Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

DIPLOMA 📚 > Gastro-intestinal Disease > Flashcards

Gastro-intestinal Disease Flashcards

(92 cards)

Start Studying
1
Q

Describe the stomach

A
  • J shaped saclike chamber
  • between oesophagus & small intestine
  • fundus - the body - antrum - pyloric sphincter
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define dyspepsia

A

Complex of symptoms of the upper GI tract including discomfort/pain, heartburn, acid reflux, nausea and vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Two categories of dyspepsia

A

Un-investigated

Investigated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Three categories of investigated dyspepsia

A

Peptic ulcer disease
Functional dyspepsia (non ulcer)
GORD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Two subtypes of peptic ulcer disease

A

Gastric ulcers

Duodenal ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Two subtypes of GORD

A

Oesophagitis

Endoscopically negative reflux disease (ENRD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Is there a link between H.pylori and dyspepsia

A

YAS - but small link

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Lifestyle advice for dyspepsia

A 
Lose weight
Stop smoking
Stop alcohol
Reduce coffee, choc, fatty food
Avoid large meals near bedtime 
Raise head of bed through blocks not pillows
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Medications causing dyspepsia

A 
NSAIDs
Aspirin
Calcium antagonists
Nitrates
Theophyllines
Bisphosphonates
Corticosteroids
Iron
Antibiotics
Slow release potassium 
Anticholinergics 
SSRIs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Alarm symptoms of dyspepsia

A 
Chronic GI bleeding 
Progressive unintentional weight loss 
Progressive difficulty swallowing 
Persistent vomiting
Iron deficiency anaemia 
Epigastric mass
Suspicion of cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Treatment options for dyspepsia

A

Antacids
Alginates
PPI
H2RA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How to antacids work and what are the counselling points

A

Neutralise gastric acid
Liquid more effective but shorter duration as leaves stomach quicker
Take when symptoms are expected between meals and at bedtime
Don’t take with other drugs as impairs absorption and can damage Enteric coating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Some antacids contain a lot of sodium - when should these be avoided

A 
Hypertension
Renal impairment
Heart failure
Lithium therapy
Salt restricted diets
Pregnant women
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

True or false: calcium containing antacids do not induce rebound acid secretion

A

False- they CAN induce it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

True or false: antacids containing magnesium can cause diarrhoea

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

True or false: antacids containing aluminium can cause constipation

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How do alginates work and when are they ideal?

A

Form a raft that floats at the surface

Ideal for reflux symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Short term side effects of PPIs

A

GI disturbances (diarrhoea)
Headaches
Dizziness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Long term side effects of PPIs

A

Hypomagnesaemia
Osteoporotic fractures
C.diff
Mask symptoms of gastric cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does the MHRA recommend with PPIs?

A

Ensure adequate vit D and Ca2+ in those at risk of osteoporosis
Measure Mg2+ levels before starting and throughout (especially in those with other Mg2+ lowering drugs such as digoxin, diuretics)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

When should PPIs be taken?

A

30-60 mins before breakfast or evening meal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How do PPIs cause interactions?

A

Lower acid in stomach which impairs absorption of some drugs

Can inhibit CYP450

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Omeprazole can interact with what

A

Warfarin
Phenytoin
Clopidogrel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Pantoprazole can interact with what

