Gastrointestinal

Question 1

What are inflammatory bowel diseases (IBD)?

Answer 1

Ulcerative colitis and Crohn’s disease

IBD includes chronic inflammatory conditions affecting the gastrointestinal tract.

Question 2

How many people in Australia are estimated to have IBD?

Answer 2

More than 75,000

This figure includes both ulcerative colitis and Crohn’s disease.

Question 3

What is ulcerative colitis?

Answer 3

A chronic inflammatory disease causing ulceration of the colonic mucosa, usually in the rectum and sigmoid colon.

Question 4

What age group is most commonly diagnosed with ulcerative colitis?

Answer 4

Individuals between 20 and 40 years old.

Question 5

What are the risk factors for ulcerative colitis?

Answer 5

• Family history of the disease
• Genetic factors
• Immune dysregulation
• Infectious factors

Question 6

What causes ulcerative colitis?

Answer 6

The cause is unknown, but infectious, genetic, and immunological factors have been suggested.

Question 7

What is the primary lesion of ulcerative colitis?

Answer 7

Inflammation at the base of the Lieberkühn crypts in the large intestine.

Question 8

What are common clinical manifestations of mild ulcerative colitis?

Answer 8

Minimal bowel movements, bleeding, and pain.

Question 9

What complications can arise from ulcerative colitis?

Answer 9

• Anal fissures
• Haemorrhoids
• Perirectal abscesses
• Increased risk of colon cancer

Question 10

What is Crohn’s disease?

Answer 10

An inflammatory disorder that can affect any part of the digestive tract, also known as granulomatous colitis.

Question 11

What is the prevalence of Crohn’s disease in Australia?

Answer 11

Affects about 28,000 people.

Question 12

What age group is most commonly diagnosed with Crohn’s disease?

Answer 12

Individuals between the ages of 15 and 40.

Question 13

What are the common sites affected by Crohn’s disease?

Answer 13

• Terminal ileum
• Ascending colon
• Transverse colon

Question 14

What type of inflammation occurs in Crohn’s disease?

Answer 14

Transmural inflammation affecting all layers of the intestinal wall.

Question 15

What are skip lesions in Crohn’s disease?

Answer 15

Inflammation affecting some segments of the intestine but not others.

Question 16

What are common symptoms of Crohn’s disease?

Answer 16

• Diarrhoea
• Weight loss
• Vomiting
• Fever
• Lower abdominal pain

Question 17

What is the standard approach to diagnosing IBD?

Answer 17

Medical history, clinical manifestations, sigmoidoscopy, barium enema, x-rays, and stool sample analysis.

Question 18

What is the first-line treatment for IBD?

Answer 18

• Antibiotics
• Steroids

Question 19

What role does infliximab play in treating IBD?

Answer 19

It is a monoclonal antibody that binds to TNFα to reduce inflammation.

Question 20

What is the purpose of stem cell therapy in IBD?

Answer 20

To induce repair mechanisms and reduce inflammation.

Question 21

What are mesenchymal stem cells (MSCs)?

Answer 21

Multipotent stem cells derived from adult tissues, including blood and bone marrow.

Question 22

What is irritable bowel syndrome (IBS)?

Answer 22

A functional gastrointestinal disorder characterized by abdominal pain and altered bowel habits.

Question 23

What percentage of the Australian population is estimated to have IBS?

Answer 23

About 10%.

Question 24

What are some alternative theories explaining the symptoms of IBS?

Answer 24

• Visceral hypersensitivity
• Abnormal gastrointestinal motility
• Intestinal infection
• Overgrowth of intestinal flora

Question 25

What is bacterial enteritis?

Answer 25

Intestinal infection associated with irritable bowel syndrome, related to low-grade inflammation and abnormal immune response in gut tissues.

Question 26

What is one proposed cause of constipation and bloating in irritable bowel syndrome?

Answer 26

Overgrowth or altered composition of intestinal flora leading to methane gas production.

Question 27

What is bile salt malabsorption?

Answer 27

A common cause of chronic diarrhoea where bile salts are not effectively reabsorbed in the terminal ileum.

Question 28

How can food allergies affect irritable bowel syndrome?

Answer 28

Food antigens may activate the mucosal immune system, mediating hypersensitivity reactions and symptoms.

Question 29

What psychosocial factors influence irritable bowel syndrome?

Answer 29

Emotional stress affects brain-gut interactions.

Question 30

What are the clinical manifestations of irritable bowel syndrome?

Answer 30

* Lower abdominal pain or discomfort * Predominant diarrhoea * Predominant constipation * Alternating diarrhoea and constipation * Gas and bloating * Nausea

Question 31

What diagnostic criteria are used for irritable bowel syndrome?

Answer 31

Abdominal pain relieved by defecation and changes in the frequency and appearance of faeces.

Question 32

What are common treatment options for irritable bowel syndrome?

Answer 32

* Laxatives and fibre * Antidiarrhoeals * Antispasmodics * Low-dose antidepressants * Visceral analgesics * Probiotics

Question 33

What are diverticula?

