Other

Question 1

Food allergies caused due to

Common allergens examples

Answer 1

Immune system - anaphylactic shock rick

Cows milk, peanuts, hens eggs, soy, wheat, fish and shellfish

Question 2

Management of food allergy

Answer 2

Strict avoidance
Sodium cromoglycate tabs/caps- given alongside avoidance

Question 3

Drug treatment for symptom control in food allergy

Answer 3

Chloremphanamine maleate (piriton)

Question 4

Food induced anaphylaxis treatment

Answer 4

1. Adrenaline

Question 5

MHRA warning for adrenaline

Answer 5

Carry 2 in date auto injectors and use as soon as anaphylaxis is suspected (airway, breathing or circulation problems arise)

Question 6

Exocrine pancreatic insufficiency means

Answer 6

Reduced secretion of pancreatic enzymes into duodenum

Question 7

Symptoms of exocrine pancreatic insufficiency

Answer 7

Maldigestion
Malnutrition
Diarrhoea
Abdominal cramps
Steatorrhea (fatty poo)

Question 8

Causes of reduced exocrine secretions

Answer 8

CF
Coeliac disease
Zollinger sydrome
Pancreatic tumour
GI surgery
Chronic pancreatitis

Question 9

Treatment of exocrine pancreatic insufficiency

Examples

Answer 9

Pancreatic enzyme replacement with pancreatin

Creon
Pancrex V
Nutrizym 2

Question 10

Pancreatic enzyme- counselling points

Answer 10

Take with food and avoid heat

Question 11

Pancreatin contains 3 groups of enzymes which are …….
Whats their role?

Answer 11

Lipase
Amylase
Protease

They assist in the digestion of fats, carbs and proteins

Question 12

Lifestyle management for pancreatic insufficiency

Answer 12

Avoid hard to digest foods (legumes), reduced fat diets
Avoid alcohol completely
Ensure adequate hydration for those on high strength pancreatin

Question 13

Can you take alcohol if you had pancreatic insufficiency

Answer 13

Avoid alcohol completely

Question 14

Whats the difference between ileostomy and colostomy

Answer 14

Ileostomy - connects end of small intestine to abdominal wall

Colostomy- connects colon to abdominal wall

Question 15

Whats a stoma, whats their two common forms

Answer 15

An external bag which connects to abdomen containing urine and faeces instead of through the anus

Colostomy
Ileostomy

Question 16

What formulations are unsuitable in stoma patients

Answer 16

Enteric coated and MR due to insufficient release of active ingredient

Question 17

Avoid this substance as can cause a laxative affect

Answer 17

Sorbitol

Question 18

Most suitable analgesics in stoma patients

Answer 18

Paracetamol

Opioids may cause constipation in colostomy patients and NSAIDs, aspirin may cause bleeding

Question 19

Antacids in stoma patients, what risks are increased

Answer 19

Magnesium—> diarrhoea

Aluminium—> constipation

Question 20

Anti diarrhoeal drugs used in ileostomy

Answer 20

Loperamide and codeine phosphate

They may be at risk of fluid depletion which can lead to hypokalaemia

Question 21

Can diuretics be used in stoma patients

Answer 21

Yes but with caution due to risk of dehydration or potassium depletion
- may use potassium sparing diuretic to prevent hypokalaemia

Question 22

Iron preparations , how do they affect bowel movement of stoma patients

Answer 22

Causes diarrhoea in ileostomy

Causes constipation in colostomy

Stools may appear black
Sore skin if output leaks
Try avoiding

Question 23

Which laxatives are preferred in colostomy

Answer 23

Bulk forming preferred over stimulants in colostomy
Stool softeners can also be used

Use laxatives with caution in ileostomy- loss of water and electrolytes

Question 24

Why do we split doses of potassium supplements in stoma patients

Answer 24

To avoid osmotic diarrhoea