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Pathophysiology MEDI212 > lower digestive system disorders > Flashcards

lower digestive system disorders Flashcards

1
Q

infective disorders: ???% of cases of enteritis are due to infection with
pathogens from food or drink

A

90%

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2
Q

other causes of enteritis (outside food/drink) include all BUT which option?
- NSAIDs
- Radiation therapy
- IBD
- Coeliac Disease
- chemo

A
  • chemo
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3
Q

pathogens causing enteritis include:
Bacterial:
 Salmonella
 Clostridium difficile
 Campylobacter jejuni
as well as what virus?

A

Rotavirus

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4
Q

TRUE or FALSE:
Bacterial infections have more severe effects than viral infections

A

TRUE

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5
Q

clinical manifestation of enteritis caused by rotavirus:
- alters function of ??? cells, causing malabsorption

A

alters function of epithelial cells causing malabsorption of food

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6
Q

watery diarrhoea (caused by CHO, fat and protein are osmotically active = leads inability to absorb water) is a clinical manifestation of enteritis caused by which pathogen?

A

rotavirus

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7
Q

fever, vomiting, dehydration are common manifestations of which pathogen causing enteritis?

A

rotavirus

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8
Q

groups most at risk of catching rotavirus = ???

A

babies and toddlers

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9
Q

TRUR of FALSE:
Clostridium Difficile: Naturally occurring gut bacteria in humans. Becomes pathogenic when there is a disruption to the number of good gut bacteria that normally suppress growth of C. Diff

A

TRUE

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10
Q

toxins of clostridium difficile bind to epithelial cells (haemorrhage), attract ??? cells, increase capillary permeability, stimulate peristalsis = Fever, Abdominal pain, Diarrhoea

A

inflammatory

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11
Q

Campylobacter Jenjuni cause enteritis by penetrating mucus
layer and attaching to ??? cells and releases toxins

A

epithelial cells

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12
Q

which pathogen is the most prevalent food borne cause of enteritis?

A

campylobacter jenjuni

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13
Q

abdominal pain, fever, diarrhoea, are common signs of which enteritis causing pathogens?
Hint: there are 2

A

campylobacter jenjuni and clostridium difficile

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14
Q

treatment of enteritis-causing pathogen includes: good hand hygiene, good food handling, hygiene in general and in the case of ??? and ??? bacteria, antibiotics

A

C Diff and C. jejuni: Antibiotics

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15
Q

IBD (irritable bowel disease) is an umbrella term for which two gut-related issues?

A

crohn’s disease
ulcerative colitis

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16
Q

TRUE or FALSE: Crohn’s disease is characterised by inflammation of the lining of the entire digestive tract and often disrupts all four layers

A

TRUE

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17
Q

Ulcerative colitis causes long-lasting
inflammation and ulcers in the ??? layer of the large intestine.

A

mucosal layer

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18
Q

TRUE or FALSE: crohn’s disease and ulcerative colitis don’t both have periods or remission and relapse

A

FALSE. they do both have them

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19
Q

Features of Chron’s disease DON’T include which one?
- Can be full thickness ulceration
- Skip regions
- Thickened wall, narrow lumen
- Fistulae
- only affects upper GI

A
  • only affects upper GI is INCORRECT, it affects all parts of GI
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20
Q

What are skip lesions in Chron’s disease? THINK progression of lesions

A

Chron’s disease is NOT progressive and can affect multiple, separate parts of the GI tract at once

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21
Q

Ulcerative colitis does or does not contain skip lesions? explain

A

ulcerative colitis does NOT contain skip lesions, it has a progressive movement along colon that beginning at the rectum

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22
Q

clinical manifestations of Chron’s disease in the Small Intestine:
??? of nutrients

A

malabsorption of nutrients

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23
Q

clinical manifestation of Chron’s disease in colon:
malabsorption of ???

A

malabsorption of water

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24
Q

Can there be clinical manifestations of Chron’s disease in the oral cavity?

A

yes

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25
Q

common clinical manifestations of Crohn’s disease:
pain
LOW,
malena (black blood from bleeding is visible),
???,
???,
low appetite

A

diarrhoea
fever

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26
Q

nutritional implications of Crohn’s disease:
Malabsorption of nutrients
- Fe, folate, B12 = nutritional ???

A

anemias

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27
Q

Malabsorption of nutrients in Crohn’s disease:
- Mg, Zn: ???

A

wound healing

28
Q

Malabsorption of nutrients in Crohn’s disease:
- Vit D and Ca: ???

A

bone health

29
Q

Malabsorption of nutrients in Chron’s disease:
- Vit K: ???

A

clotting

30
Q

Malabsorption of nutrients in Chron’s disease:
- Fat: ??? – LOW

A

steatorrhoea

31
Q

treatment for Crohn’s disease:
nothing. Can control it through:
- Medication–> Immunosuppression: can be life long.
- Some evidence high dose ??? fat can be helpful.
- Antibiotics for infection eg abscess
- Elemental tube feeds
- Surgery: can resect regions and rejoin

A

omega 3

32
Q

Ulcerative colitis features:
Chronic inflammation of mucosal and submuscosal layer of ??? that IS or ISN’t progressive?

A

colon
it IS progressive

33
Q

Ulcerative colitis is characterised by frequent bloody mucousy ???
(> 30 x day)

A

diarrhoea

34
Q

clinical manifestations of Ulcerative Colitis:
- Loss of mucin layer. Lesions form in crypts of Lieberkühn in base of ??? layer

  • Diarrhoea, Abdo pain, Malena, LOW
A

mucosal

35
Q

TRUE or FALSE: long term complications of ulcerative colitis is that it can lead to bowel cancer due to acute bowel obstruction and toxic megacolon.

