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ICS > GI > Flashcards

GI Flashcards

1
Q

what is coelic dieseas

A

autoimmuen t4 hypersensitivity due to gluten intolerance causing abdo pain and malabsorption

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2
Q

what type of hypersensitivity is coeliacs disease

A

t4

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3
Q

pathophysiology coeliacs disease

A

gluten is broken down into gliadin (prolamin) which triggers an immune reposne of anti tTG and anti EMA (tissue transglutaminase and endomysial antibodies) this causes complete villous atrophy, crypt hyperplasia, and intraluminal lymphocytes

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4
Q

AB involved in coeliac disease

A

anti tTG (tissue transglutaminase)
anti EMA (endomysial antibodies)

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5
Q

signs and symptoms coeliac disease

A
  • anaemia (fe/ folate/ b12 deficiency)
  • wt loss
  • abdo pain
  • bloating
  • diarrhoea
  • dermatitis herpeformis
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6
Q

diagnosis of coeliac disease

A

1st anti tTG
2nd anti EMA
gold. duodenal biopsy

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7
Q

what si seen on duodenal biopsy for coeliacs disease

A

complete villous atrophy
crypt hyperplasia
intraluminal lymphocytes

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8
Q

managment of coeliacs disease

A

stop eating gluten
folate, iron, n12 supplements

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9
Q

common vit/ mineral def w coeliac disease

A

iron, b12, folate

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10
Q

what is IBS

A

functional chronic bowel condition with changed bowel habits and abdo pain with no structural abnormalities

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11
Q

who is commonly affected with IBS

A

women with stress/ anxiety/ depression/ recent gastroenteritis

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12
Q

risk factors/ exacerbating factors for iBS

A

recent gastroenteritis
anxiety
stress
depression
food triggers

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13
Q

what si seen on duodenal biopsy for coeliacs disease

A

complete villous atrophy
crypt hyperplasia
intraluminal lymphocytes

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14
Q

signs and symptoms for IBS

A
  • abdo pain - worse on eating and better on defecation
  • bloating
  • change in bowel habits - constipation, diarrhoea, mucus in stool
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15
Q

3 classes of ibs

A

ibs-c constipation
ibs-d diarrhoea
ibs-m mixed

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16
Q

diagnosis of ibs

A

diagnosis of exclusion
- esr/crp for inflam
- faecal calprotectin for ibd
- colonoscopy for colorectal cancer
- anti tTG and EMA for coeliac d

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17
Q

differentials for ibs

A

ibd
lactose intolerance
coeliacs
colorectal cancer

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18
Q

management for ibs

A
  • education
  • avoid triggers
  • cbt for anxiety/ depression
  • lactatives for constipation
  • loperamide (immodium) for diarrhoea
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19
Q

whats anti tTG and EMA associated with

A

coelaics disease

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20
Q

what is tropical sprue

A

chronic inflammation due to travel to the tropics eg SEA, india, caribbeans

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21
Q

what is the diagnosis of tropical sprue

A

jejunal biopsy-> partial villous atrophy

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22
Q

treatment for tropical sprue

A

AB - tetracycline for 6 months and folate supplements

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23
Q

what is ulcerative colitis

A

autoimmune mucosal inflammation of the rectum, variably spreading proximally to the colon stopping before the ileum
type of IBD

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24
Q

GI signs and symptoms of ulcerative colitis

A

left lower quadrant abdo pain
blood and mucus in stool
diarrhoea
urgency

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25
Q

non GI signs of ulcerative colitis

A

arthritis
ankylosing spondolitis
amyloidosis
primary sclerosing cholangits
clubbing
erythema nodusum
iritis

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26
Q

investigations for ulcerative colitis

A

1st. +ve faecal calprotectin
2nd. +ve pANCA

gold: colonoscopy and biopsy

27
Q

results colonscopy and biopsy for ulcerative colitis

A

colonoscopy: continuous ‘leadpipe’ inflammation
biopsy: crypt abscesses, mucosal inflammation pseudopolyps

