Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Week 10 -GI > Small bowel disease > Flashcards

Small bowel disease Flashcards

(48 cards)

Start Studying
1
Q

What are the causes of inflammatory bowel disease?

A
  • Environmental factors: diet, sanitation, medication
  • Genetic predisposition
  • Host immune response: related to psoriasis, ankylosing spondylitis
  • Gut microbiota
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What kind of bowel opening is almost always pathological?

A

Nocturnal

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

What is the classical presentation of infective colitis?

A
  • Short history of diarrhoea +/- vomiting
  • Abrupt onset +/- resolution of symptoms
  • Systemic upset and fevers prominent
  • Travel
  • Unwell contacts
  • Immunocompromised
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the investigation for suspected infective colitis?

A

Stool culture - need at least 4 for 90% sensitivity

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

What is the treatment for infective colitis?

A

Normally conservative if immunocompetent

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

What is the classical presentation of ischaemic colitis?

A
  • Abrupt onset of pain

* bloody diarrhoea +/- SIRS

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

What are the risk factors for ischaemic colitis?

A
  • Elderly
  • Cardiovascular disease
  • Heart failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What may be seen on a CT scan in someone with ischaemic colitis?

A

May show segmental colitis in watershed areas

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

What is the treatment of ischaemic colitis?

A
  • IV fluids

* Consider antibiotics if systemic features

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

Above what number of bloody stools a day should you admit a patient, regardless of other symptoms?

A

> 6

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

What are the signs of ulcerative colitis on an abdominal X-ray?

A

Thumb printing due to extensive bowel wall thickening

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

What can be evaluated/seen in an abdominal X-ray which you should be worried about in someone with ulcerative colitis?

A
  • Megacolon

* toxic megacolon

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

What is the difference between megacolon and toxic megacolon?

A
  • Megacolon: diameter>5.5cm or caecum >9cm

* Toxic megacolon: megacolon and signs of systemic toxicity

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

What causes a megacolon in ulcerative colitis?

A

Inflammation in the colon causes gas to get trapped resulting in the colon becoming enlarged and swollen

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

What investigations should be carried out in someone with suspected ulcerative colitis?

A
  • Abdominal X ray
  • Flexible sigmoidoscopy or colonoscopy
  • Potentially a CT scan
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the layers of the normal bowel wall starting at the luminal surface?

A
  • Mucosa
  • Sub mucosa
  • Muscularis
  • Sub-serosa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the two components of the muscularis in the bowel wall?

A
  • Inner circular

* Outer longitudinal

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

Describe the lamina propria

A
  • Supporting scaffold of connective tissue
  • contains a few inflammatory cells
  • Fibroblasts, blood vessels, lymphocytes, plasma cells, a few eosinophils
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the acute pathological changes in inflammatory bowel disease?

A
  • Acute inflammation
  • Ulceration
  • Loss of goblet cells
  • Crypt abscess formation - collection of neutrophils
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the chronic pathological changes in IBD?

Study These Flashcards
A
  • Architectural changes
  • Paneth cell metaplasia (in more distal bowel)
  • Chronic inflammatory infiltrates in the lamina propria (more plasma cells)
  • Neuronal hyperplasia
  • Fibrosis
21
Q

In ulcerative colitis, where is the inflammation confined to?

22
Q

In regards to the histopathology, what is lost in inflammatory bowel disease which is not lost in infective colitis?

Study These Flashcards
A

The plasma cell gradient - normally there are more plasma cells on the luminal side of the bowel wall whereas in IBD there are increased plasma cells throughout the whole of the bowel wall

23
Q

What are the macroscopic features of ulcerative colitis?

Study These Flashcards
A
  • Diffuse involvement of the lower GIT

* The terminal ileum can be involved but generally only if severe

24
Q

What are the microscopic features of ulcerative colitis?

Study These Flashcards
A
  • Crypt architectural changes are generally very marked
  • Little to no fibrosis
  • No granulomas
25
What drugs can be prescribed for chronic ulcerative colitis
*  5-ASA/mesalazine both orally and topically (foam enema or suppository) *  Azathioprine/6MP (severe relapses/frequently relapsing)
26
What is the treatment of an acute severe ulcerative colitis?
*  IV steroids e.g. methylprednisolone | *  Low molecular weight heparin
27
What can predict the need for a colectomy in those with an acute severe ulcerative colitis?
Either of the following on day 3 of treatment: • Stool frequency >8 a day • Stool frequency >3 and CRP > 45
28
What are the rescue medical therapy for those with ulcerative colitis
Infliximab or ciclosporin
29
What is infliximab?
• Monoclonal antibody to TNF-alpha
30
What are the local complications of ulcerative colitis?
*  Haemorrhage | *  Toxic dilation (aka toxic megacolon)
31
What are the systemic complications of ulcerative colitis?
*  Skin: erythema nodosum( red bumps and patches), pyoderma gangrenosum (painful ulcers) *  Liver: sclerosing cholangitis, cholangiocarcinoma *  Eyes: iritis, uveitis, episcleritis *  Ankylosing spondylitis *  malignancy
32
What surveillance should be done in those with ulcerative colitis?
Screening colonoscopies: • If no active inflammation: once every 5 years • If mild active inflammation: once every 3 years • If moderate/severe inflammation; once a year
33
Which of the IBDs is more likely to cause a high MCV?
Chron's - due to the effect on the absorption of B12
34
What is Chron's disease?
Ac chronic inflammatory condition affecting anywhere from the mouth to the anus
35
Where are the most common sites of Chrons?
The terminal ileum and caecum
36
What is the peak incidence of Chron's disease?
15-25 years
37
What lifestyle change can someone with Crohn's do to reduce the risk of relapse?
Stop smoking
38
What are the features of Crohn's disease?
*  Abdominal pain *  Diarrhoea *  Weight loss *  Fistulae, abscesses, oropharyngeal, gastroduodenal *  Extra-intestinal symptoms
39
What are the extra-intestinal symptoms of crohn's disease?
*  Eyes: uveitis and episcelritis *  Joints: sacroilitis, inflammatory arthropathy *  Skin: erythema nodosum
40
What investigations should be carried out in suspected Crohn's disease?
*  Abdominal Xray *  Ileocolonoscopy *  Faecal calprotectin *  Stool cultures *  MR/CT enterography
41
What is faecal calprotectin?
Calcium binding protein, predominantly derived from neutrophils
42
What is faecal calprotectin useful for?
Differentiating between IBD and IBS
43
What can be seen on histology of the bowel which would confirm Crohn's?
Granulomas
44
How can a pathologist tell the difference between ulcerative colitis and Crohn's?
*  Distribution of the inflammation *  Type of inflammation *  Clinical context/scope findings
45
What are the differences between Crohn's and ulcerative colitis?
*  Crohn's = small and large bowel inflammation, UC= large bowel only *  Crohn's tends to involve the proximal large bowel, UC tends to extend from the rectum to involve left side of bowel *  Crohn's= patchy inflammation with skip lesions , transmural deeply ulcerating, UC= confluent, diffuse inflammation centred on mucosa
46
What is the classification system of crohn's?
The Montreal category
47
What are the medications for Crohn's?
``` • Azathioprine and 6-mercaptopurine • Methotrexate • Biologics: - TNF alpha antagonists - Anti-integrins - Anti-interleukin ```
48
What are the risk factors for needing surgery in Crohn's disease?
*  Young onset *  smoking *  Perianal disease *  Stricturing SB disease

Week 10 -GI (8 decks)

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