Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Y2 BRS (Haroop) > Lower GI Disorders > Flashcards

Lower GI Disorders Flashcards

(73 cards)

Start Studying
1
Q

Which artery supplies the proximal colon?

A

Superior mesenteric artery

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

Which artery supplies the distal colon?

A

Inferior mesenteric artery

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

Which venous vessels drain the colon?

A

Inferior and superior mesenteric veins draining into the portal vein

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

What structures reside within the submucosal space?

A

Submucosal glands and Meissner’s plexus

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

Which molecule is secreted by the submucosal glands, lubricating the mucosal surface?

A

Mucin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Between which two layers does the myenteric plexus reside?

A

Intermediate between the circular and longitudinal muscles within the muscularis layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Where are the myenteric plexus ganglia located in relation to the taenia coli?

A

Concentrated deep to the taenia coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which nerve provides the parasympathetic supply to the ascending and proximal transverse colon?

A

Vagus nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which nerves provides parasympathetic supply to the distal transverse and descending colon?

A

Pelvic nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the sympathetic supply of the colon?

A

Pre-ganglionic fibres arise from the thoracolumbar spinal cord

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

Which nerve controls the external anal sphincter?

A

Pudenal nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the nerve roots of the pudenal nerves?

A

S1-S3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is Hirschprung;s disease?

A

Characterised by a congenial absence of myenteric and Meissner’s ganglion.
• Peristalsis is impaired due to unstimulated muscular contractions within the muscularis layer.
• Obstruction  Constipation.
• There is an absence of propulsive peristalsis and mass contraction in the aganglionic segment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the inflammatory causes of lower GI tract disorders?

A

IBD and microscopic colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the infective causes of lower GI tract disorders?

A

C. difficile

E. coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the structural causes of lower GI tract disorders?

A

Diverticular disease
Haemorrhoids
Fissures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the functional causes of lower GI tract diosrders?

A

IBS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the neoplastic causes of lower GI tract disorders?

A

Colonic polyps

Colon cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the two causes of IBD?

A

Ulcerative colitis

Crohn’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is ulcerative colitis?

A

Inflammatory disorder characterised by diffuse inflammation of colonic superficial mucosa.

No granulomas

Extends continuously and proximally from the rectum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which GI organ is always concerned with ulcerative colitis?

A

Rectum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is proctitis?

A

Inflammation of the rectum

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

What is pancolitis?

A

Inflammation of the entire colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What term describes ulcerative colitis of the rectum and sigmoid colon?

