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Flashcards in Week 2 Deck (56)
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1

List 4 functions of mucosal tissue

Reproduction
Sensory activities
Food absorption
Gas exchange

2

What is the dominant antibody in the gut?

IgA (usually IgG elsewhere)

3

Which antibody takes over if the patient can't make IgA?

IgM

4

What are intra-epithelial lymphocytes (IELs)?

CD8 +ve T cells which lie within the epithelial lining of the gut

5

Describe what is meant by intestinal failure

Where gut is no longer able to supply the hydration and nutritional needs of the body

6

Describe the 3 types/ levels of intestinal failure

1 - self-limiting, short term postoperative (most common) -(days to weeks)
2- Prolonged, associated with sepsis and metabolic complications, often related to abdominal surgery with complications
3 - long-term but stable

7

How would you treat Type 1 intestinal failure

- Fluids and electrolytes
- Parenteral nutrition if unable to tolerate foods and fluids
- Acid suppression (proton pump inhibitors/ ocreteotide)
- Alpha hyrdocycholecalciferol (to presevre magnesium)

8

What is a risk associated with insertion of lines for parenteral nutrition?

Due to the close proximity to the lungs, there is a risk of pneumothorax

9

Is bowel lengthening as a treatment of Type 3 intestinal failure used in adults or children?

CHILDREN

10

Which other type of transplant is a small bowel transplant usually given in combination with?

Liver transplant

11

Which vessel supplies the small bowel?

The superior mesenteric artery

12

Describe the outcomes of the three types of infarct to the small bowel

Mucosal infarct - There will be regeneration and mucosal integrity will be restored
Mural infarct - Repair and regeneration - fibrous stricture
Transmural - Gangrene and death if not sorted

13

What is 'Meckel's Diverticulum'

A slight bulge in the small intestine due to incomplete regression of the vitello-intestinal duct (an embryological remnant)

14

Secondary small bowel tumours are more common than primary tumours. Where do these secondary tumours commonly metastasise from?

Ovaries
Colon
Stomach

15

What are the three types of primary tumour that can occur in the small bowel?

Lymphomas
Carcinoid tumours
Carcinomas

16

What are the symptoms of appendicitis

Epigastric pain initially, RIF pain later
Vomiting
Fever possible

17

List possible consequences of appendicitis

Rupture
Abscess
Sepsis
Peritonitis

18

Which genes is coeliac disease associated with?

HLADQ2/HLADQ8

19

What component of gluten is the toxic agent?

GLIADIN

20

What do serology tests to investigate for coeliac disease look for?

IgA (deficiency - 10X more likely to have coeliacs)
Anti-TTG
Anti-gliadin antibodies
Anti-endomesial antibodies

21

What can malabsorption of fats do to stool?

Cause STEATORRHOEA (fat in the stool)

22

List the negative possible effects of malabsorption

Weight Loss
Anaemia
Abdominal Bloating
Vitamin deficiencies
Failure to thrive

23

What are 'Peyer's Patches'

The lymph nodes of the gut

24

What is the function of M cells within payer's patches?

They provide maximum surface area for antigen absorption

25

What happens in the TH1 response to infection?

Macrophages and B cells are activated

26

What happens in the TH2 response to infection and which Interleukins are responsible?

- IgE production (IL 4)
- Recruitment and activation of eosinophils (IL-5)
- Recruitment of mast cells which produce histamine/ TNFa and MMCP (IL-3 and IL-9)
- Epithelial repair and production of mucus (IL- 13)

27

What are the two main receptors for the HIV virus?

CCR5 and CD4

28

List disorders associated with primary immunodeficieny

SCID
CVID
XLA
Selective IgA deficiency

29

Which mucosal disorder is associated with low IgG, IgA, IgM and IgE, causing recurrent sinopulmonary and GI infections?

CVID

30

Which mucosal disorder is x-linked and involves agammaglobulinaemia (No B cells!)

XLA