Motility

Question 1

How does polymyositis affect GI motility?

Answer 1

Causes pharyngeal dysphagia. Reduced contractions in pharynx and proximal esophagus.

Question 2

Familial Visceral Myopathy or Neuropathy Presentation and inheritance pattern. Histology?

Answer 2

Causes severe GI motility issues and chronic intestinal pseudo obstruction. type 1 is AD, type 2 is AR. Histology shows mitochondrial damage and “ragged red fibers”.

Question 3

Use of octreotide in scleroderma?

Answer 3

Can be good at increasing MMC induced small bowel clearance but slows gastric emptying

Question 4

Paraneoplastic Visceral Neuropathy Antibodies

Answer 4

Anti-Hu and Antineuronal nuclear antibody 1 (ANNA-1)

Question 5

What is paraneoplastic visceral neuropathy?

Answer 5

Intestinal pseudoobstruction in patients with malignancy (usually small cell carcinoma)

Question 6

Suspected paraneoplastic visceral neuropathy with negative CXR?

Answer 6

Do a CT scan!

Question 7

Which meds have the following mechanism of action:
1. Type 2 Chloride channel activator
2. Guanylate Cyclase C agonist

Answer 7

1.Lubiprostone (Amitiza)
2. Linaclotide and Plecanatide (Trulance)

Question 8

Eluxadoline use, mechanism, side effect

Answer 8

Used for IBS-D, mixed opioid agonist, can cause pancreatitis

Question 9

Alosetron use, mechanism, why is its use restricted?

Answer 9

IBS D, 5Ht3 antagonist, significant side effects like constipation and ischemic colitis

Question 10

Approved invasive therapies for fecal incontinence

Answer 10

Sacral nerve stimulation and injection of dextranomer for sphincter bulking

Question 11

How does MEN IIB affect GI motility?

Answer 11

Neuronal intestinal dysplasia syndrome: can cause mega colon and constipation.

MEN IIB: medullary carcinoma of thyroid and pheo