A

TRUE

36
Q

Treatment of ulcerative colitis:
No treatment, but can have medication: immunosuppression which can be life long. ALSO ??? can resect whole colon

A

surgery

37
Q

what type of inflammation does Crohn’s disease have in comparison to ulcerative colitis?
granulatomous orulcerative/exudative

A

granulatomous

38
Q

are fistulas common in Crohn’s disease or ulcerative colitis?

A

crohn’s disease

39
Q

diverticular disease is a pathological condition: presence of several sacs/pouches formed by ??? of the intestine wall

A

herniation

40
Q

TRUE or FALSE:
Diverticulitis: inflammation of one or more of the diverticula, especially the colon

A

TRUE

41
Q

TRUE or FALSE: Diverticulitis is not very common in western world

A

FALSE it is rare in developing countries

42
Q

reasons for diverticulitis developing include:
- Age = weakening of colon wall
- Obesity.
- ???
- Lack of exercise.
- Diet high in animal fat and low in fiber (constipation)
- NSAIDs, steroids

A

Smoking.

43
Q

clinical manifestations of Diverticulitis:
- 80% suffer no adverse effects
- Hypertrophy in the sigmoid colon =
narrowing of ??? = bowel blockage

A

lumen

44
Q

TRUE or FALSE: ~25% of diverticulitis develop infection of pouch – perforation and abscess =
pain, bleeding, pus, diarrhoea . 1 In 3 need surgery

A

TRUE

45
Q

treatment of diverticulitis includes:
- antibiotics, bowel rest, IV fluids for acute cases
- Diet progression: NBM /clear fluids/ ??? or ??? diet

A

low fibre / normal diet

46
Q

prevention of diverticulitis includes a ??? diet, exercise, correct technique to poo (which is 35 degree angle)

A

high fibre

47
Q

IBS is a functional bowel disorder involving:
- ??? contractions (motility)
- increased gut sensations (visceral hypersensitivity)
- Relief from symptoms after defecation

A

abnormal gut contractions

48
Q

IBS is present in ??? of the population

A

15%

49
Q

cause of IBS is KNOWN or UNKNOWN and related to multiple factors including motility,
inflammatory, genetic, immune, psychological, and dietary components

A

unknown

50
Q

IBS has no structural abnormalities, but it is a real ??? problem due to altered colonic motility and hormones. ALSO associated with ???, stress and lifestyle

A

physiological.

menstruation

51
Q

common clinical manifestations fo the 3 types of IBS (classified by stool):
pain, ???, flatulence, nausea, anorexia, anxiety or depression.

A

bloating

52
Q

treatment of IBS includes lifestyle management to reduce ???, avoid
gastric stimulants eg caffeine, alcohol, and personal triggers

A

stress

53
Q

TRUE or FALSE: Constipation is the most common function GI disorder and causes major morbidity

A

True

54
Q

primary causes of constipation do NOT include which one:
- Slow transit time eg IBS-C, neuropathy
- Inadequate fibre and
fluid intake
- Cancer eg bowel or
obstruction or stricture

A

Cancer eg bowel or
obstruction or stricture– this is a secondary cause

55
Q

secondary causes of constipation do NOT include which one:
- Metabolic: eg hypothyroid
- Neurological – MS, Parkinson’s disease, SCI
- Medication: eg opioids, Fe,
antihistamines
- Cancer eg bowel or obstruction or stricture
- inadequate fibre and fluid intake

A
  • inadequate fibre and fluid intake – primary cause, NOT secondary
56
Q

nutritional implications of constipation:
can impact absorbance/intake of ???

A

nutrients

57
Q

constipation treatment includes:
??? and fluid +/ - regular aperients

A

fibre

58
Q

coeliac disease is a short or long term autoimmune disorder characterised by damage to the small intestine from ingestion of gluten

A

long term

59
Q

TRUE or FALSE: coeliac disease is present 1 in 70 (1% =1:86 men; 1 :52 Australians women)

A

TRUE

60
Q

clinical manifestations of coeliac disease:
- Allergy to gluten = inflammation gastritis and atrophy of JEJUNAL, ILEUM, or DUODENAL mucosa in SI (Loss of mature villous epithelium)

A

JEJUNAL

61
Q

clinical manifestations of coeliac disease:
- Flat jejunal mucosa (ie villi absent) =
reduced OR increased enzyme activity for digestion

A

reduced

62
Q

signs of coeliac disease:
???, Steatorrhea, Abdo pain, lethargy, anaemia,

A

Diarrhoea

63
Q

steatorrhea is ??? = undigested fat in faeces, stinky stool, and rapid LOW

A

Malabsorption of fat

64
Q

nutritional consequences of coeliac diseasE:
Lack of minerals
- Fe, folate and B12 = nutritional anaemias
- Ca: ???

A

osteoporosis

65
Q

nutritional consequences of coeliac disease:
Lack of vitamins:
- Vit B, C
- Vit K: ???

A

blood clotting

66
Q

TRUE or FALSE: Ca not absorbed in coeliac disease can lead to development of oxalate kidney stones

A

TRUE

67
Q

treatment of coeliac disease includes lifelong avoidance of gluten. Atrophied intestinal villi can take ???years to heal

A

3.8 years

Pathophysiology MEDI212 (14 decks)

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