Answer 33

Abnormal sac-like outpouchings of mucosa through the muscle layers, typically found in the sigmoid colon.

Question 34

What is diverticulitis?

Answer 34

Infection or inflammation of diverticula.

Question 35

What factors contribute to the formation of diverticula?

Answer 35

* Increases in intraluminal pressure * Low-fibre diet * Muscle hypertrophy

Question 36

What are the symptoms of diverticulitis?

Answer 36

* Cramping pain in the lower abdomen * Diarrhoea * Constipation * Distension * Flatulence * Fever * Leucocytosis

Question 37

How is diverticular disease diagnosed?

Answer 37

* Sigmoidoscopy * Ultrasound * Barium enema * Abdominal CT scan

Question 38

What is appendicitis?

Answer 38

Inflammation of the appendix and the most common surgical emergency of the abdomen.

Question 39

What is the typical symptom of appendicitis?

Answer 39

Gastric or peri-umbilical pain that may localize to the right lower quadrant.

Question 40

What is the treatment for appendicitis?

Answer 40

Appendectomy, which is the surgical removal of the appendix.

Question 41

What is acute gastritis?

Answer 41

An inflammatory disorder of the gastric mucosa that erodes the surface epithelium.

Question 42

What are common causes of acute gastritis?

Answer 42

* Alcohol consumption * Aspirin and other NSAIDs * Damage to the protective mucosal barrier

Question 43

What is chronic gastritis?

Answer 43

A long-term inflammatory disorder affecting the gastric mucosa, often leading to gastric atrophy.

Question 44

What can chronic atrophic gastritis lead to?

Answer 44

Pernicious anaemia and increased risk for gastric carcinoma.

Question 45

What are peptic ulcers?

Answer 45

Breaks or ulcerations in the mucosal lining of the stomach or duodenum.

Question 46

What are risk factors for peptic ulcer disease?

Answer 46

* Tobacco use * Advanced age * Regular NSAID use * Alcohol use * H. pylori infection * Chronic diseases * Psychological stress

Question 47

What is the main clinical manifestation of gastric ulcers?

Answer 47

Intermittent pain in the epigastric region, often relieved by food.

Question 48

What are duodenal ulcers?

Answer 48

Ulcers that occur more frequently than other types of peptic ulcers, typically in younger individuals.

Question 49

What is a common symptom of gastric ulcers?

Answer 49

Pain that may occur immediately after eating ## Footnote Gastric ulcers tend to be chronic and can cause anorexia, vomiting, and weight loss.

Question 50

What are some complications of gastric ulcers?

Answer 50

Perforation of ulcer, acute bleeding ## Footnote These complications can lead to mortality.

Question 51

Which type of ulcer occurs with greater frequency?

Answer 51

Duodenal ulcers

Question 52

What are the major causes of duodenal ulcers?

Answer 52

* Infection with H. pylori * Use of NSAIDs * Hypersecretion of acid and pepsin * Inadequate secretion of bicarbonate

Question 53

What factors contribute to ulcer formation?

Answer 53

* Greater number of parietal cells in gastric mucosa * High blood gastrin levels * H. pylori infection

Question 54

What is the main clinical manifestation of duodenal ulcers?

Answer 54

Chronic intermittent pain in the epigastric area

Question 55

What serious complications can arise from duodenal ulcers?

Answer 55

* Bleeding * Perforation * Obstruction

Question 56

What is the most common cause of mortality associated with duodenal ulcers?

Answer 56

Bleeding

Question 57

What are the symptoms of bleeding from duodenal ulcers?

Answer 57

* Haematemesis * Melaena

Question 58

What defines a stress ulcer?

Answer 58

An acute form of peptic ulcer that tends to accompany severe illness or trauma

Question 59

What are the types of stress ulcers?

Answer 59

* Ischaemic ulcer * Cushing’s ulcer

Question 60

What is the primary clinical manifestation of stress ulcers?

Answer 60

Bleeding

Question 61

What are the methods used for evaluating peptic ulcer disease?

Answer 61

* X-ray examinations with barium * Flexible endoscopic evaluations * Testing gastrin levels * H. pylori detection methods

Question 62

What is the management aim for duodenal and gastric ulcers?

Answer 62

* Relieving hyperacidity * Administering antacids and acid-reducing drugs * Treating H. pylori with antibiotics

Question 63

What lifestyle modifications can assist in the treatment of ulcers?

Answer 63

* Lowering stress levels * Reducing irritant medications * Smoking cessation * Diet high in vitamin A and fibre

Question 64

How can bleeding from ulcers be treated?

Answer 64

Endoscopic heater probes or surgical approaches

Question 65

What are aphthous ulcers also known as?

Answer 65

Canker sores

Question 66

What is the recommended treatment for severe and recurrent aphthous ulcers?

Answer 66

* Topical or systemic therapy * Glucocorticoids * Antimicrobial therapy * Anti-inflammatory therapies

Question 67

What should patients with aphthous ulcers maintain?

Answer 67

Good oral hygiene

Question 68

Fill in the blank: The primary cause of duodenal ulcers is _______.

Answer 68

Hypersecretion of acid and pepsin