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GASTRO - RIA > Digestion pathologies > Flashcards

Digestion pathologies Flashcards

1
Q

definition of coeliac disease

A

autoimmune reaction to gluten causing chronic inflammation

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2
Q

auto-antibodies in Coeliac disease?

A
  • IgA Anti-endomyosial

- IgA Anti-tissue transglutaminase

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3
Q

2 typical histological features in coeliac disease

A
  • Villous atrophy
  • Crypt hyperplasia
  • inflammatory infiltration (influx of immune cells into lamina propria)
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4
Q

gastrointestinal manifestations of malabsorption (4)

A
  • bloating
  • abdo pain
  • loose stools
  • steatorrhoea
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5
Q

skin condition that is strongly associated with coeliac disease?

A

Dermatitis herpetiformis

blistering skin condition; intensely pruritic rash

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6
Q

describe the rash of dermititis herpetiformis

A

extremely itchy papulovesicular rash on extenensor surfaces

subepidermal bullae are seen on histology with linear IgA deposite on dermal papillar

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7
Q

management of Dermatitis herpetiformis

A

dapsone

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8
Q

genetic associations with coeliac disease

A

HLA DQ2 gene

HLA DQ8 gene

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9
Q

Chrons NESTS pneumonic for Chrons disease

A 
N - no blood/mucus 
E - entire GI tract 
S - Skip lesion on endoscopy 
T - Terminal ileum & transmural thickness 
S - Smoking is a risk factor
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10
Q

UC ‘Close up’ pneumonic

A 
C - Continuous inflammation 
L - Limited to colon & rectum 
O - Only superficial mucosa affected 
S - Smoking is protective 
E - Excrete blood & mucus 
U - Use aminosalicylates 
P - Primary sclerosing cholangitis
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11
Q

extracolonic manifestations of UC

A
  • uveitis
  • episcleritis
  • arthritis
  • aphthous ulcers
  • erythema nodosum
  • PSC (isolated rise in ALP)
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12
Q

what is erythema nodosum

A

multiple, painful, purple nodules on the anterior aspect of the shins

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13
Q

screening required for patients with IBD?

A

surveillance colonoscopy due to increased risk of colorectal cancer

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14
Q

mechanism of ciclosprin

A

calcineurin inhibitor

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15
Q

mechanism of infliximab

A

monoclonal antiboy targeting TNF alpha

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16
Q

contraindications to infliximab?

A

latent TB

demyelination

active sepsis

17
Q

smoking effect on Chrons disease

A

worsens chrons disease

18
Q

type of IBD that can affect any part of thr GI tract

A

Chrons disease

19
Q

pathophysilogical/histological features of Chrons disease

A
  • Cobblestone appearance
  • Rosethorn ulcers
  • Obstruction
  • Hyperplasia
  • Narrowing of lumen
  • Skin lesions
20
Q

non caeseating granulomas

A

crohns disease

21
Q

2 skin lesions seen in crohns disease

A
  • erythema nodosum

- pyoderma gangrenosum

22
Q

describe pyoderma gangrenosum

A

ulcerating nodules characterised by black (gangrenosum) edges & cdntral pus (pyoderma)

23
Q

what marker is released following degranulation of neutrophils in IBD

A

Faecal calprotectin

24
Q

number of bowel movements a day for mild, moderate & severe flare up?

A

mild - < 4 stools a day

moderate - 4 to 6 stools a day

severe - more than 6 stools a day

25
Q

medication to induce remission in mild-moderate UC flare up

A

oral 5-ASA: sulfasalazine/mesalazine

26
Q

management of severe UC flare up?

A
  • admission
  • IV fluids
  • Hydrocortisone IV
  • rectal steroids
  • monitor stools & observations
27
Q

2 types of aminosalicylate?

A
  • mesalazine

- sulfasalazine

28
Q

side effects of sulfasalazine

A
  • headache
  • rash
  • nausea
  • diarrhoea
29
Q

adverse effects of azothioprine

A
  • decrease blood counts
  • nausea
  • flu like sy,ptoms
  • liver inflammation
  • pancreatitis
30
Q

radiological findings in UC

A
  • loss of haustrations

if long standing: narrow colon, drainpipe colon

31
Q

inheritance of Lynch syndrome?

A

autosomal dominant

32
Q

most common cancers predisposed to with lynch syndrome

A
  • Colorectal cancer

- Endometrial cancer

33
Q

NICE diagnostic criteria for IBS

A 
Abdominal pain/discomfort OR associated with change in bowel habit
& 
2 of: 
- Abnormal stool passage 
- Bloating 
- Worse symptoms after eatign
- PR mucus
34
Q

medication for diarrhoea in IBS?

A

Loperamide

35
Q

medication for constipation in IBS?

A

laxative

36
Q

medication for cramps in IBS?

A

Antispasmodic e.g. hyoscine butylbromide (Buscopan)

37
Q

2nd & 3rd line medication for IBS

A

2nd - Amitriptyline (TCA)

3rd - SSRI

38
Q

duration of symptoms needed for diagnosis of IBS

A

3 or more days a month and symptoms over 6 or more months

39
Q

what does a positive and negative Carnett’s sign suggest?

A

positive - suggests abdominal wall cause of pain

negative - suggests an intra abdominal cause of pain

GASTRO - RIA (10 decks)

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