Passmed Gastroenterology - Pharmacological Managements

Question 1

Acute upper GI bleed

Answer 1

Platelets if <50
FFP if fibrinogen/APTT deranged
Terlipressin + antibiotics

Question 2

Alcoholic ketoacidosis

Answer 2

Infusion of saline + thiamine

Question 3

Alcoholic hepatitis

Answer 3

Prednisolone

Question 4

Ascites

Answer 4

Spironolactone
Prophylactic ciprofloxacin

Question 5

Autoimmune hepatitis

Answer 5

Steroids

Question 6

Bile acid malabsorption

Answer 6

Cholestyramine

Question 7

Carcinoid tumours

Answer 7

Octreotide (somatostatin analogue)

Question 8

H. pylori eradication

Answer 8

PPI + amoxicillin + clarithromycin/metronidazole (both if PA)

Question 9

Prophylaxis of hepatic encephalopathy

Answer 9

1st - lactulose
2nd - add rifaximin

Question 10

IBS symptom management

Answer 10

Pain - antispasmodic agents
Constipation - laxatives, avoid lactulose
Diarrhoea - loperamide

Question 11

Peptic ulcer - acute bleeding

Answer 11

IV PPI

Question 12

Primary biliary cirrhosis

Answer 12

Ursodeoxycholic acid
If itching = cholestyramine as well

Question 13

Main adverse effects of PPIs (3)

Answer 13

Hyponatraemia, hypomagnesaemia
Osteoporosis
Increased risk of C. diff

Question 14

Consequences of refeeding syndrome

Answer 14

Hypophosphataemia
Hypokalaemia
Hypomagnesaemia

Question 15

How to prevent refeeding syndrome?

Answer 15

If haven’t eaten for >5 days, only re-feed at max 50% of requirements for the first 2 days

Question 16

Spontaneous bacterial peritonitis

Answer 16

IV cefotaxime

Question 17

Wilson’s disease

Answer 17

Penicillamine