GI

Question 1

Examples of osmotic laxatives (2) + duration of action

Answer 1

Macrogol, Lactulose

24-48 hrs

Question 2

Examples of bulk-forming laxatives (2) + duration of action

Answer 2

Fybogel (Isaghula husk), Methylcellulose

Up to 72 hrs

Question 3

Examples of stimulant laxatives (6) + duration of action

Answer 3

Senna, Bisacodyl, Sodium Docusate, Sodium Picosulphate, Glycerol, Co-danthramer

6-12 hrs, except Docusate (1-2 days)

Glycerol suppositories are faster

Question 4

Examples of stool softeners (2)

Answer 4

Docusate, Glycerol

Question 5

Max daily dose of Senna

Answer 5

30mg

Question 6

In which case bulk-forming and stimulant laxatives are contraindicated and why?

Answer 6

Bowel obstruction.

Can cause cramping and bloating.

Question 7

First line for acute constipation

Answer 7

Bulk-forming

Question 8

First line for opioid-induced constipation

Answer 8

Stimulant laxatives

Question 9

Constipation treatment in pregnancy

Answer 9

1st line - bulk-forming
2nf line - osmotic

Avoid stimulants, especially near term or in unstable pregnancy

Question 10

Indications of Loperamide (3)

Answer 10

1st line faecal incontinence

mild-moderate travellers diarrhoea

2nd line in acute diarrhoea if rapid control needed

Question 11

When is Loperamide contraindicated?

Answer 11

Ulcerative colitis

Question 12

When would you refer patients with dyspepsia?

Answer 12

Alarm symptoms

New dyspepsia in >55yo unresponsive to OTC

Question 13

How is H.pylori diagnosed?

Answer 13

C-Urea breath test

Question 14

Example of H.Pylori eradication treatment regimen + 1 for penicillin allergy

Answer 14

Lansoprazole 30mg BD + Clarithromycin 500mg BD + Amoxicillin 1g BD

OR

Lansoprazole 30mg BD + Clarithromycin 250mg BD + Metronidazole 400mg BD

Question 15

What can misoprostol be indicated for in GI?

Answer 15

Ulcers associated with NSAID use

Question 16

When would you need to adjust the dose of H2-receptor antagonists?

Answer 16

Renal impairment

Question 17

Which pump PPIs act on?

Answer 17

H+/K- adenosine triphosphate pump in Parietal cells

Question 18

Risks associated with long-term PPI use?

Answer 18

Reduced bone density, osteoporosis

Question 19

Which severe infection is PPI use associated with?

Answer 19

C.diff

Question 20

How do you take Lansoprazole? (admin warning labels x2)

Answer 20

Take 30-60 min before food

Do not take indigestion remedies 2 hrs before/after

Question 21

What drug class is Hyoscine Butylpromide?

Answer 21

Anti-muscarinic

Question 22

What class is Mebeverine?

Answer 22

Anti-spasmodic

Question 23

What can be given for colestatic pruritis? (2)

Answer 23

Colestyramine, Ursodeoxycholic acid

Question 24

What can be given for bleeding oesophageal varices?

Answer 24

Terlipressin

Question 25

When is bariatric surgery indicated?

Answer 25

BMI >40 kg/m2

Question 26

When is Orlistat indicated?

Answer 26

Adjunct therapy in BMI >30 kg/m2

Question 27

Dosage and admin directions of Orlistat?

Answer 27

120mg TDS before/during or up to 1 hrs after each meal

Question 28

MOA of Orlistat?

Answer 28

Lipase inhibitor