GI

Question 1

What is the treatment of xerostomia (dry mouth)?

Answer 1

drink more water frequently
chewing sugar free gum/ pastilles
artificial saliva
flouride treatment
chlorhexidine mouthwash
xylitlol gum

Question 2

What is the treatment of ulcers?

Answer 2

• red halo around yellow/ grey pseudo membrane (painful)
  types: minor(lips&cheek), major( anywhere) , herpetiform( back of mouth)
  treatments: carbomer & hydroxy cellulose - iglu gel
  lidocaine - anasthetic or bezydamine mouthwash / spray
  chlohexidine mouthwash

Question 3

What is treatment for angular chelitis?

Answer 3

cracked fissures at the angles of the mouth, may get infected
treatment: lip balm/ thick emollient/ if infected antifungal eg ketoconazole
factors that can cause it: chrons disease, coleic disease, oral candidasis

Question 4

What is the treatment for herpes simplex (cold sores)?

Answer 4

raised red fluid filled blisters - tingling follwed by pain

treatments: aciclovir (zovirax) / cold sore patches

Question 5

What is the treatment of oral thrush (candidasis)?

Answer 5

creamy white patches than can wipe off occurs at cheek, lips, tongue, throad and gums
treatment: antifuncal mouth gell - miconazole
for age <4mnths = nystatin

Question 6

what is treatment for lichen planus?

Answer 6

similar to oral thrush - white lacy patches spiderweb like
no pain involved
clears naturally within 18 mnths
benzydamine mouth wash or corticosteroids eg betamethasone, flucinolone for any inflammation

Question 7

what is leukoplakia?

Answer 7

singular white patch no pain but cant be rubbed off

treatment is to stop smoking , chewing tobacco or whatever is the irritant

Question 8

What is squamous cell cancer?

Answer 8

singular lesion on tongue cheek or gums
red or white patch
presistent mouth sores that don’t heal
need to be referred to doctor if suspected so if cancer it can be treated

Question 9

What is the treatment for obesity?

Answer 9

orlistat is used for ppl with a BMI OF MORE THAN 28

Question 10

What is GeRD/GORD?

Answer 10

gastro osepphogal reflux disease
symptoms: heartburn, acid reflux, bad breath, belching,bloating
treatments: antacids - weak base neutralises acid and stops production of pepsin - eg gaviscon
pt can be prescribed PPI or H2 antagnist eg famotidine

Question 11

What is gastritis?

Answer 11

inflammation of gastric lining
symptom - worse when stomach is empty, bloating, burping, weight loss
its transmitted by faecal, untreated water, crowded conditions, poor hygiene

Question 12

What are tests done for gastritis?

Answer 12

blood test: antibodies of hpylori
breath test: more co2 is measures
stool test: foreign protiens present
biopsy test: remove tissue sample from upper digestive tract

Question 13

What is the treatment for gastritis?

Answer 13

triple therapy with PPI + macrolide + penicillin

if penicillin allergy - metronadiazole

Question 14

What is the treatment for hpylori peptic ulcers?

Answer 14

triple therapy: PPi - inhibits hydrogen
h2 receptor antagonist - inhibits nocturnal acid production
sucraflate - 30-60 mins before food
misoprostol - promotes cell regeneration by stimulating mucus & bicarbonate

Question 15

What is the treatment for constipation?

Answer 15

increasing dietary fiber, fluid intake, and activity

laxatives: - Bulk forming Laxatives – FIRST LINE TREATMENT. (Ispaghula husk, methycellulose) allows more water to be absorbed into the stool
- Osmotic Laxatives – Macrogol - It binds with the water in which it has been dissolved and retains that water
- Osmotic Laxative – Lactulose, Magnesium hydroxide/Magnesium sulphate- increases osmotic pressure in colon
- Faecal Softener (surfactant laxative) – Docusate / glycerol supp / poloxamer – Reduces surface tension of stool, increases water
- Stimulant laxative – Senna- sennosides (A and B) / Bisacodyl / sodium picosulfate: are metabolised within senna to rheinanthrone, stimulates peristalsis and increases fecal water

Question 16

What type of laxative should you avoid with opiod induced constipation?

Answer 16

bulk - (Ispaghula husk, methycellulose) allows more water to be absorbed into the stool

Question 17

What is treatment for acute dairrhoea?

Answer 17

the passage of three or more loose or liquid stools per day
- Avoid certain foods such as dairy products, fatty foods, high-fiber foods or highly seasoned foods for a few days.
- Eat low-fibre food
- Avoid caffeine/alcohol
- First priority- oral rehydration : Use of powders which could contain Na+ and glucose (plus other things), this will promote water uptake
Anti-infective agents :
- Use of antimotility drugs to act on the gut
- Loperamide (Imodium) – helps with acute diarrhoea. Slows intestinal motility so more water can be reabsorbed by the body