A

Proctosigmoiditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is distal colitis?
Diffuse continuous inflammation from the rectum to the ascending colon
26
What are the symptoms concerned with ulcerative colitis?
Patients present with severe and frequent rectal bleeding, diarrhoea, and blood in stool (detected on digital rectal examination)
27
What is Crohn's disease?
Characterised by transmural inflammation of the gastrointestinal tract, predominantly in the terminal ileum and perianal locations Skip lesions inflammation can penetrate through the serosa, giving rise to perforations and fistulae Inflammatory infiltrate initially begins around intestinal crypts, developing into ulcerations of the superficial mucosa. • Inflammation progresses to involve non-caseating granulomas (all layers of the intestinal wall and the mesentery are affected). • Granulomatous inflammation is characteristic of CD. • Strictures are narrowing of the bowel due to inflammation. N.B: Involvement of the terminal ileum will disrupt bile acid absorption  Steatorrhea and fat-soluble vitamin deficiency.
28
Which areas of the GI tract does Crohn's disease predominantly affect?
Terminal ileum and perianal locations
29
What are the characteristic features of Crohn's disease?
``` Skip lesions Fistulae Transmural inflammation Strictures Non-caseating granulomas ```
30
What is a fistula?
Inflammation can penetrate through the serosa giving rise to perforation and fistulae
31
What type of granulomas form in Crohn's disease?
Non-caseating granulomas
32
What is a stricture?
Narrowing of the bowel due to inflammation
33
What are the side effects concerned with Crohn's disease of the terminal ileum?
Disrupts bile reabsorption, manifesting as steatorrhea
34
Which gender is most likely to be affected by Crohn's disease?
Females (1.5:1)
35
What are the symptoms of Crohn's disease?
* Abdominal pain (Right lower quadrant and peri-umbilical regions common – ileitis). * Prolonged diarrhoea * Perianal lesions (skin tags, fistulae, abscesses, scarring or sinuses) * Bowel obstruction – strictures  Manifests as bloating, vomiting and constipation. * Fever * Abdominal tenderness
36
What are the symptoms concerned with colitis?
* Bleeding * Mucus * Urgency- hallmark of lower-rectal disorder due to sensory changes. Urgency occurs when the arrival faeces in the rectum causes strong contractions and precipitate anal relaxation. * Diarrhoea
37
What is urgency?
occurs when the arrival of faeces in rectum results in strong contractions and precipitate anal relaxation
38
What are the symptoms of perianal inflammation?
* Anal pain * Leakage * Crohn’s disease is fistulating and associated with deep ulcerations.
39
What are the symptoms associated with small bowel disease?
* Abdominal pain * Weight loss (Inadequate absorption  Anaemic). * Tiredness/lethargy * Diarrhoea * Abdominal mass
40
What extra-intestinal manifestations are linked with IBD?
Arthritis • Axial- Ankylosing spondylitis • Peripheral Skin • Erythema nodosum • Pyoderma gangrenosum Eyes • Anterior uveitis • Episcleritis/iritis Liver • Primary sclerosing cholangitis (PSC) – Inflammation and scarring of the bile ducts. • Autoimmune hepatitis
41
Which genes lead to a genetic predisposition of IBD?
NOD2 HLA ATG IL23-R
42
Which specific auto-antibodies are concerned with Crohn's disease?
ASCA
43
Which specific auto-antibodies are associated with ulcerative colitis?
pANCA
44
Which bacteria has a possible relationship with IBD?
Mycobacterium paratuberculosis
45
What is dysbiosis?
: In Crohn’s disease there is dysbiosis, as the gut microbiota is disrupted – lipopolysaccharides enter into systemic circulation. • Loss of peripheral tolerance.
46
What are the three management strategies for the treatment of IBD?
1. Induce clinical remission 2. Maintain clinical remission  Decrease hospitalisation/surgery & overall cost. 3. Improve quality of life.
47
What is the first line of treatment for IBD?
Short-acting steroids (as a bridge to other interventions + used in acute unwell patients).
48
How do steroids work in IBD?
Diffuse into the nucleus, and bind onto glucocorticoid responsive elements (GRE) GRE interacts with specific DNA sequences Increase expression anti-inflammatory gene products Block pro-infammatory genes
49
Which immunmodulators are used in the treatment of IBD?
Azathioprine | Methotrexate and folic acid
50
What is the mechanism of immunomodulators?
Immunomodulators help induce remission in active CD, downregulating DNA & RNA synthesis (causing cell proliferation to arrest).
51
What is the mechanism of action of Azathioprine?
6-TGN interferes with adenine and guanine ribonucleotide production, inhibiting DNA synthesis within B- and T-lymphocytes (apoptosis of WBCs) Decreased Ig and IL production
52
Which ribonucleotides are affected by 6-TGN in azathioprine?
Adenine and guanine
53
What type of drug is azathioprine?
Prodrug (That is activated into TGNs)
54
What is the active metabolite of azathioprine?
6-TGN
55
Which enzyme inactivates TGNs?
Thiopurine methyltransferase (TPMT)
56
What is the risk in individuals with reduced activity of TPMT?
Thus, individuals with reduced activity of TMPT are exposed to higher levels of thioguanine – high risk of toxicity (including myelosuppression). -Reduce dose in those with low TPMT.
57
What are the side effects associated with azathioprine?
* Bone marrow suppression * Lymphoma * Pancreatitis * Infection * Nodular regenerative hyperplasia/hepatotoxicity * GI-disturbances * Allergic reaction: Fever, rash, arthralgias, myalgias, fatigue.
58
What is the mechanism of action of methotrexate?
Interferes with DNA synthesis and reproduction - Increased adenosine levels (anti-inflammatory) - Increased apoptosis of peripheral T cells
59
What are the side effects associated with methotrexate?
``` • Rash • Nausea, mucositis, diarrhoea • Bone marrow suppression • Hypersensitivity pneumonitis • Increased liver enzymes • Hepatic fibrosis/cirrhosis • Abortifacient N.B: There is no documented increased risk of lymphoma or skin cancer. ```
60
What is the mechanism of 5 ASA?
• Inhibition of lipo-oxygenase pathway (Prostaglandin and leukotrienes). • Inhibition of pro-inflammatory cytokines (IL-1 and TNF-alpha). • Scavenging of free radicals • Inhibition of NF-kB/TLR via PPAR-gamma induction (peroxisome proliferator activated receptor-gamma). N.B: Expresses immunosuppressive activity through inhibiting T-cell proliferation and differentiation. In addition to impairing neutrophil chemotaxis and activation.
61
Which pro-inflammatory cytokines are inhibited by 5 ASA?
IL-1 and TNF-alpha
62
Which pathway is inhibited by 5 ASA?
• Inhibition of lipo-oxygenase pathway (Prostaglandin and leukotrienes).
63
How is 5 ASA delivered?
Mode of delivery: Orally & Rectal
64
What are the side effects with using 5 ASA?
* Diarrhoea * Renal impairment * Headache * Malaise * Pancreatitis * Pneumonitis * Intolerance
65
How do biologics work?
Anti TNF-alpha | Infliximab and adalimumab
66
What is infliximab?
A biologic - anti-TNF alpha
67
How is Infliximab administered?
IV infliximab  8 weekly maintenance, induction 0,2,6 weeks, in hospital – less frequent.
68
What is the effect of TNF-alpha on macrophages?
Increased release of pro-inflammatory cytokines and chemokines
69
What is the effect of TNF-alpha on the endothelium?
Increased expression of adhesion molecules (increased cell infiltration)
70
What is the effect of TNF-alpha on fibroblasts?
Increased acute phase response and metalloproteinase synthesis Decreased collagen production (Tissue remodelling) Increased CRP in serum
71
What is the effect of TNF-alpha on the epithelium?
Increased ion transport Increased permeability This compromises barrier function
72
What are the side effects with using biologics in IBD?
``` vSide effects: • Opportunistic infections • Infusion or site reactions • Infusion reactions • Neutropenia • Infections • Demyelinating disease • Heart failure (HF) • Cutaneous reactions, including psoriasis • Malignancy • Induction of autoimmunity ```
73
Which two drugs are used as a combination therapy in the treatment of IBD?
AZA/6MP and an anti-TNFA work synergistically, thus combination therapy improves patient outcomes and recovery. • Reduces the rate of antibody formation.

Y2 BRS (Haroop) (62 decks)

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