Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Phase 2a Green Conditions > Gastrointestinal > Flashcards

Gastrointestinal Flashcards

(73 cards)

Start Studying
1
Q

What is inflammatory bowel disease?

A
  • umbrella term for disease causing inflammation of the GI tract
  • associated with periods of remission and exacerbation
  • crohn’s and ulcerative colitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Crohn’s vs UC: Crohn’s

A

NESTS

  • no blood or mucous (less common)
  • entire GI tract
  • skip lesions on endoscopy
  • terminal ileum most affected and transmural (full thickness) inflammation
  • smoking is a risk factor

also associated with weight loss, strictures and fistulas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Crohn’s vs UC: UC

A

CLOSEUP

  • continuous inflammation
  • limited to colon and rectum
  • only superficial mucosa affected
  • smoking is protective
  • excrete blood and mucus
  • use aminosalicyclates
  • primary sclerosing cholangitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Presentation of inflammatory bowel disease

A
  • diarrhoea
  • abdominal pain
  • passing blood
  • weight loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Testing for inflammatory bowel disease

A
  • routine bloods
  • CRP → inflammation and active disease
  • faecal calprotectin
  • DIAGNOSTIC = endoscopy (OGD/colonoscopy) with biopsy
  • imaging → complications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is faecal calprotectin?

A
  • released by intestines when inflamed
  • >90% sensitive and specific to IBD in adults
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does management of IBD involve?

A
  • inducing remission
  • maintaining remission
  • surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Inducing remission in Crohn’s

A
  1. steroids → oral prednisolone, IV hydrocortisone
    - consider adding immunosuppressants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What immunosuppressants can be used in Crohn’s

A
  • mercaptopurine
  • azathioprinee
  • methotrexate
  • adalimumab
  • infliximab
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Maintaining remission in Crohn’s

A

based on risks, side effects, nature of the disease, patient’s wishes

  1. azathioprine, mercaptopurine

alternatives = rest of the immunosuppressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Surgery in Crohn’s

A
  • if only distal ileum affected → surgical resection of area to prevent further flare ups
  • treat stricture and fistulas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Inducing remission in UC

A

mild to moderate

  1. aminosalicylates eg mesalazine
  2. corticosteroids eg prednisolone

severe

  1. IV corticosteroids eg hydrocortisone
  2. IV ciclosporin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Maintaining remission in UC

A
  • aminosalicylates
  • azathioprine
  • mercaptopurine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Surgery in UC

A
  • removal of colon and rectum → panproctocolectomy
  • patient left with permanent ileostomy or ileo-anal anastomosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is IBS?

A
  • functional bowel disorder
  • no identifiable organic disease underlying symptoms
  • result of abnormal functioning of normal bowel
  • very common, more common if young/female
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Symptoms of IBS

A

ABCDEF

  • abdominal pain
  • bloating
  • constipation
  • diarrhoea
  • eating makes it worse
  • fluctuating bowel habit
  • improved by opening bowels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Diagnostic criteria of IBS

A

diagnosis of exclusion

  • normal bloods
  • faecal calprotectin -ve
  • coeliac disease serology -ve
  • cancer not suspected/excluded
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Management of IBS

A
  • general healthy diet and exercise advice
  1. loperamide for diarrhoea, linaclotide for constipation, antispasmodics for cramps
  2. tricyclic antidepressants
  3. SSRIs
    can also offer CBT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is coeliac disease?

A
  • exposure to gluten = autoimmune reaction that causes inflammation in small bowel
  • usually develops in early childhood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Pathophysiology of coeliac disease

A
  1. auto-antibodies created in response to gluten
  2. target epithelial cells of the intestine → inflammation
  3. affects small bowel esp jejunum
  4. causes atrophy of intestinal villi and crypt hypertrophy
  5. malabsorption of nutrients → symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Presentation of coeliac disease

A
  • often asymptomatic
  • failure to thrive in children
  • mouth ulcers
  • anaemia secondary to iron, B12, folate deficiency
  • dermatitis herpetiformis
  • neurological symptoms (rare)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is dermatitis herpetiformis?

