GI Diseases Flashcards by Elizabeth Matthews

What two conditions are included under inflammatory bowel disease

Crohns and ulcerative colitis

How well did you know this?

Not at all

Perfectly

Does crohns affect a specific part of the gi tract or not

No it can form anywhere in the gi tract

How well did you know this?

Not at all

Perfectly

Does crohns affect all layers of the bowel wall or just a certain layer

Crohns is transumural so can affect any layer in the bowel wall

How well did you know this?

Not at all

Perfectly

What triggers crohns

Pathogens

How well did you know this?

Not at all

Perfectly

What part of the gi tract does crohns most commonly affect

Ileum and colon

How well did you know this?

Not at all

Perfectly

Is the inflammation in crohns scattered or continuous

Scattered

How well did you know this?

Not at all

Perfectly

What are the symptoms of crohns

Right lower quadrant pain
Blood in stool
Malabsorption of nutrients
Diarrhoea

How well did you know this?

Not at all

Perfectly

Briefly describe why crohns is called granulomatous

Big masses of immune cells form in the bowel wall trying to encapsulate what they think is foreign

How well did you know this?

Not at all

Perfectly

Why do ulcers form in crohns

Crohns can affect all layers of the bowel wall so effectively make a hole right through it, or ulcers form around the granulomas due to infl and cell damage

How well did you know this?

Not at all

Perfectly

Does surgical removal of bowel cure crohns

No because it can come back in another part of the bowel

How well did you know this?

Not at all

Perfectly

What are the treatment options for crohns

Anti-infl
Abx to control gut bacterial and reduce the immune response
Immunosuppressants if severe

How well did you know this?

Not at all

Perfectly

What are some common complications of crohns

Malabsorption 
Obstruction 
Perforation 
Neoplasia
Fistula formation

How well did you know this?

Not at all

Perfectly

Which bit of the gi tract does ulcerative colitis affect

Large intestine

How well did you know this?

Not at all

Perfectly

Does ulcerative colitis affect the entire bowel wall or only a specific part

A specific part - only the mucosa

How well did you know this?

Not at all

Perfectly

What causes ulcerative colitis

Autoimmune - T cells target the tissue

Mainly unknown cause

How well did you know this?

Not at all

Perfectly

What are the symptoms of ulcerative colitis

Pain in left lower quadrant (rectum)

Severe and frequent diarrhoea with blood

How well did you know this?

Not at all

Perfectly

Give some treatments for ulcerative colitis

Anti-inflammatory drugs
Immunosuppressant drugs
Colectomy

How well did you know this?

Not at all

Perfectly

Does a colectomy in ulcerative colitis cure the disease or not

Yes it cures it

How well did you know this?

Not at all

Perfectly

Where does ulcerative colitis start

Rectum

How well did you know this?

Not at all

Perfectly

Symptoms and signs of malabsorption

Unintended weight loss
Pale stools more often
Anaemia

How well did you know this?

Not at all

Perfectly

What malabsorption leads to microcytic anaemia

Iron deficiency

How well did you know this?

Not at all

Perfectly

What malabsorption leads to macrocytic anaemia

B12/folate deficiency

How well did you know this?

Not at all

Perfectly

Define malabsorption

Not absorbing enough food from the diet

How well did you know this?

Not at all

Perfectly

What are the 6 causes of malabsorption

Study These Flashcards

Insufficient intake
Defective intraluminal digestion
Insufficient absorptive area
Lack of digestive enzymes
Lymphatic obstruction
Defective epithelial transport

Name 3 things that can cause defective intraluminal digestion (malabsorption)

1. Pancreatic insufficiency (not enough enzymes from the pancreas) 2. Defective bile secretion (lack of fat solubilisation) 3. Bacterial overgrowth

Name 4 things that will cause an insufficient absorptive area (malabsorption) and how they cause it

1. Coeliac - villous atrophy and crypt hyperplasia 2. Crohns - damage to small bowel mucosa 3. Giardia - parasite 4. Small bowel intestinal resection or bypass

Name two diseases that will cause a lymphatic obstruction (malabsorption)

TB | Lymphoma

What are the symptoms of GORD

Heartburn Burping Acid brash (acid/bile regurgitation) Water brash (excess saliva)

