Uworld COPY

Question 1

Side effects of Diltiazem (non-dihydropyridine CCB)

Answer 1

Constipation, oedema, hypotension

Question 2

Medications causing constipation

Answer 2

Ondansetron, granisterone, verapamil, diltiazem, iron, aluminium,diphenhydramine, amytriptyline, diclyclomine, haloperidol, morphine, oxycodone, loperamide.

Question 3

MOA of constipation caused by CCB

Answer 3

slow contraction of colonic smooth muscle

Question 4

MOA of constipation in diabetic neuropathy

Answer 4

impairement of gastrocolic reflex

Question 5

MOA of constipation in elderly/neurologic conditions?

Answer 5

dyssenergic defecation

Question 6

Symptoms of sigmoid volvulus

Answer 6

abdominal pain, nausea, vomitting, bowel obstruction

Question 7

How are pigment gall stones formed

Answer 7

increased efflux of bilirubin into bile

Question 8

How are gall stones formed in ileal disease like Chrons

Answer 8

altered enterohepatic circulation

Question 9

How are pigment gall stones formed

Answer 9

increased efflux of bilirubin into bile

Question 10

How are gall stones formed in ileal disease like Chrons

Answer 10

altered enterohepatic circulation

Question 11

Cause of diabetic diarrhea that persists at night (even with fasting) and day

Answer 11

autonomic neuropathy causing disordered motility of small bowel and colon and increased secretions

Question 12

Risk factors for diabetic diarrhea

Answer 12

Impaired glucose control and vascular (obesity and HT)

Question 13

Cause of diabetic diarrhea that persists at night and day

Answer 13

disordered motility of small bowel and colon

Question 14

Risk factors for diabetic diarehea

Answer 14

Impaired glucose control and vascular (obesity and HT)

Question 15

Diarrhea in exocrine pancreatic insufficiency

Answer 15

steatorrhea

Question 16

What nutrient deficiency is seen with PPI

Answer 16

calcium, iron, magnesium and vitamin B12

PPI improve lipase as acid inactivates lipase

Question 17

MOA of constipation in pregnancy

Answer 17

progesterone causes decreased colonic smooth muscle activity

Question 18

Pathophysiology of ADH/RAS in cirrhosis

Answer 18

cirrhosis causes vasodilatation, reduces blood flow, activates RAS and increase ADH, increases renal Na reabsorption (hence decreasing urine sodium). This increases TBW but due to third spacing they are intravascularly depleted causing hypervolumic hypernatremia in advanced cirrhosis

Question 19

MOA of constipwtion in pregnancy

Answer 19

progesterone causes colonic smooth muscle activity

Question 20

Effects of pregnancy on GI tract

Answer 20

progesterone decreases LE tone-GERD
estrogen increases cholesterol secretion in bile, progesterone decreases GB motility-GB stones
Gravid uterus mechanical effect-flatulence
gravid uterus increase mechanical pressure-hemorrhoids

Question 21

constipation after a traumatic vaginal delivery MOA

Answer 21

defecatory dysfunction, inablity to relax pelvic floor muscles
Rectoceles can occur after multiple vaginal deliveries