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Flashcards in Week 4 Deck (58)
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1

What is the gastroileal reflex stimulated by and what does it involve?

Stimulated by gastric distension
Involves opening of the ileocaecal valve

2

What is absorbed and secreted by the large intestine?

Water, sodium and chloride ions are absorbed
Potassium, bicarbonate and mucus are secreted

3

Carbohydrates not absorbed in the S.I can be absorbed in the L.I but first must be converted. What does this involve?

Colonic flora ferment the carbohydrates to short-chain fatty acids which can then be absorbed

4

Is the internal anal sphincter under control of the brain or the spinal cord?

Spinal cord

5

What does RELAXATION of the skeletal muscle of the external anal sphincter cause?

Defecation

6

What does CONTRACTION of the skeletal muscle of the external anal sphincter cause?

Delays defecation

7

What are some of the roles of colonic bacteria within the bowel?

Increase intestinal immunity
Promote motility
Activate some drugs
Synthesis vitamin K2 and free fatty acids

8

What are the two main important drug classes used for IBD?

Steroids and immunosuppressants

9

What two conditions fall under IBD?

Crohn's Disease and Ulcerative Colitis

10

What is a polyp?

A protrusion above an epithelial surface

11

What is an adenoma?

Benign tumours composed of epithelial cells

12

What is an adenocarcinoma?

A malignant epithelial tumour

13

Injecting what substance can prevent bleeding when removing a polyp?

Adrenaline

14

Why must all adenomas be removed?

They are dysplastic and are pre-malignant - it would only take a few more mutations for a cancer to develop and thus they need to be removed to prevent this from happening

15

Are left or right sided colorectal cancers more common?

Left- sided

16

Why can there be spread to the liver from a colorectal cancer?

The merging of the systemic with the portal venous system allows metastasis to be directed towards the liver

17

Name two types of inherited cancer syndromes

HNPCC (hereditary non polyposis coli)
FAP (familial adenomatous polyposis)

18

What are causes of diverticular disease?

Low fibre diet
Increased intraluminal pressure

19

What is diverticulitis?

Inflammation of the diverticulae

20

What are some of the complications of diverticular disease?

Inflammation
Rupture/ Perforation - peritonitis/ sepsis
Abscess
Fistula
Stricture
Massive bleeding

21

What is the most common fistula that can occur from the large intestine? What can this cause?

Colovesical fistula (bladder and L.I communicate)
- Can cause recurrent UTI's and flatus (bubbles) in the urine

22

What is a fistula?

A pathological communication between two epithelial surfaces

23

What classification is used to stage acute diverticulitis?

Hinchey Classification

24

What is the name of the surgery used in the management of complex diverticulitis?

Hartmann's procedure

25

Who gets ischaemic colitis?

Elderly patients
Arteriopaths (patients with artery disease)

26

What are some of the causes of rectal bleeding?

Haemorrhoids
Diverticular disease
Cancer
Large polyps

27

What are some of the possible causes of large bowel obstruction?

Colorectal cancer
Hernias
Volvulus
Strictures

28

What are the symptoms of large bowel obstruction?

Constipation
Distension
Pain
Vomiting

29

What is a sigmoid volvulus?

When the sigmoid colon twists on its mesentery causing the lumen to be blocked off and the vasculature to be pinched off - can cause infarction and gangrene

30

What is meant by a 'pseudo obstruction'?

When there is no real mechanical/ physical obstruction - can be due to hypoxia/ biochemistry