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Gastroenterology > Coeliac Disease and Bowel Carcinoma > Flashcards

Coeliac Disease and Bowel Carcinoma Flashcards

1
Q

Examples of significant GI disease (3)

A

OESOPHAGUS + UPPER GI

  • Crohns disease
  • Coeliac disease
  • Tumours

BOWEL DISEASE

  • Inflammatory bowel disease
  • Crohns disease
  • Ulcerative colitis
  • Colonic Ca

INFECTIONS

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2
Q

Aetiology of coeliac disease (3)

A

Sensitivity to the a-gliaden component of gluten

  • Can cause inflamed villi
    Loss of villi (which increase SA for absorption)
  • May lead to villous atrophy
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3
Q

Name examples gluten can be found in (2)

A

Wheat + barley

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4
Q

Coeliac disease can cause jejunal atrophy in the SI,

what are the effects of this? (2)

A

CLINICAL (30-40%)

  • Growth failure
  • Oral ulceration

SUBCLINICAL
- None

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5
Q

Coeliac disease symptoms (9)

A
  1. Weakness
  2. Lassitude
  3. Weight loss
  4. Dysphagia
  5. Abdominal pain
  6. Steatorrhea
  7. Diarrhoea
  8. Glossitus
  9. Aphthae
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6
Q

Coeliac disease investigations (4)

A
  1. Jejunal biopsy
    - Capsule
    - Endoscopy
  2. Faecal fat
  3. Haematinics
  4. Autoantibodies
    - antigliadin
    - antiendomyseal antibodies
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7
Q

How can a gluten free diet aid coeliac disease? (3)

A
  1. Reversal of jejunal atrophy
  2. Improved wellbeing
  3. Reduced risk of lymphoma
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8
Q

What autoimmune skin disease is Coeliac disease associated with?

A

Dermatitis herpetiformis

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9
Q

Describe how Dermatitis herpetiformis presents? (3)

A
  1. Blisters on skin filled with watery fluid, very itchy
  2. Granular iGA deposits in skin and mucosa
  3. Reaction to gluten
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10
Q

What tests are used for aphthae patients, and what do they show (2)

A
  • Haematinic tests to detect deficiency

- Folate/ folate + ferrin deficiecy suggests malabsorption

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11
Q

Colonic carcinoma symptoms? (3)

A
  1. None
  2. Anaemia
  3. Rectal blood loss
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12
Q

Colonic carcinoma screening

A
  1. FOB
    - Tests faeces for blood
  2. Barium enema
    - Xray for colon abnormalities
  3. Endoscopy
  4. MRI/CT scan
  5. Carcinoembrionic antigen (CEA)
    - Low levels of this protein may be increased in certain types of cancer
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13
Q

What age does colonic carcinoma screening start at?

A

Over 50s

5 year repeat if negative

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14
Q

Aetiology of colonic carcinoma (7)

A
  1. Diet
    - Increased meat and fat
    - Decreased veg and fibre
  2. Smoking
  3. Alcohol
  4. Less exercise
  5. Genetics - P53 in 75%
  6. Ulcerative colitis
  7. Intestinal polyps
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15
Q

Define polyps

A

Abnormal growth of tissue from a mucous membrane

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16
Q

How long do carcinomas in polyps take to progress to malignancy

A

5 years

17
Q

Where can a colonic carcinoma present?

A

Polyps

- Most will bleed due to irritation and trauma

18
Q

What risk does an intestinal polyposis carry?

A

Risk of a carcinoma

19
Q

What part of the intestine has greater risk of a carcinoma

A

Large intestine

20
Q

Example of low risk syndromes in SI

A

Peutz-jehgers syndrome

  • Polyps in GI tract give hyper pigmented macule on lips/oral mucosa
21
Q

Examples of high risk syndromes in LI

A
  1. Gardiners syndrome
    - Multiple polyps in the colon together with tumours outside the colon
  2. Cowdens syndrome
    - Benign overgrowth
22
Q

Colonic carcinoma grading (3)

A

Well differentiated - 80%
Moderately differentiated - 60%
Poorly differentiated - 25%

23
Q

Colonic carcinoma staging (4)

A

Submucosal - 80%
Muscularis - 65%
Lymph nodes - 45%
Liver - 5%

24
Q

Colonic carcinoma treatment (3)

A
  1. Surgery
  2. Radiotherapy
  3. Chemotherapy

Gastroenterology (4 decks)

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