Lecture 13 Lower GI tract disease Flashcards Preview

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Flashcards in Lecture 13 Lower GI tract disease Deck (36):
1

Name the parts of the large intestine

Ileum, Cecum, ascending colon, transverse colon and descending colon, rectum.

2

Large intestine membranes

Mucosa -> submucosa -> taeniae coli

3

Define appendicitis

Acute bacterial infection of the appendix caused by lumen obstruction

4

What are clinical symptoms of appendicitis?

Pain, rebound tenderness, systemic symptoms

5

Define pseudomembranous colitis

Acute inflammation of the colon presenting with the formation of plaque like fibrinous exudate (pseudomembranes) covering parts of mucosa

6

What causes pseudomembranous colitis?

Toxin produced by overgrowth of C.diff, replacing normal intestinal flora

7

Who is more likely to develop pseudomembranous colitis

patients treated with broad spectrum antibiotics

8

What are symptoms of pseudomembranous colitis?

Fever and lower abdo tenderness

9

How is pseudomembranous colitis treated?

Stopping antibiotics, hydration, specifical antibacteria therapy

10

Define inflammatory bowel disease

Chronic inflammatory conditions of unknown aetiology affecting the gastrointestinal tract

11

What is the pathogenesis of IBD?

Genetics, environment, constitutional susceptibility

12

What are the two types of IBD?

Crohn's disease and ulcerative colitis

13

What is crohn's disease?

Idiopathic IBD, affects any part of GIT from mouth to anus. Has skip lesions

14

What are the percentages of the areas affected by crohns disease?

50% ileum and colon, 30% terminal ileum and 20% colon alone. Perianal skin involvement (75%)

15

Pathology of Crohns disease?

Mucosal ulceration, fissures, Oedema of adjacent epithelium (cobblestone), pseudopolyp formation regen. Transmural inflam, non-caseating

16

Complications of Crohns disease?

Anaemia, malabsorption, fistulas, extra-intestinal. ^risk of bowel carcinoma.

17

Define colitis?

Disease affecting only colon, starts in rectum spreading proximally, continuous mucosal disease.

18

Microscopy findings for ulcerative colitis?

Affects mucosa only above muscularis mucosae, cryptitis, crypt abscess, goblet cell depletion, pseudopolp formation regeneration

19

What is pseudopolyp formation regeneration found in?

Crohn's and ulcerative colitis

20

Complications of ulcerative colitis

Anaemia, electrolyte loss, extra-interstinal disease, ^ carcinoma risk.

21

What mimic IBD?

Ischaemic colitis, radiation colitis, Behcet's disease, pouchitis, diversion colitis,

22

What genetic factors can lead to colorectal carcinoma?

Familial adenomatous polyposis & lynch syndrome

23

What dietary factors can lead to colorectal carcinoma?

Low, fibre, bile aerobes, red meat, lack of vits and antioxidants

24

What is involved in the National Bowel Cancer Screening Programme?

60-75 years old, faecal occult blood test (FOBT) -> colonoscopy looking for polyps

25

What is a polyp?

Projection above an epithelial surface

26

Define adenoma

benign tumour of glandular epithelium

27

What does the quantity and size of the polyps mean?

The more polyps -> ^ the risk. The larger the polyp -> ^ likely to be malignant

28

Notes on familial adenomatous polyposis (FAP)

Autosomal dominant, chromosome 5, polyps from mid-teens onwards, Carcinoma inevitable (15 years). Needs genetic counselling.

29

Which condition needs genetic counselling?

Familial adeonmatous polyposis

30

What are the variants of familial adenomatous polyposis?

Gardner's and Turcot syndromes

31

Define lynch syndrome

hereditary non-polyposis colorectal carcinoma

32

Notes on lynch syndrome?

autosomal dominant, associated with CRCa (70-85%)

33

What disease is microsatellite instability is linked to?

Lynch syndrome

34

Define TEMS

transanal endoscopic microsurgery

35

What is the staging of colorecatal carcinoma?

Dukes stage A (above muscle 95%survival) B into serosal fat (66%) C LN involved (33%)

36

Define desmoplasic response

Growth of fibres or connective tissue.