GI DISEASE

Question 1

Medications for GI disorders

Answer 1

antacids
H2 receptor blockers
proton pump inhibitors

Question 2

anatacids action

Answer 2

elimination of formed acids

Question 3

h2 receptor blockers and PPI action

Answer 3

reduction of acid secretion

Question 4

antacid examples

Answer 4

rennies
gaviscon

Question 5

what triggers stomach acid production

Answer 5

acetylcholine
gastrin
histamine

Question 6

h2 receptor antagonist examples

Answer 6

cimetidine
ranitidine

Question 7

cimetidine and ranitidine mode of action

Answer 7

prevent histamine activation

Question 8

PPI examples

Answer 8

omeprazole
lanzoprazolem
pantoprazole

Question 9

heartburn

Answer 9

GORD

Question 10

GORD cause

Answer 10

defective lower oesophageal and sphincter, impaired lower clearing, impaired gastric emptying

Question 11

GORD effects

Answer 11

ulceration
inflammation
metaplasia

Question 12

potentially malignant GORD

Answer 12

Barrett’s Oesophagitis

Question 13

GORD signs and symptoms

Answer 13

epigastric burning
dysphagia
GI bleeding
severe pain which mimics an MI

Question 14

Hiatus hernia

Answer 14

part of the stomach is in the thorax

Question 15

GORD management

Answer 15

stop smoking
lose weight
antacids
H2 blockers
PPI

Question 16

where is PUD

Answer 16

oesophagus stomach or duodenum

Question 17

PUD cause

Answer 17

high acid secretion (duodenal)
normal acid secretion (stomach)
drugs (NSAIDs, steroids)

Question 18

what infection causes inflammation of gastric mucosa

Answer 18

Helicobacter Pylori

Question 19

PUD management

Answer 19

triple therapy - 2 antibiotics and 1 PPI

Question 20

PUD investigations

Answer 20

endoscopy
radiology (barium seal)
anaemia blood test
H.pylori breath
antibodies

Question 21

local PUD complications

Answer 21

perforation and escape of gastric contents into peritoneum
haemorrhage vomited up
stricture- chronic ulceration
malignancy from chronic ulceration

Question 22

systemic PUD complications

Answer 22

anaemia

Question 23

PUD medical tx outline

Answer 23

H2 receptor blockers and PPIs
NSAIDs
triple therapy

Question 24

why NSAIDs for PUD

Answer 24

inhibit prostaglandin removal

Question 25

what medications are used for triple therapy for PUD

Answer 25

amoxycillan metronidazole omeprazole

Question 26

surgican tx for PUD

Answer 26

gastrectomy vagotomy

Question 27

why medical tx for PUD

Answer 27

REVERSIBLE PROBLEM and H.Pylori present

Question 28

why surgical tx for PUD

Answer 28

stricture acute bleed perforation malignancy

Question 29

coeliac disease

Answer 29

sensitivity to a-gliaden component of gluten - malabsorption - small bowel disease

Question 30

coeliac disease aetiology

Answer 30

genetic environmental triggers gluten consumption T lymphocytes damage mucosal tissue villous atrophy of the jejunum

Question 31

coeliac disease effects

Answer 31

growth failure and oral ulceration weight loss, lassitude, weakness, abdominal pain/ swelling, oral aphthae, tongue papillary loss, steatorrhea, dysphagia.

Question 32

coeliac disease malabsorption issues

Answer 32

iron folate vit B12 fat

Question 33

coeliac disease investigations

Answer 33

autoantibody test - serum transglutaminase, anti-gliadin/ anti-endomyseal antibodies. jejunal biopsy feacal fat increases if malabsorption haematinics

Question 34

associated skin diseases with coeliac disease

Answer 34

dermatitis herpetiformis

Question 35

oral disease associated with coeliac disease

Answer 35

ulceration and blisters

Question 36

what are pts with oral aphthous ulcers screened for?

Answer 36

folate/ combined ferritin and folate deficiency suggests malabsorption. TTG tests

Question 37

pernicious anaemia

Answer 37

vit B12 deficiency

Question 38

vit B12 absorption site

Answer 38

terminal ileum

Question 39

pernicious anaemia causes

Answer 39

lack of vitB12 in diet gastric parietal cell disease (autoimmune) IBD of terminal ileum (Crohn's) Bowel cancer at the ielo-coecal junction

Question 40

vit B12 deficiency tx

Answer 40

diet IM injections if absorption not possible

Question 41

bowel cancer symptoms

Answer 41

none anaemia rectal blood loss

Question 42

bowel cancer aetiology

Answer 42

carcinomas arise in polyps and they will bleed 5 years to turn malignant

Question 43

bowel cancer causes

Answer 43

diet low in fibre and veg and high in fat and meat smoking alcohol poor exercise p53 gene ulcerative colitis and intestinal polyps

Question 44

Peutz-Jehgers syndrome

Answer 44

intestinal polyps in small intetsine - low risk

Question 45

Gardiners/ Cowden's syndrome

Answer 45

intestinal polyps in large intestine - high risk

Question 46

Duke's classification of bowel cancer

Answer 46

A - submucosal B - muscularis C - lymph nodes D - liver

Question 47

bowel cancer tx

Answer 47

colon cancer surgery hepatic metastases radiotherapy chemotherapy

Question 48

colonic carcinoma screening

Answer 48

FiT test - all adults over 60 - 2 year repeat - endoscopy if positive