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GI SYSTEM - MEDIUM > Other GI stuff > Flashcards

Other GI stuff Flashcards

1
Q

What are signs that a patient is allergic to certain food?

A
  • cutaneous e.g. rash, hives
  • GI e.g. colic, vomiting
  • Resp e.g. breathing probs
  • Anaphylaxis
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2
Q

What are main causes of food allergy?

A
  • peanuts
  • cows milk
  • soy
  • hens eggs
  • fish
  • shellfish
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3
Q

How do you treat food allergy?

A
  • sodium cromoglicate in adjunct to dietary adjustment
  • chlorphenamine
  • adrenaline for anaphylaxis
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4
Q

What can cause GI smooth muscle spasm?

A
  • IBD
  • IBS
  • Bowel colic in palliative care
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5
Q

How do you treat GI smooth muscle spasm?

A
  • antispasmodics

- antimuscarinics

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6
Q

What are examples of antimuscarinics used for GI muscle spasm?

A
  • Atropine (rarely used)
  • Dicycoverine
  • Hyoscine butylbromide
  • Propantheline bromide
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7
Q

What are side effects of antimuscarinics?

A
  • Blurred vision
  • Urinary retention
  • Constipation
  • Dry mouth
  • Tachycardia
  • Pupil dilation
  • Reduced bronchial secretions
  • Angle-closure glaucoma
  • Confusion in elderly
  • Drowsiness
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8
Q

Who should you be cautious in when prescribing antimuscarinics?

A
  • pts who are susceptible to angle-closure glaucoma
  • conditions causing tachycardia
  • CVD e.g. arrhythmias, congestive heart failure
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9
Q

Who are antimuscarinics contra-indicated in?

A
  • prostatic enlargement/urinary retention
  • closed-angle glaucoma
  • paralytic ileus, GI obstruction, toxic megacolon
  • Myasthenia gravis
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10
Q

What is the difference between antimuscarinics and antispasmodics?

A
  • musc = reduce intestinal motility

- spas = directly relaxes intestinal smooth muscle

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11
Q

What are examples of antispasmodics?

A
  • Mebeverine
  • Alverine (dizziness, driving warning)
  • Peppermint oil (heartburn)
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12
Q

What is ursodeoxycholic acid used for?

A
  • dissolution of gall stones

- primary biliary cirrhosis

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13
Q

How do you treat oesophageal varices?

A
  • Treated with terlipressin
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14
Q

How do you treat obesity?

A
  • orlistat
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15
Q

What is reduced exocrine secretions?

A
  • reduced secretions of pancreatic enzymes

- can cause maldigestion, malnutrition, GI symptoms

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16
Q

What causes a reduction of exocrine secretions?

A
  • cystic fibrosis
  • chronic pancreatitis
  • zollinger-ellison syndrome
17
Q

What dietary advice would you give to someone with reduced exocrine secretions?

A
  • distribute food intake between 2 main meals and 2-3 snacks
  • avoid food difficult to digest
  • do not consume alcohol
  • avoid reduced fat diets
18
Q

What would you take for reduction of exocrine secretions?

A
  • pancreatin - amylases, lipases, proteases
  • Pancreatin inactivated by gastric acid
  • E/C preparations deliver higher pancreatin levels
  • Pancreatin inactivated by heat (do not mix with hot food or drink)
19
Q

What are side effects of pancreatin (creon)?

A
  • N+V
  • Abdominal discomfort
  • Irritations

e.g. excessive doses = perianal irritation, hyperuricaemia, hyperuricosuria

20
Q

Who is pancreatin contraindicated in?

A
  • Nutrizym 22/pancrease HL in children 15 years old or under with cystic fibrosis
21
Q

What counselling points are needed with pancreatin?

A
  • ensure adequate hydration at all times with high strength preparations
22
Q

What are the symptoms of anal fissure (tear in lining of anal canal)?

A
  • bleeding
  • sharp pain on defecation
  • linear split in anal mucosa
23
Q

How do you treat an acute anal fissure that has lasted less than 6 weeks?

A
  • soft stools to ease pain - bulk forming or osmotic laxatives
  • prolonged burning pain - short term anaesthetic (lidocaine) (apply before emptying bowel)
24
Q

How do you treat chronic anal fissure that has lasted longer than 6 weeks?

A
  • GTN rectal ointment (side effect = headache)

- OR oral/topical CCB (diltiazem/nifedipine)

25
Q

What are haemorrhoids?

A
  • swelling of anal mucosal cushion
26
Q

What are the symptoms of haemorrhoids?

A
  • pain after defecation
  • bleeding
  • swelling
  • itchy/sore skin
27
Q

What are the risk factors for developing haemorrhoids?

A
  • pregnancy

- constipation - bulk forming laxative

28
Q

What topical treatment can be used for haemorrhoids?

A
  • local anaesthetic - lidocaine
  • corticosteroids
  • astringents (liquid based formula)
  • lubricants
  • antiseptics
29
Q

How do you treat local haemorrhoid pain?

A
  • anaesthetics - few days max
30
Q

How do you treat local perianal inflammation?

A
  • preparations with corticosteroids - max 7 days

- hydrocortisone, flucortolone, pred

31
Q

What do you avoid if you have haemorrhoids?

A
  • NSAIDs if there is rectal bleeding

- Opioids

32
Q

What should you avoid if pt has a stoma?

A
  • sorbitol preparations
33
Q

People with stoma are vulnerable to water and electrolyte depletion - what should you be careful of?

A
  • diuretics - excessive dehydration and potassium loss
  • hypokalaemia - risk of digoxin toxicity
  • avoid laxatives

GI SYSTEM - MEDIUM (5 decks)

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