosteroid
Moderate
The most common site of inflammation in Crohn’s disease:
Ileum
A neurokinin-1 receptor blocker that is effective in highly-emetogenic chemotherapy regimens.
Aprepitant
A drug with low antiemetic potency used for anticipatory vomiting. It has sedative and anxiolytic properties.
Lorazepam
Emetic potential of Anticancer Drugs: Doxorubicin
Moderate
A 60-year old male came for consultation due to epigastric pain occurring about 2 hours after meals, relieved by food and that awakens him at night. Medical history includes hypertension and rheumatoid arthritis. He is taking a thiazide and an NSAID regularly as prescribed. He is also a chronic smoker and drinks alcoholic
beverages. Upon abdominal palpation, the abdomen is soft but there is tenderness in the epigastric area. Endoscopy was done with findings of a duodenal ulcer 2 cm from the pylorus. He is negative for H. pylori infection. Which drug would be most effective in treating the ulcer and in reducing gastric acid secretion?
- Omeprazole
- Sucralfate
- Ranitidine
- Aluminum hydroxide
Omeprazole
The use of this drug is restricted to severe refractory Crohn’s disease because of its association with
multifocal leukoencephalopathy.
Natalizumab
An antacid that may cause constipation as a side effect:
Aluminum hydroxide
An osmotic laxative
- Lactulose
- Docusate sodium
- Senna
- Methylcellulose
Lactulose
Which of the following is not true of H2-receptor antagonists?
- They only partially inhibit gastric secretion induced by acetylcholine
- Cimetidine is the prototype agent and the most commonly used
- Their effect is fully reversible
- Can inhibit >90% of gastric acid secretion after a single dose
They only partially inhibit gastric secretion induced by acetylcholine
The most common complication in peptic ulcer disease:
GI Bleeding
Potencies of Antiemetic Drugs: Antihistamine
Low
A 27-year-old American went on vacation in the Philippines. However, a day prior to his flight back home, he develops acute gastroenteritis and has had 4 episodes of diarrhea associated with crampy abdominal pain. You prescribed oral rehydrating solution. Also, which is an antidiarrheal agent that he can take while on the plane?
- Lactulose
- Loperamide
- Ondansetron
- Domperidone
Loperamide
A 25-year-old female has been having intermittent episodes of colicky right lower quadrant pain and diarrhea the past 3 months. She has lost weight because of the diarrhea and anorexia. Endoscopy showed inflammation and ulcers all over the ileum with areas of fusion, forming a cobblestone appearance. She was
diagnosed with Crohn’s disease. The following may help treat the patient’s condition, except:
- Prednisone
- Ursodiol
- Azathioprine
- Methotrexate
Ursodiol
What is the mechanism of action of proton pump inhibitors?
- Competitively binds to H2 receptors in the stomach and inhibits gastric secretion induced by histamine or gastrin
- Enhances mucous bicarbonate secretion, stimulates mucosal blood flow, and decreases mucosal cell turnover
- Reacts with gastric acid to form water and a salt, thereby diminishing gastric acidity
- Inactivates the parietal cell H+/K+ ATPase, thus inhibiting gastric acid secretion
Inactivates the parietal cell H+/K+ ATPase, thus inhibiting gastric acid secretion
In the treatment of Crohn’s disease, the use of this agent may be limited because of its side effects which include GI upset, bone marrow suppression, hepatitis, and severe hypersensitivity reactions.
• Azathioprine
A 37-year old woman noted several instances of vaginal bleeding after sexual intercourse. She has been sexually active since 16 years old and has multiple partners. Work-up was done and it revealed stage III cervical cancer. Since the malignancy has already extended to the pelvic wall and lower third of the vagina,
surgery can no longer be done. The physician opted to subject her to chemotherapy with cisplatin along with
radiation therapy. The physician anticipated that cisplatin would be highly emetogenic. Which drug combination would be most effective to prevent nausea and vomiting in the patient?
Dexamethasone and Ondansetron
