Gastrointestinal - Bowel Disease Flashcards

1
Q

what occurs in coeliac disease?

A

T cell mediated AI disease of the small bowel

results in an enteropathy to gluten

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2
Q

features of coeliac disease?

A
diarrhoea
pale stools
wt loss
steatorrhoea
bloating 
ulcers
fatigue
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3
Q

what is the intolerance to in coeliac disease? what is this in?

A

prolamin

alcohol soluble proteins (wheat, barley, rye, oats)

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4
Q

Ix for coeliac disease and results?

A
FBC (anaemia)
ferritin
stool culture
B12/folate
anti TTG
endoscopy + duodenal biopsy
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5
Q

what is seen on duodenal biopsy in coeliac disease?

A

villous atrophy
intra epithelial WBCs
crypt hyperplasia

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6
Q

how can paeds diagnose coeliac disease?

A

blood tests if tTG >10x normal

if not, still need scope and biopsy

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7
Q

Tx for coeliac disease?

A

gluten free diet

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8
Q

what malignancy are those with coeliac disease at higher risk of?

A

T cell lymphoma (gastric)

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9
Q

what rash is associated with coeliac disease?

A

dermatitis herpetiformis

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10
Q

describe dermatitis herpetiformis?

A

extensors
buttocks
small blisters on a red base
itchy

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11
Q

what is seen on biopsy of dermatitis herpetiformis?

A

granular deposits of dermal papillary IgA on immunofluorescence

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12
Q

what is used to treat dermatitis herpetiformis?

A
gluten free diet
dapsone gel (Abx)
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13
Q

where can crohn’s effect?

A

mouth to anus

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14
Q

describe crohns pathology?

A
transmural
skip lesions
cobblestone
deep fissures
abscesses
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15
Q

features of crohn’s?

A
diarrhoea
blood
urgency
abdo pain 
fever
ulcers
abscesses 
fistulae
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16
Q

what other non GI symptoms can occur in crohn’s?

A

clubbing
erythema nodosum
gallstones
anterior uveitis

17
Q

what type of arthritis do those with crohn’s get? features?

A

enteropathic

peripheral joints and spine

18
Q

diagnostic Ix for crohn’s? what can be done in kids?

A

colonoscopy and biopsy

MRI small bowel barium study

19
Q

what other Ix should be done for crohn’s ?

A

LFTs, FBC, U+Es, CRP, ferritin, B12, folate
tTG
stool culture

20
Q

what faecal marker can be used to assess IBD?

A

faecal calprotectin

21
Q

Tx for crohn’s?

A
steroids in attacks
AZA/MTX
infliximab
stop smoking 
ileostomy 
colectomy
22
Q

complications of crohn’s?

A
bowel obstruction
fistulae
abscesses
toxic dilatation 
osteoporosis
23
Q

what size is classed as toxic colon dilatation?

A

> 6cm

24
Q

what IBD is made worse by smoking?

A

crohn’s

25
Q

what non GI symptoms can occur in UC?

A
clubbing 
ulcers
erythema nodosum
pyoderma gangrenosum 
joint pain 
anterior uveitis
26
Q

where does UC affect?

A

rectum to ileocaecal valve

27
Q

what is found on UC pathology?

A

crypt abscesses
peudopolyps
goblet cell depletion
drainpipe colon (thin wall)

28
Q

what IBD is PSC more common in?

A

UC

29
Q

what IBD is bloody diarrhoea more common in?

A

UC

30
Q

Ix for UC?

A

FBC, U+E, CRP, Ferritiv
faecal calprotectin
stool culture
colonoscopy

31
Q

Tx for UC?

A

topical mesalazine (rectal disease)
oral mesalazine
sulfasalazine
steroids

32
Q

what surgery is curative in crohn’s?

A

ileostomy (R sided) formed through a colectomy or proctocolectomy

33
Q

what cancer can occur as a complication of UC?

A

colorectal

34
Q

what are the categories of UC severity?

A
mild = <4stools 
mod = 4-6 stools
severe = >6 stools and systemic upset
35
Q

features of IBS?

A
bloating 
urgency
tenesmus
mucus
nocturia
worse when stressed
36
Q

what is the rome IV criteria for IBS?

A

Recurrent abdo pain/discomfort for ≥1 day/week in the last 3 months

+ 2 or more of

  • pain associated with defecation (better/worse)
  • Onset associated with stool frequency
  • Onset associated with stool form
37
Q

Ix for IBS?

A

FBC, ESR, CRP
TTG
Ca125 (if suspicious)
colonoscopy (if suspicious)

38
Q

Tx for IBS?

A

FODMAP diet
reduce caffeine
loperamide
amitriptyline