What is the pathophysiology behind GORD

Dysfunction of the lower oesophageal sphincter pre-disposes to the gastro-oesophageal reflux of acid

What is the management of GORD

Life style - weight loss, small and regular meals Drugs - antacids Surgery - only if severe

Risk factors for GORD

``` Smoking Alcohol Hiatus hernia Pregnancy Obesity Big meals Drugs ```

What is the leading risk factor for oesophageal adenocarcinoma

GORD

What is the pathophysiology behind GORD leading to oesophageal adenocarcinoma

Continuous stomach acid reflux destroys squamous cells and leads to ulceration, the adaptive change is to produce glandular epithelium that produces mucin to try and protect the oesophagus from the acid. This metaplasia leads to dysplasia then neoplasia.

What is the change in epithelium seen in Barrett's oesophagus

Squamous epithelium becomes glandular epithelium

What are the symptoms of oesophageal adenocarcinoma

``` Difficulty swallowing Weight loss Regurgitation of food or vomiting Pain when swallowing Persistent heartburn ```

What is the % 5 year survival rate for oesophageal adenocarcinoma

10%

What is the typical age someone with oesophageal adenocarcinoma presents

60-70s

What are the commonly linked associates of gastric adenocarcinoma

H. Pylori (metaplasia) Smoked/picked food diet Pernicious anaemia

What are the symptoms of gastric oesophageal cancer

``` Poor appetite Feeling full after a small meal Weight loss Abdominal pain Heartburn Nausea Vomiting with or without blood ```

What are the symptoms of colorectal adenocarcinoma

``` Change in bowel habits Rectal bleeding or blood in the stool Persistent abdominal discomfort Unexplained weight loss Fatigue/weakness ```

Where is the most common colorectal cancer found

Rectum and lower part of sigmoid colon

Name 3 predisposes to colorectal adenocarcinoma

1. Polyps 2. Familial adenomatous polyposis (FAP) 3. Hereditary nonpolyposis colorectal cancer (HNPCC)

Briefly describe the tumour resection coding for colorectal adenocarcinomas

``` R0 = tumour completely excised locally R1 = microscopic involvement of margin by tumour R2 = macroscopic involvement of margin by tumour ```

What are the 5 causes of gastroduodenal ulceration

1. Mucosal ischaemia 2. Increased acidity 3. Bile reflux 4. Alcohol 5. Helicobacter pylori

How does H Pylori cause ulceration

Live in the mucous layer and secrete chemicals causing inflammation, attract neutrophil polymorphs which enter and damage the epithelium Increases acid production in stomach and causes intestinal metaplasia

Name 3 complications of gastroduodenal ulceration

1. Peritonitis 2. Pancreatitis 3. Haemorrhage

What are the symptoms of gastroduodenal ulceration

``` Nighttime upper abdominal pain Burping Vomiting Weight loss Anorexia ```

When food is eaten, how can you tell if the ulcer is gastric or duodenal

If duodenal - eating relieves the pain | If gastric - eating worsens the pain

What is the most common cause of appendicitis and name some things that cause that

``` Obstruction: Fecalith Undigested seeds Pinworm infection Lymphoid hyperplasia ```

What are the symptoms of appendicitis

``` Pain that migrates from the umbilicus to the RIF Pain worse on movement Off food Nausea and vomiting Fever ```

What is the Tx for appendicitis

Appendectomy

What is an intestinal obstruction

Blockage to the lumen of the gut

What can block the lumen of the gut

Tumours Diaphragm disease - caused by NSAIDs Gallstone ileus - stone erodes through the gallbladder into the bowel

What can occur in the wall of the GI tract to cause an obstruction

Inflammation Diverticular disease Tumours - of nerve is most common Hirschprungs disease - chronic, huge dilation of bowel loops

What can occur outside of the GI tract to cause obstruction

Adhesions Volvulus Peritoneal tumours

What are the two main symptoms of a small bowel obstruction

1. Nausea and vomiting | 2. Pain - colicky to constant

In Europe, what is the most common cause of large bowel obstruction

Colorectal malignancy 90%

What is intersussuption and who is it more common in

One bit of bowel going into another bit | More common in children

GI Diseases Flashcards

(58 cards)