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Gastrointestinal > Session 7 > Flashcards

Session 7 Flashcards

1
Q

What are the 2 main branches of defences in the GI tract?

A

Innate (Physical and cellular)

Adaptive

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2
Q

What are some of the physical defences in the GI tract?

A 
Sight
Smell
Taste
Saliva
Gastric acid
Peristalsis (If slowed, infections are prolonged)
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3
Q

What does saliva contain to aid defence?

A

Lysozyme
Lactoperoxidase
Complement
IgA

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4
Q

How does saliva aid defence?

A

Its contents

Helps wash food down to the stomach which the stomach acid can kill it

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5
Q

What is Xerostomia?

A

Decreased salivary flow. It can lead to microbial overgrowth in the mouth eg parotitis caused by Staphylococcus aureus - swelling of parotid gland

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6
Q

How does the oesophagus aid GI defences?

A

Aiding the flow of liquids

Peristalsis

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7
Q

How does the stomach aid GI defences?

A

Gastric acid
Sterilisation
Low pH which kills most bacteria

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8
Q

Why do some patients have an increased risk of Clostridium difficile?

A

Because they are on proton pump inhibitors, therefore their stomach pH is higher than it should be and more pathogens can survive

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9
Q

What pathogens are resistant to gastric acid?

A 
Mycobacterium TB (Can do gastric washings to collect bacteria for diagnosis)
Helicobacter pylori (Produces urease which acts on urea to make a protective cloud of ammonia
Norovirus
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10
Q

How does the small intestine aid GI defences?

A 
Bile
Proteolytic enzymes
Lack of nutrients
Anaerobic conditions
Shredding of epithelial cells
Peristalsis
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11
Q

What protects the epithelium of the colon?

A

The thick mucus layer

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12
Q

What are some of the cellular defences of the GI system?

A 
Neutrophils
Macrophages
Eosinophils (Parasites)
Natural Killer Cells (Especially good for Viruses)
Mast cells
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13
Q

Why can infections that activate Mast cells be very dangerous?

A

They release the Histamine which causes vasodilation and increased capillary permeability leading to mass fluid loss

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14
Q

Which areas of the body have a very large population of Macrophages?

A

Lung
Liver
Spleen

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15
Q

How does the portal system work in the Liver?

A

2 capillary systems work in series (The hepatic lobule and villus) - Hepatic portal system and Hypothalamus hypophyseal portal system

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16
Q

Define Cirrhosis

A

Hepatic fibrosis

17
Q

What are Caput Medusae?

A

The appearance of distended and engorged paraumbilical veins, which are seen radiating from the umbilicus across the abdomen

18
Q

What can cause Caput Medusae?

A

Cirrhosis causes portal venous hypertension which then causes portosystemic shunting and therefore toxic shunting. Leads to oesophageal varicies – > Haemorrhoids and Caput Medusae

19
Q

What is acute alcoholic hepatitis?

A

Acute enlargement of the liver
Painful
Usually occurs when the patient has been drinking a lot in a short space of time

20
Q

What are some of the adaptive defences of the GI system?

A 
B lymphocytes (Produce antibodies, best against extracellular microbes)
T lymphocytes (Directed against intracellular microbes)
21
Q

How many layers does the anorectal junction have?

A

3 layers of sphincters

2 muscular and 1 mucosal

22
Q

Where is the GI system is lymphoid tissue nodular?

A

Tonsils
Appendix
Peyer’s patches (In lumen on Ileum)
Non nodular lymphoid tissue is diffusely distributed

23
Q

Define tonsil

A

A mass of lymphoid tissue

24
Q

What are the 3 main tonsils?

A

Linguinal (on tongue, drains to cervical lymph node)
Palatine (on tongue)
Nasopharyngeal (Also called aderoids)

25
Q

What can easily be mistaken for appendicitis in young children?

A 
Mesenteric adenitis (Commonly causes Right iliac fossa pain, due to inflammation of the lymph nodes)
Caused by adenovirus/coxsachie virus
26
Q

Why can Typhoid fever be so dangerous?

A

Because the inflammed Peyer’s patches in the terminal Ileum can perforate leading to mass bleeding and death

27
Q

How can inflammation cause appendicitis?

A

Inflammation causes lymphoid hyperplasia at the base of the appendix. This means that if something enters the appendix it may not be able to leave again due to the obstructed outflow. This stasis can lead to infection

28
Q

How can arsenic poisoning manifest itself?

A

A skin defect that looks slightly like a rash

Can then develop into further issues

29
Q

How can ischaemia of the bowel lead to death?

A

If its due to systemic hypertension or intestinal venous thrombosis can lead to overwhelming sepsis and rapid death
Important to remember that for the GI defences to work they need an intact blood supply

30
Q

WHat is the immediate course of action if there is bowel ischaemia?

A

Remove the ischaemic bowel because if it breaks down it will allow bacterial translocation which can cause sepsis

Gastrointestinal (13 decks)

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