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19 Cards in this Set
- Front
- Back
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What symptoms make up dyspepsia?
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upper abdominal pain
fullness satiety bloating nausea |
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What symptoms make up GORD?
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heartburn
acid regurgitation dysphagia oesophagitis ulceration stricture formation |
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What are the alarm features?
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bleeding
dysphagia recurrent vomiting unplanned weight loss unexplained, recent onset <55yo that is unresponsive to treatment |
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What lifestyle changes may be of benefit for a patient with dyspepsia or GORD?
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avoidance of alcohol
aggravating foods, including fatty food weight reduction smoking cessation raising the head of the bed |
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How should *uninvestigated* dyspepsia be treated?
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Usually involves a proton pump inhibitor first line
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How long should treatment with a PPI be continued in *uninvestigated* dyspepsia?
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For up to 4 weeks, although may be used intermittently to control symptoms.
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If there is no response to a PPI, what should be done?
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Patient should be tested for H.pylori and given eradication therapy if test is positive.
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What populations are more likely to have a H.pylori infection?
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Living in crowded conditions
Unreliable supply of hot water Unclean living conditions Developing countries Living with someone with H.pylori |
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Should these populations be treated in the same way?
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No, the "test and treat" option is preferred, with testing and treating for H.pylori 1st line, then a PPI.
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What is the treatment option in *investigated* dyspepsia?
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Eradication therapy, then a PPI or an H2 receptor antagonist for up to 4 weeks. Again, these may be used intermittently long term to control symptoms.
Most patients with functional dyspepsia do not benefit from eradication or anti-secretory drugs |
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Name 3 PPIs
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Esomeprazole
Omeprazole Lansoprazole Pantoprazole Rabeprazole |
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Name 2 H2 antagonists
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Cimetadine
Famotidine Nizatidine Ranitidine |
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What cautions should be taken when taking PPIs?
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May mask symptoms of gastric cancer
Patients at risk of osteoporosis need to maintain adequate calcium and vitD intake may cause hypomagnesaemia PPIs should be used at the lowest effective dose for the shortest period |
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What other indications do PPIs have?
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used for gastric ulcer healing
Used to prevent degredation of pancreatic enzymes in patients with CF used to prevent rebleeding after endoscopic treatment |
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Which is the best option for H. Pylori eradication?
A) ONE week triple therapy B) TWO week triple therapy C) TWO week DUAL therapy D) treatment is generally not required |
A - two week triple is associated with side effects that prevent compliance, thus eliminating benefit. Two week dual therapy is often ineffective and not recommended.
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A patient presents with food poisoning, and would like to take something to alleviate the diarrhoea. Which of the following would you recommend and why? (combinations possible)
a) racecadotril b) kaolin c) loperamide d) dioralyte |
D - dioralyte only. If food poisoning is suspected, or if the diarrhoea is thought to be caused by an infection, anti-motility drugs SHOULD NOT be given. Instead the patient will have to wait it out, but try and maintain adequate hydration and electrolytes.
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Which antibiotics are most likely to be associated with C.Diff infection?
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Broad spectrum antibiotics. Specific examples are ampiciillin, amoxicillin, co-amoxicillin, cephalosporins and quinolones.
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What are the primary treatment options in ulcerative colitis and Crohn's disease?
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Steroids, preferably locally applied (e.g. rectal foams)
aminosalicylates anti-folate drugs infliximab adalimumab |
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What preparations are UNsuitable for stoma patients?
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Enteric coated
Modified release enemas |