A

Warfarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Esomeprazole can interact with what
Phenytoin | Clopidogrel
26
Key drugs that should be used with caution or not at all with PPIs
``` Warfarin Protease inhibitors Ulipristal Clopidogrel Phenytoin ```
27
PPI dosing recommendations
Full dose for 1 month or H.pylori test and treat then if symptoms return after successful treatment use PPI low dose then PRN. If no response try H2RA
28
Name 4 licensed H2RA
Cimetidine Famotidine Nizatidine Ranitidine
29
Side effects of H2RAs
``` Diarrhoea Headache Dizziness Rash Tiredness ```
30
How does cimetidine interact with other meds?
Bonds to microsomal cytochrome P450 in the liver
31
Stepping down PPI/H2RA is not appropriate in what scenarios
Complicated oesophagitis (past strictures, ulcers, haemorrhage, Barrett’s oesophagus) People taking a PPI for GI protection against NSAIDs Previous bleeding peptic ulcer who remain H pylori +ve after at least 2 attempts at eradication
32
Advice for patients before endoscopy?
Do NOT take PPI/H2RAs for a minimum of 2 weeks before endoscopy and don’t take NSAIDs *can use antacids/alginates for symptom relief if needed*
33
NSAID associated GI adverse effects are classified into what three broad categories
Nuisance symptoms Mucosal lesions Serious GI complications
34
How do NSAIDs work and cause GI bleeds
Inhibit the prostaglandin-generating enzyme (cyclo-oxygenase COX) therefore you have no inhibition of acid secretion
35
Which type of NSAID are associated with lower GI risk?
COX-2 selective such as entoricoxib/celecoxib
36
NSAIDs with HIGH GI risk
Piroxicam Ketoprofen Ketorolac
37
NSAIDs with intermediate GI risk
Indometacin Diclofenac Naproxen High dose ibuprofen
38
NSAIDs with lowest GI risk
Ibuprofen
39
Which NSAIDs are associated with a small increased risk of thrombotic events (MI & stroke)
All NSAIDs including COX2 selective
40
Which NSAIDs are associated with highest CV risk
Diclofenac 150mg/ day | Ibuprofen 2.4g/ day
41
Which NSAIDs have lowest CV risk
Naproxen (1g/day) | Low dose ibuprofen has not been associated
42
NICE guidance on PUD disease
Stop NSAID full dose PPI for 8 weeks Treat H.pylori once healed If still need NSAID review every 6 months, consider alternatives, use COX -2 selective with PPI
43
Risk factors for GORD
``` Age 45-64 Women Caucasian Lifestyle factors Pregnancy (increase progesterone and oestrogen decrease LOS pressure) Drugs ```
44
True or false: h.pylori is protective against GORD
True dat
45
Clinical presentation of reflux
``` Heartburn Regurgitation Waterbrash Dysphagia Odynophagia Chronic hoarseness/cough ```
46
What are the aggressive factors for GORD
Gastric contents | Duodenal contents
47
What are the defensive factors for GORD
Lower oesophageal sphincter Clearing mechanisms Tissue resistance
48
What are the complications of GORD
Aspiration Oesophageal stricture Haemorrhage Barrett’s oesophagus and adenocarcinoma
49
What is Barrett’s oesophagus
The squamous cells of the oesophagus undergo metaplasia to columnar cells which resemble cells of the intestinal mucosa
50
What’s the surgical procedure for GORD
Nissen fundoplication
51
Patient has PUD from NSAID use and tests +ve for h. Pylori- what do they need
8 weeks full dose PPI as NSAID poses greatest risk THEN eradication therapy
52
How would you describe H.pylori
``` Spiral Gram negative Microserophilic Rod-shaped bacteria Multiple flagella ```
53
What are the virulence determinants of H. Pylori
Expression of active forms of a vacuolating cytotoxin | Possession of the cagA (cytotoxin associated gene)
54
Risk factors for peptic ulcer disease
``` h.pylori Use of NSAIDs Smoking Alcohol Lower socio-economic status Family history Blood group O Hyperacidity (zollinger-Ellison syndrome) ```
55
Two common forms/causes of PUD
H.pylori associated | NSAID associated
56
Three complications of ulcers
Bleeding Perforation Obstruction
57
Diagnosis of H.pylori
Carbon-13 urea breath test (UBT) Stool antigen tests Serological tests
58
Retest to confirm eradication no sooner than *** weeks after completion of treatment using UBT not stool antigen
4 weeks
59
Why can you not use serological tests to check eradication of H.pylori
Antibody can persist for up to two years after successful eradication
60
Two types of endoscopy to diagnose H.pylori
Urease testing | Histology
61
How does urease testing via endoscopy work
Urea in the test gel is hydrolysed by urease to produce ammonia (alkaline) brings about a change in pH indicator (phenol red) from yellow to red
62
True or false: false positive urease testing endoscopy results can occur 24 hours after
True
63
What bacteria can also produce urease that can cause false positive h.pylori test
Proteus spp
64
True or false: healing of GU is not increased by H pylori eradication
true - it only benefit healing of DU
65
Eradication of H.pylori treatment
Full dose PPI Amoxicillin + Clarithromycin/metronidazole Pen allergic? Full dose PPI Clarithromycin Metronidazole
66
Side effects of PPI
Headache | Diarrhoea
67
Side effects of clarithromycin
GI upset Diarrhoea Altered taste
68
Side effects of amoxicillin
GI upset Headache Diarrhoea
69
Side effects of metronidazole
Metallic tase Dyspepsia Alcohol reaction
70
Side effects of tetracyclines
GI upset | Photo sensitivity
71
Bismuth containing products can cause what
Darkening of the tongue, stool, nausea | GI upset
72
The Rome committee of functional gastrointestinal disorders diagnostic criteria must include one of more of the following
Postprandial fullness Early satiety Epigastric pain Epigastric burning
73
Management of h. Pylori negative functional dyspepsia
low dose PPI or H2RA for four weeks
74
True or false: SSRIs have been beneficial in functional dyspepsia
False - TCAs such as amitriptyline has been
75
Acute diarrhoea is defined as what
3 or more watery stools in a day lasting <14 days
76
How long is it classes as persistent diarrhoea
> 14 days
77
Causes of travellers diarrhoea
Escherichia coli Salmonella Cryptosporidium Giardia
78
What’s dysentry
Acute infectious gastroenteritis characterised by loose stools with blood and mucus accompanied by Pyrexia and abdominal cramps
79
Organisms that cause bloody diarrhoea
``` Campylobacter Entamoeba histolytica Escherichia coli Salmonella Shigella ```
80
Type of gastroenteritis
``` Acute diarrhoea Persistent diarrhoea Travellers diarrhoea Dysentry Antibiotic associated diarrhoea ```
81
Why do adults not normally get rotavirus causing gastroenteritis
Commonly before 5yrs - immunity is long lasting
82
Three classes of virus causing gastroenenteritis
Rotavirus Norovirus Adenovirus
83
5 types of bacteria causing gastroenteritis
``` Campylobacter Escherichia coli Salmonella Shigella Yersinia enterolcolitica (rare) ```
84
Two types of campylobacter
C jejuni | C coli
85
What is shigella
Gram negative rod shaped bacterium
86
What is yersinia enterolcolitica
Rare gram negative rod shaped bacterium
87
Facts about small intestine
Digestion and absorption 6m long with 2.5cm diameter Three segments: duodenum, jejunum and ileum
88
Large intestine consists of what
Colon Caecum Appendix Rectum
89
What does the colon do
Extracts water and salt from the chyme received from small intestine
90
Colon can be decided into 3 relatively straight portions
Ascending colon Transverse colon Descending colon
91
Name the S shaped part of the descending colon
Sigmoid colon
92
True or false: numbers and secretion from mast cells are increased in IBS
True

DIPLOMA 📚 (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions