Treatments

Question 1

Treat gastritis

Answer 1

Triple therpay to eradicate H.pylori:
Proton Pump Inhibitor (PPI)
Amoxicillin
Clarithromycin or Metronidazole

Step-wise approach to treating gastritis:
Mild - antacids or H2 receptor antagonists
Moderate/severe - PPI

Question 2

Conservative treatment of IBS

Answer 2

Education and avoidance of triggering factors e.g. decrease stress

Question 3

Medical treatment of IBS

Answer 3

Depends on symptoms;

Anti-muscarinics, Laxatives, Stool softeners, Antispasmodics and Antidepressants may play a role

Question 4

Treatment of appendicitis

Answer 4

Surgical excision

Question 5

Two types of Inflammatory Bowel Disease (IBD)

Answer 5

Ulcerative colitis

Crohn’s disease

Question 6

Conservative treatment of Ulcerative colitis

Answer 6

Patient education;

smoking has been shown to be protective but is not advised

Question 7

Medical treatment of Ulcerative colitis

Answer 7

Corticosteroids
5-aminosalicylic acid (5-ASA) analogues e.g. Sulfasalazine
Mesalazine
6-mercaptopurine
Azathioprine

Question 8

Surgical treatment of Ulcerative colitis

Answer 8

Colectomy

Question 9

Conservative treatment of Crohn’s disease

Answer 9

Smoking cessation

Low residue diet may be encouraged but usually diet is normal

Question 10

Medical treatment of Crohn’s disease

Answer 10

Corticosteroids
Infliximab
5-ASA analogues (Sulfasalazine)
Azathioprine
Methotrexate

Question 11

Surgical treatment of Crohn’s disease

Answer 11

Remove strictured or obstructed region of bowel

Question 12

Conservative treatment of GORD

Answer 12

Education
Weight loss
Raising head of bed at night
Avoidance of precipitating factors e.g. smoking, large meals

Question 13

Medical treatment of GORD

Answer 13

Antacids e.g. aluminium hydroxide
H2 receptor antagonists e.g. ranitidine
Proton pump inhibitors e.g. omeprazole

Question 14

Surgical treatment of GORD

Answer 14

Nissen’s fundoplication

Question 15

Treatment of Barrett’s Oesophagus

Answer 15

Halo system radiofrequency ablation
OR
Mucosal resection for highly dysplastic lesions

Question 16

Conservative treatment of Hepatitis A virus

Answer 16

Vaccine for travellers to endemic areas

Question 17

Medical treatment of Hepatitis A virus

Answer 17

Supportive since HAV is often self-resolving

Question 18

Conservative treatment of Hepatitis B virus

Answer 18

Education and prevention of disease

Vaccine for at-risk groups e.g. health workers

Question 19

Medical treatment of Hepatitis B virus

Answer 19

Antiviral medications e.g. pegylated alpha-2a interferon
Adefovir
Entecavir
Lamivudine
Tenofovir
Telbivudine

Question 20

Conservative treatment of Hepatitis C virus

Answer 20

Education and prevention of disease

Question 21

Medical treatment of Hepatitis C virus

Answer 21

Antiviral medications 
e.g. pegylated alpha-2a interferon
ribavirin
taribavirin
telaprevir

Question 22

Treatment of Hepatitis D virus

Answer 22

Pegylated alpha-2a interferon

Question 23

Treatment of Hepatitis E virus

Answer 23

Usually self-limiting

Question 24

Conservative treatment of Colorectal cancer

Answer 24

Patient education and referral to Macmillan nurses

Question 25

Medical treatment of colorectal cancer

Answer 25

Chemotherapy (oxaliplatin, folinic acid and 5-fluorouracil is most common regime)
Radiotherapy also used possibly

Question 26

Surgical treatment of colorectal cancer

Answer 26

Surgical resection is usually treatment of choice

Question 27

Treatment of acute pancreatitis

Answer 27

This is usually symptomatic relief
Keep ‘nil by mouth’ (NBM), IV fluids and analgesia e.g. tramadol
Treat underlying causes e.g. ERCP to remove gallstones

Question 28

Conservative treatment of chronic pancreatitis

Answer 28

Alcohol cessation

Question 29

Medical treatment of chronic pancreatitis

Answer 29

Analgesia e.g. tramadol and pancreatic enzyme replacement therapy - start insulin therapy if diabetes has developed