A

itchy blistering skin rash that typically appears on the abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Diagnosis of coeliac

A
  1. raised anti-TTG
    - raised anti-EMA
    - total IgA levels → exclude IgA deficiency first
    - endoscopy and intestinal biopsy → crypt hypertrophy and villous atrophy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What conditions are associated with coeliac disease?

A
  • T1DM
  • thyroid disease
  • autoimmune hepatitis
  • PBC
  • PSC
  • Down’s syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Complications of coeliac disease
- vitamin deficiency - anaemia - osteoporosis - ulcerative jejunitis - non-hodgkin's lymphoma
26
Treatment for coeliac diease
lifelong gluten free diet
27
What is GORD?
- gastro-oesophageal reflux disease - acid from stomach refluxes through the lower oesophageal sphincter and irritates lining of oesophagus
28
Why is the oesophagus more sensitive to stomach acid?
the epithelial lining is squamous
29
Presentation of GORD
- dyspepsia - heartburn - acid regurgitation - retrosternal/epigastric pain - bloating - nocturnal cough - hoarse voice
30
Diagnosis of GORD
- clinical diagnosis - refer for endoscopy if red flags
31
When would you refer for an endoscopy?
- dysphagia - \>55yrs - upper abdominal pain/reflux - treatment resistant dyspepsia - anaemia - raised platelets
32
Management for GORD
- lifestyle advice - acid neutralising medications → gaviscon, rennies - PPIs → reduce stomach acid eg omeprazole, lansoprazole - ranitidine = alternative to PPIs surgery = laparascopic fundoplication → tie fundus of stomach around lower oesophagus → narrows lower oesophageal sphincter
33
What lifestyle advice would you suggest for GI problems?
- reduce tea, coffee, alcohol - weight loss - avoid smoking - smaller, lighter meals - avoid heavy meals before bed time - stay upright after meals
34
What is a peptic ulcer?
ulceration of the mucosa of the stomach (gastric) or duodenum (duodenal) duodenal are more common
35
Risk factors of peptic ulcers
- h.pylori - NSAIDs/SSRIs/steroids - smoking gastric → stress duodenal → alcohol
36
Presentation of peptic ulcers
epigastric pain - gastric = worse on eating, relieved by antacids - duodenal = before meals and at night, relieved by eating/milk - N&V - dyspepsia - bleeding causing haematemesis, coffee ground vomiting, maelaena - iron deficiency anaemia
37
Diagnosis of peptic ulcers
- h.pylori test → urease breath test - endoscopy if red flags
38
Treatment for peptic ulcers
- lifestyle modification - treat cause - high dose PPIs
39
Complications of peptic ulcer
- haemorrhage - perforation - gastric outflow obstruction - malignancy
40
What is appendicitis?
- inflammation of the appendix - peak incidence = 10-20 - less common in young children and adults over 50
41
Pathophysiology of appendicitis
1. pathogens can get trapped due to obstruction at the point where appendix meets bowel 2. infection and inflammation 3. may proceed to gangrene and rupture 4. faecal contents and infective material are released into peritoneal cavity 5. peritonitis → inflammation of peritoneal lining
42
Signs and symptoms of appendicitis
KEY FEATURE = abdominal pain - loss of appetite - N&V - low-grade fever - Rovsing's sign → palpation of LIF causes pain in RIF - guarding on palpation - rebound tenderness in RIF - percussion tenderness
43
Describe abdominal pain in appendicitis
- starts as central - moves down to RIF within first 24hrs - eventually becomes localised in RIF - on palpation → tenderness at McBurney's point
44
What is McBurney's point
1/3 of the distance from the anterior superior iliac spine to the umbilicus
45
Diagnosis of appendicitis
- based on clinical presentation and raised inflammatory markers - GOLD STANDARD = CT → confirms diagnosis - US to exclude female pathology
46
Differential diagnoses for appendicitis
- ectopic pregnancy - ovarian cysts - Meckel's diverticulum = malformation of distal ileum - mesenteric adenitis
47
Management of appendicitis
- appendicectomy - laparoscopic preferred → less risks and faster recovery
