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PHAM01 > Wk 11: OTC GI (abdominal pain, oral thrush, mouth ulcers, dyspepsia) > Flashcards

Wk 11: OTC GI (abdominal pain, oral thrush, mouth ulcers, dyspepsia) Flashcards

1
Q

What are the red flags of Gut related diseases?

A
  • Difficulty swallowing
  • Bloody di/vomit
  • Vomiting w/ constipation
  • Weight loss
  • Sustained alteration of bowel habit
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2
Q

When do you refer for abdominal pain?

A
  • Continuous severe pain >1hr
  • Mild/mod on/off 7 days
  • Swelling (hernia)
  • > 45ys + dyspepsia
  • Unexplained weight loss
  • Vom/constipation/di + persistent abdominal pain
  • Blood in vom/stools
  • Babies: projectile vom, constipation, di
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3
Q

Which medications cause GI symptoms?

A
  • NSAIDs: gastric pain
  • Opioids, TCA, iron: constipation
  • Potassium chloride, alendronic + doxy: oesophageal ulceration
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4
Q

What is the cause of oral thrush?

A

Candida infection

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5
Q

What factors can increase the number of organisms for oral thrush?

A
  • Antibiotic therapy
  • Diabetes
  • Pregnancy
  • Immunocompromised
  • Ill fitting dentures
  • Inhaled corticosteroids
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6
Q

What are the symptoms of oral thrush?

A
  • White raised patches on oral mucosa
  • Bleed
  • Painful
  • Baby: refuse feed
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7
Q

What is the treatment for oral thrush?

A
  • Miconazole 20mg/g (daktarin oral gel)
  • From 4 months
  • Continue for 7 days after symptoms have gone
  • Apply after food
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8
Q

What are the counselling points for people with oral thrush?

A
  • Maintain good oral hygiene
  • Inhaler technique
  • Dentures
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9
Q

What is contraindicated in miconazole?

A
  • Warfarin
  • Sulphonylureas
  • Phenytoin
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10
Q

When do you refer for patients with oral thrush?

A

Pregnant/breastfeeding

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11
Q

What are the causes of mouth ulcers?

A
  • Vit B, folic acid deficiency
  • Stress
  • Chrohns, IBD
  • Nutrition
  • Trauma
  • Carcinoma
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12
Q

What are the symptoms of mouth ulcers?

A
  • Shallow yellow/white ulcers on tongue, cheek + lip
  • Painful
  • Single/clusters
  • Recurrent
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13
Q

What are the treatment for mouth ulcers - topical anaesthetics?

A
  • Anbesol liquid
  • Bonjela
  • Short duration
  • Not before meals
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14
Q

What are the available treatment for mouth ulcers - mouthwash?

A

Chlorhexidine (corsodyl mouthwash)

  • Red 2ndry infection
  • Accelerates healing
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15
Q

What are the available treatments for mouth ulcers - topical anti-inflammatory?

A

Benzydamine HCl (Difflam Oral Rinse)

  • Numb + sting
  • dilute w/ equal amount of water if stings
  • Every 1.5 to 3 hrs prn, max 7 days
  • > 13
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16
Q

What is used for previously diagnosed ulceration?

A

Hydrocortisone 2.5mg muco-adhesive buccal tabs

  • > 12
  • Keep in mouth + dissolve QDS
17
Q

When do you refer patients with mouth ulcers?

A
  • Recurrent
  • > 3wks
  • Pregnant/breastfeeding
  • Diabetic
  • Due to infection
18
Q

What are the symptoms of oral cancer?

A
  • White patch + red on gums, tongue, lining of mouth
  • Small sore that fails to heal
  • Lump/mass on lip/mouth/throat
19
Q

What are the causes of dyspepsia?

A
  • Smoking
  • Overweight
  • Pregnancy
  • NSAIDs, digoxin + iron
  • HF
  • H pylori
20
Q

What are the symptoms of dyspepsia?

A
  • Epigastric discomfort after eating/drinking
  • Fullness
  • Heartburn
  • Trapped wind
  • N+V
21
Q

Give examples of treatment given for dyspepsia - antacids

A
  • Magnesium salt: cause di
  • Aluminum salt: cause constipation
  • Pepto-bismol
  • Kolanticon gel
  • Co-magaldrox
22
Q

Who can’t be given pepto-bismol?

A
  • Aspirin sensitive
  • Pregnant
  • <16yrs old
23
Q

What treatment is best for trapped wind?

A

Activated semeticone: Windsetlers

  • Antifoaming - red surface tension of gas bubbles
24
Q

What treatment is best for acid reflux?

A
  • Alginates: Gaviscon + peptac
  • In combination w/ antacids
24
Q

Which drugs interact with antacids?

A
  • Digoxin
  • Lithium
  • Tetracycline
  • Warfarin
  • Iron
  • Alendronic acid
25
Q

What is used for short term symptomatic relief of excess acid, dyspepsia + heartburn?

A

H2 receptor antagonists:

  • Ranitidine
  • > 16
  • Interacts w/ cimetidine
  • CI: pregnant/breastfeeding
  • LT: refer
26
Q

What is given for recurrent heartburn?

A
  • Omeprazole 20mg/10mg tabs
  • 20mg OD
  • Refer: no improvements after 2 wks
  • Can use upto 4wks at 10mg
27
Q

What are the counselling points for dyspepsia?

A
  • Avoid meals at night
  • Avoid spicy
  • Raise head of bed
  • Take antacids 1 hr after food
28
Q

When do you refer someone with dyspepsia?

A

> 55:

  • Persistent vom
  • Loss of appetite
  • Difficulty swallowing
  • Lump in throat
  • GI bleed

PHAM01 (47 decks)

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