Gastro

Question 1

Upper GI bleed - what action to take if GBS 0, 1, 2-7 (stable), 7+ or unstable?

Answer 1

0 - discharge from ED
1 - dicuss with Gastro SpR
2-7 - admit gastro - endoscopy within 24h
7+ - Urgernt gastro review and emergency OGD

Question 2

What Hb value should you consider transfusion in upper GI bleed?

Answer 2

<80 - transfuse

80-100 discuss with gastro Reg

NB If suspect variceal bleeding - only transfuse if <80 as can encourage bleeding

Question 3

What prokinetic agent can be given before endoscopy in upper GI bleed?

Answer 3

Erythromycin

Question 4

What two medications are often given in maangement of variceal bleeding?

Answer 4

1. Terlepressin

2. Tazocin

Question 5

How do bulk forming laxatives work and give an example?

Answer 5

Work by adding water to the stool and thus volume

Isphagula husk, Fibergel

Question 6

How do osmotic laxatives work and give an example?

Answer 6

Add water to BOWEL to soften stool?

Movicol (also stimulant), Docusate

Question 7

How do stimulant laxatives work and give an example?

Answer 7

Induce colon muscles to induce a bowel movement

Senna

Question 8

What medication can be used in the treatment of PSC?

Answer 8

Ursodeoxycholic acid

Question 9

What liver marker is raised into 1000s with viral hepatitits?

Answer 9

ALT

Question 10

What is in a NILS? (8)

Answer 10

1. US and doppler
2. Hep A, B, C , EBV, CMV
3. IgG, anti smooth muscle Ab, ANA –> AI hepatitis
4. IgM, anti mitochondrial Ab –> primary sclerosing cholangitis
5. IgA - raised in alcohol abuse
6. Anti trysinogen (Alpha 1 antitrypsinogen)
7. Ferritin (Haemachromatosis)
8. Caerusplatin (Wilsons)