48
Complications of appendidectomy
- damage to other organs eg bowel, bladder - removal of normal appendix
49
What is a diverticulum?
- a pouch/pocket in the bowel wall - 0.5-1cm - diverticulosis = diverticula without inflammation or infection - diverticular disease = if patients have symptoms - diverticulitis = inflammation and infection of diverticula
50
Pathophysiology of diverticula
- wall of LI contains a layer of circular muscle - weaker in areas penetrated by blood vessels - increased pressure can cause a gap to form - mucus herniates through muscle layer and forms diveritcula do not form in the rectum
51
Diverticulosis
- wear and tear of bowel - most commonly in sigmoid colon - diagnosis = colonoscopy or CT - treatment not needed if asymptomatic - high fibre diet, bulk-forming laxatives
52
Presentation of diverticulitis
- pain and tenderness in LIF - fever - D,N&V - rectal bleeding - palpable abdominal mass - rasied inflammatory markers
53
Management of diverticulitis
- oral co-amoxiclav (5 days) - analgesia (not NSAIDs or opiates) - clear liquids until symptoms improve severe - manage like acute abdomen/sepsis
54
Complications of diverticulitis
- perforation - peritonitis - peridiverticular disease - large haemorrhage - fistula
55
What is acute gastritis?
acute inflammation of the stomach mucosa due to imbalance between mucus defence and acid
56
Pathophysiology of acute gastritis
- stomach usually lined by HCO3, prostaglandins and mucus barrier → protects against stomach acid - acid damage → superficial inflammation and can given erosions - loss of superficial layer - progression to ulcer - loss of mucosal layer
57
Risk factors for acute gastritis
- alcohol - drugs → NSAIDs, steroids - hiatus hernia
58
Symptoms of acute gastritis
- epigastric pain/discomfort - vomiting - heartburn
59
Management of acute gastritis
- PPIs/H2 blockers - decrease alcohol and tobacco
60
What is chronic infective gastritis?
- most common form of gastritis - caused by H.pylori → makes a urease enzyme - breaks down mucus defence - destroys protective layer - leads to chronic inflammation
61
What can chronic inflammation lead to in gastritis?
increases risk of - gastric adenocarcinoma - MALT lymphoma
62
Symptoms of chronic infective gastritis
- epigastric pain - peptic ulcer disease
63
Tests for chronic infective gastritis
1. breath test - stool antigen, serology - histology from biopsy, CLO test → pH
64
Management for chronic infective gastritis
tripe therapy to kill H.pylori - PPI → lansoprazole - amoxicillin - clarithromycin
65
What is chronic autoimmune gastritis?
- occurs due to autoimmune destruction of gastric parietal cells - T cells make antibodies against parietal cells and/or IFs → stomach atrophy main problem = lack of IF → B12 deficiency
66
Symptoms of chronic autoimmune gastritis
- megaloblastic/pernicious anaemia (lack of IF) - mild jaundice - diarrhoea - sore tongue
67
Management of chronic autoimmune gastritis
- B12 injections - folic acid supplements
68
What is Barrett's oesophagus?
- metaplasia of lower oesophagus mucosa - stratified squamous to columnar epithelium with goblet cells
69
Risk factors for Barrett's oesophagus
- GORD - male - caucasian - family history - hiatus hernia - obesity - smoking - alcohol
70
Presentation of Barrett's oesophagus
classic history = middle aged caucasian male with long history GORD and dysphagia
71
Investigations for Barrett's oesophagus
- oesophago-gastro-duodenoscopy - biopsy
72
Management of Barrett's oesophagus
- lifestyle changes - endoscopic surveillance with biopsies - high dose PPIs - dysplasia → endoscopic mucosal resection, radiofrequency ablation - severe = oesophagectomy
73
What lifestyle changes are needed in Barrett's oesophagus?
- weight loss - smoking cessation - reduce alcohol - small regular meals - avoid hot drinks/alcohol/eating <3hrs before bed - avoid nitrates, anticholinergics, TCAs, NSAIDs, K+ salts, alendronate

Phase 2a Green Conditions (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions