gi system

Question 1

what bmi is allowed to take orlistat?

what age?

Answer 1

over 28

over 18 yo

Question 2

what are the s/e of orlistat?

Answer 2

oily stools and faecal incontinence

Question 3

which medication can you not give alongside orlistat?

Answer 3

levothyroxine
amiodarone
ciclosporin
warfarin
acarbose
anti-epileptics

Question 4

which medication must you caution alongside orlistat

Answer 4

oral contraceptives

Question 5

what vitamin deficiency can orlistat cause?

when must you advice pt to take vitamin supplements?

Answer 5

ADEK

take vitamins at night or 2 hours after orlistat dose

Question 6

what are the symptoms of constipation?

Answer 6

small hard stools passed less frequently less than 3 times a week
straining
incomplete emptying
abdominal cramps/bloating
nausea

Question 7

when would you refer someone with constipation?

Answer 7

blood in stools - black/tarry/blood mixed in stools
unexplained weight loss
pt over 40 yo with sudden change in bowel habit
medication adr
constipation for more than 2 weeks

Question 8

what are the 1st line and 2nd line treatment for constipation?

Answer 8

1st line: lifestyle advice

2nd line: bulk forming, stimulant, stool softner, osmotic laxatives

Question 9

which laxative colours urine yellow/brown?

Answer 9

senna

Question 10

what are the symptoms of dyspepsia?

Answer 10

bloating, belching, flatulence
early satiety
fullness
nausea and vom
heart burn

Question 11

when would you refer someone with dyspepsia?

Answer 11

ALARM
anaemia
loss of weight
anorexia
recently changes or new unexplained dyspepsia in over 55 yo
malaena [black stools]/persistant vomiting

Question 12

what is the difference between gastric ulcers and duodenal ulcers?

Answer 12

gastric: pain aggravated by food after eating
duodenal: pain when stomach is empty and keeps pt awake at night

Question 13

what otc products would you recommend for dyspepsia?

how to take these products?

Answer 13

antacids
alginates [form raft on top of stomach contents]

take after each meal and at bedtime or when required

Question 14

which otc product is recommended first line for pregnant women suffering from gord [heart burn]

Answer 14

alginates eg gaviscon

Question 15

what are the s/e of ppis?

Answer 15

abdominal pain, nausea. diarrhoea, vomiting, flatuelence, masks symptoms of gastric cancer

Question 16

what can long term use of ppi cause?

Answer 16

hypo magnesaemia

osteoporosis

Question 17

which 3 drugs does omeprazole interact with?

Answer 17

warfarin, phenytoin, clopidogrel

Question 18

what advice would you give to someone suffering from dyspepsia?

Answer 18

smoking stop
avoid alcohol
raise head of bed

Question 19

what are the symptoms of haemorrhoids?

Answer 19

swollen veins [inside anal canal = internal. or prolapses outside of anus = external]
dull pain on defecation
rectal bleeding
itching
swelling and soreness

Question 20

when would you refer someone with haemorrhoids?

Answer 20

blood mixed in stools. dark, tarry stools
abdominal pain
n&v fever loss of appeite 
severe sharp pain on defecation
symptoms more than 3 weeks
unresponsive to otc for more than 1 week

Question 21

what kind of otc products would you recommend for haemorrhoids?

Answer 21

anusol [soothing]
mild astringents
local anaesthetics eg lidocaine
products with hydrocortisone eg anusol HC

Question 22

which otc haemorrhoid product is not recommended for pregnant and breastfeeding?

Answer 22

preparations containing hydrocortisone eg anusol hc

Question 23

what is the age requirement for hydrocortisone HAEMORRHOID products??

Answer 23

18 and over

Question 24

what are the symptoms of diarrhoea?

Answer 24

frequent loose watery stools

dehydration

Question 25

when would you refer someone with diarrhoea? for how long must symptoms last?

Answer 25

for more than 3 days when they are showing signs of dehydration

Question 26

when would you refer a child under 3 months experiencing diarrhoea?

Answer 26

immediately

Question 27

when would you refer a child under 1 years old, diabetic pt and elderly pt experiencing diarrhoea?

Answer 27

if symptoms more than 1 day

Question 28

when would you refer a child under 3 years old experiencing diarrhoea?

Answer 28

more than 2 days symptoms

Question 29

what symptoms would require a referral for someone experiencing diarroea?

Answer 29

``` blood/mucus in stool weight loss faecal impaction in elderly severe vomiting recent travel abroad chronic diarrhoea for more than 3 weeks ```

Question 30

what is 1st line treatment for diarrhoea?

Answer 30

oral rehydration sachets

Question 31

what are the reconstitution advice for oral rehydration sachets?

Answer 31

dissolve in 200ml water 1 or 2 sachets after each loose motion must use boiled and cooled water for babies under 1 the solution itself should not be boiled make immediately before use and store in fridge for 24 hours

Question 32

what is 2nd line treatment for diarrhoea? what is the age requirement how to take it and what is the max amount in a day?

Answer 32

12+ loperamide 2 caps after each loose motion. max 8 in a day [16mg]

Question 33

what are the symptoms of IBS?

Answer 33

lower abdominal spasm bloating constipation and diarrhoea

Question 34

when would you refer someone with iBS?

Answer 34

``` children over 45 yo and first time symtpoms blood in stools bowel obstruction unexplained weight loss pregnant women suspected depression ```

Question 35

name some antispasmodics to treat IBS and the age requirements for them?

Answer 35

mebeverine [18+] alverine [12+] peppermint oil [15+]

Question 36

what is a common s/e of peppermint oil?

Answer 36

heartburn

Question 37

name some antimuscarincs that can be used to treat ibs and the age requirements of them?

Answer 37

hyoscine [12+ eg buscopan] | diclycloverine [12+]