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GI Liver > Appendix inflammatory bowel disease > Flashcards

Appendix inflammatory bowel disease Flashcards

0
Q

What causes appendicitis in children and adults?

A

@Kids = GI infection – >
LYMPHOID HYPERPLASIA =obstruct appendix

@Adults fecalith

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1
Q

What is the most common cause of acute abdomen

A

Appendicitis = acute inflammation of appendix

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2
Q

When the appendix ruptures What’s do you get?

Explain the five Clinical features

A

Peritonitis

  1. pain increase = guarding
  2. rebound tenderness
  3. Rovsing sign positive
  4. obturator sign positive
  5. Psoas positive
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3
Q

Causes of inflammatory bowel disease

A

Idiopathic

Possibly due to abnormal immune response to enteric flora

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4
Q 
A young woman presents with a 
recurrent bouts of bloody diarrhoea 
abdominal pain and 
happens to be a Jewish Caucasian. 
What's the DDX
A

Inflammatory bowel disease

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5
Q

What must you do before reaching a diagnosis of inflammatory bowel disease

A

Exclude other diseases e.g. ischaemia

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6
Q

What eighth things can we look at to compare ulcerative colitis and Crohn’s disease?

A

Complications,
GRoss appearance, Location, Symptoms,
Wall involvement, Associations, Smoking, Histology

C GrLS WASH
See girls wash!!!!

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7
Q

In ulcerative colitis How are the walls involved

A

Mucosal + submucosal ulcers

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8
Q

In ulcerative colitis What location Is involved

A

Restricted to colon. Small intestine not involved

Rectum – > up colon – >
extend anywhere up to cecum only

Involves entire radius of tube + CONTINUOUS

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9
Q

Symptoms of ulcerative colitis

A

Left lower quadrant pain + bloody diarrhoea

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10
Q

Histology of the ulcerative colitis

A

Crypt abscess with neutrophils inside crypts

T-helper 2 cells

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11
Q

Gross appearance of the ulcerative colitis

A

Free hanging mesentery + Friable Pseudopolyps – numerous bumps at colon surface in response to healing of ulceration

Loss of haustra –> LEAD PIPE @imaging

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12
Q

What are the complications of ulcerative colitis

A

Toxic mega: – >increased risk of rupture

Increased extent of colonic involvement
+
Increased duration e.g. 10 years
– >

Increased p(cancer) - 
worse with right sided colitis/pancolitis
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13
Q

What are the associations of ulcerative colitis

A

Primary sclerosing cholangitis

p-ANCA

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14
Q

What is the relationship between smoking and ulcerative colitis

A

Protects against ulcerative colitis

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15
Q

Explain The wall involvement in Crohn’s disease

A

TRANSMURAL inflammation =

Large fissures of inflammation

through FULL thickness of wall

16
Q

Explain the location of Crohn’s disease

A

Anywhere from the mouth to the anus with skip lesions

17
Q

Where is the most + least common site in Crohn’s disease

A

Terminal ileum

Rectum

18
Q

Symptoms of Crohn’s disease

A

Right lower quadrant pain + non-bloody diarrhoea

19
Q

What does histology in Crohn’s disease reveal?

A

Noncaseating granulomas with lymphoid aggregates

20
Q

Gross appearance of Crohn’s disease

A

FUCCS

Healing process –>
Fissures, linear Ulcers, Cobblestone mucosa,

Creeping fat + strictures:
Full/TRANSMURAL thickness inflammation – > healing = knock stem cell out – >
granulation tissue + fibrosis – >
Myofibroblasts contract – >

narrow lumen forming a stricture = obstruct = STRING SIGN @imaging + pull fat up creeping into serosa

21
Q

What are the complications of Crohn’s disease

A

GaStric MaNuFiSto CoPe

GAllstones + STRICtures

MAlabsorption due to small intestine damage –> NUtritional deficiency

transmural full thickness damage – > rupture – > entire tube plug into another tube = FISTula (enterovesical fistulae –> recurrent UTI’s)

bowel inflammation –> can’t excrete oxalate – > oxalate into blood – > bind to calcium –>
calcium kidney STOne

⬆️p(COlorectal cancer/PErianal disease )

22
Q

Where in the gastrointestinal tract do you need to have Crohn’s disease for there to be a high risk of carcinoma

A

Colon

23
Q

What diseases is Crohn’s AND ulcerative colitis associated with

A

U An APE

Uveitis
Ankylosing spondylitis
Apthous ulcers 
Pyoderma gangrenosum
Erythema nodosum
24
Q

What disease is ulcerative colitis alone associated with apart from the common ones with crohns

A

Primary sclerosing cholangitis

p-ANCA

25
Q

What disease is crowns alone associated with apart from the common ones?

A

Migratory polyarthritis

Kidney stones

26
Q

Treatment for ulcerative colitis and crohns?

A

I CAM

Infliximab,
Colectomy
5-Aminosalicylic preparations (mesalamine),
6-Mer capto purine

CAZAN In Adalimumab

Corticosteroids, AZathioprine, ANtibiotics
(cipro + metronidazole),

Infliximab
Adalimumab

GI Liver (11 decks)

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