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InnovAiT 2008 1(9):664; doi:10.1093/innovait/inn143
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© The Author 2008. Published by Oxford University Press on behalf of the RCGP. All rights reserved. For permissions please e-mail: journals.permissions@oxfordjournals.org

AKT answers—Gastroenterology


   AKT answers—Gastroenterology
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 AKT answers--Gastroenterology
AKT answers--Theme--Men's health
 
  1. Answer D—Mebeverine. Loperamide may exacerbate his pain at this stage and he has no ‘red flag’ symptoms
  2. Answer E. Many GPs would be happy to prescribe mesalazine (with blood monitoring) pending gastroenterology referral
  3. Answer C—Iron. She is most likely to have a coincidental cause for her iron deficiency. Coeliac disease needs excluding—initially with an antibody screen (IgA transglutaminase antibody is the test of choice with specificity and sensitivity at least as good as endomysial antibody. Since EMA used monkey oesophagus, TTG is kinder to monkeys) Dietary advice for ooelia disease should be carried out by an expert.
  4. Answer E. Mesalazine would be first line in primary care—especially with the small (but real) risk of sepsis with steroids. Having said that many gastroenterologists would be happy for steroids to be commenced in primary care if there was a delay in seeing a gastroenterologist. Mesalazine is much less effective in small bowel Crohn’s.
  5. Answer A. This is most likely to be IBS in the absence of red flags. It is not uncommon to find associated chronic fatigue or fibromyalgia. Low-dose amitriptyline (although unlicensed) may treat both conditions. Low-dose amitriptyline is unlikely to cause significant diarrhoea although this is possible and as in all these cases this patient should be reviewed.


   AKT answers—Theme—Men's health
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 AKT answers--Gastroenterology
 AKT answers--Theme--Men's health
 
Answer 2—double voiding.


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This Article
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