28
Q

treatment for mild ulcerative colitis

A
  • aminosalicylate (mesalazine)
  • then add prednisolone
  • with azathioprine for remission
29
Q

treatment for severe/ moderate ulcerative colitis

A
  • IV hydrocortisone (steroids)
  • then add TNFa inhib (infliximab)
  • azathioprine for remission
30
Q

layers affected by ulecerative colitis

A

mucosal

31
Q

featuresof ulcerative colitis

A

continuous mucosal inflammation
mucosal ulceration and psuedopolyps
rectal -> ileocaecal valve
LLQ pain

32
Q

smoking and ulcerative colitis

A

a protective factor

33
Q

what is crohns

A

type of IBD with transmural inflammation with non caseating granuloma formation n occur anywhere in the GIT

34
Q

what are the 3 types of bowel ischaemia

A

acute mesenteric
chronic mesenteric
ischaemic colitis

35
Q

what is the main cause of bowel ischaemia

A

thromboembolism
also vasospasm

36
Q

what are the risk factors for bowel ischaemia

A

incr age
men
htn
t2dm
obesity
smoking
all the same for cardiac ischaemia

37
Q

what is mainly affected in chronic mesenteric ischameia

A

mesenteric vessels

38
Q

what is mainly affected in acute mesenteric ischamia

A

superior mesenteric artery

39
Q

what are the signs and symptoms for acute mesenteric ischaemia

A

severe colicky abdo pain
abdo bruit - noise
N+V
hypovolaemia- shock
melanea and haematochezia

40
Q

signs and symptoms for chronic mesenteric ischaemia

A

abdo pain - constant
abdo bruit
wt loss

41
Q

what is ischamic colitis

A

type of bowel ischaemia mainly affecting watershed areas of the bowel- far away from blood supply
- mainly splenic flexure of colon

42
Q

signs ans symptoms of ischamic colitis

A

left abdo pain
abdo bruit
n+v

43
Q

investigations for bowel ischaemia

A

ct angiography and gold - colonoscopy for acute mesenteric

44
Q

treatment for bowel ischaemia

A
  • anticoagulants - heparin
  • abs - prophylactic
  • surgery
45
Q

complications of bowel ischaemia

A

necrosis and sepsis

46
Q

what is pseudomembranous colitis

A

bowel inflammation due to clostridium difficile and recent ab use
characterised by owl eye inclusion bodies

47
Q

signs and symptoms of pseudomembranous colitis

A

abdo pain
n+v
diarrhoea

48
Q

investigations

A
  • stool sample and culture
  • bloods - esr, crp
  • abdo ct
  • histology - owl eye inclusion bodies
49
Q

what are owl eye inclusion bodies characteristic of

A

pseudomembranous colitis

50
Q

treatment for psuedomembranous colitis

A

ab eg oral vancomycin

51
Q

what is a divertcula

A

mucosal outpouching of bowel wall typically near perforating vessels, in sigmoid colon

52
Q

what is diverticulosis

A

presence of diverticula

53
Q

what is diverticular disease

A

symptomatic diverticulum

54
Q

what is diverticulitis

A

inflammation of diverticulum, commonly due to bacteria from faeces

55
Q

where are diverticulum commonly found

A

near perforating vessels
sigmoid colon

56
Q

what are the risk factors for diverticular disease

A

low fibre diet -> constipation
smoking
obesity
NSAIDS

57
Q

brief pathophysiology for diverticular disease

A

high colonic pressure causes mucosal outpouches into mucularis

58
Q

signs and symptoms of diverticular disease

A
  • left lower quadrant abdo pain
  • bowel habits changed
  • bloating
59
Q

signs and symptoms for diverticulitis

A

LLQ abdo pain
bloating
bowel habits changed
fever
blood in stool

60
Q

investigations for diverticular disease

A

colonoscopy
GS - ct abdo

61
Q

treatment for diverticular disease

A

ASx- monitor - incr fibre
Sx- monitor, analgesic, antispasmodics
diverticulitis- AB , analgesic, antispasmodics

62
Q

what is merkles diverticulum

A
  • congenital diverticulum in the ileum
  • ddx - acute appendicitisis
63
Q

what is merkles diverticulum commonly confused with - presentation wise

A

acute appendicitis

64
Q

complications of diverticular disease

A

perforation
infection/ inflammation
bleeding

ICS (11 decks)

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