GI 4

Question 1

4 important organs of the GI tract

Answer 1

1. esophagus
2. stomach
3. small intestine
4. colon

Question 2

esophagus function

Answer 2

transport food entering mouth to stomach

Question 3

stomach role

Answer 3

digestion, some absorption

Question 4

small intestine role

Answer 4

absorption and digestion
different micornutrients absorbed in different parts

Question 5

colon role

Answer 5

fluid/electrolyte absorption
propulsion/holding feces
vitamin produciton (gut microbiome)

Question 6

GERD =

Answer 6

gastroesophageal reflux disease

Question 7

GERD is characterized by

Answer 7

1. transient lower esophageal sphincter relaxation
2. increased intra-abdominal pressure

Question 8

dietary triggers of GERD

Answer 8

caffeine
alcohol

Question 9

lifestyle risk factors for GERD

Answer 9

obesity
pregnancy
exercise after eating

Question 10

GERD pathophys
increased exposure of esophageal mucosa to __
impacts local microbiome and stimulate __ response
increased intracellular __

Answer 10

GERD pathophys
increased exposure of esophageal mucosa to gastric contents
impacts local microbiome and stimulate immune response
increased intracellular permeability

Question 11

IBD = __ immune dysregulation due to interaction between __ microbiota and __ immunity

Answer 11

IBD = mucosal immune dysregulation due to interaction between intestinal microbiota and host immunity

Question 12

IBD genetics

Answer 12

host must be genetically susceptible

Question 13

IBD diagnosis

Answer 13

1. symptoms (dermatological, vascular, respiratory, inflammatory)
2. exams, stool tests, imaging, biopsy

Question 14

IBD diagnosis requires high __ (detects inflammation) and low __ (tells us you are in active IBD)

Answer 14

IBD diagnosis requires high calprotectin (detects inflammation) and low albumin (tells us you are in active IBD)

Question 15

IBD: __ immune defects involving __ receptors

Answer 15

IBD: innate immune defects involving pattern recognition receptors

Question 16

IBD also has __ dysfunction that affects __

Answer 16

IBD also has epithelial barrier dysfunction that affects mucus secretion, peristalsis, antimicrobial factors

Question 17

IBD also has __ immunity defects

Answer 17

IBD also has adaptive immunity defects

Question 18

goal of IBD treatment

Answer 18

mucosal healing
absence of ulcerations and erosions

Question 19

pharmacotherapy for IBD

Answer 19

1. steroids (short-term)
2. aminosalicylates (UC only)
3. immunosuppressants
4. biologics

Question 20

what types of remission must we achieve with IBD

Answer 20

clinical, serologic, endoscopic remission

Question 21

step-up therapy:
top-down therapy:

Answer 21

step-up therapy: nutrition, probiotics, start with antiobiotics, go up to more severe treatments
top-down therapy: start with surgery, supplement with simpler treatment options

Question 22

is current approach to IBD step-up or top-down?

Answer 22

top-down!

Question 23

anti-__ meds are effective in treating IBD

Answer 23

anti-TNF meds are effective in treating IBD

Question 24

dietary approaches to treat IBD

Answer 24

1. specific carbohydrate diet (SCD)
2. Crohn’s disease exclusion diet (CDED)
3. exclusive enteral nutrition (no solid foods)

Question 25

what diet is really bad for IBD?

Answer 25

low fiber with food additives increase risk

Question 26

IBS is __, __ abdominal pain with altered __

Answer 26

IBS is **chronic**, **recurrent** abdominal pain with altered **bowel habits**

Question 27

prevalence of IBS

Answer 27

10-15%

Question 28

IBS makes up __% of referrals to GI

Answer 28

IBS makes up **25-50**% of referrals to GI

Question 29

__ is the most common funcitonal GI disorder

Answer 29

**IBS** is the most common funcitonal GI disorder

Question 30

8 parts of IBS pathophys

Answer 30

1. dysregulated gut motility 2. visceral hypersensitivity 3. inflammation 4. postinfections 5. microbiome 6. food sensitivity 7. genetics 8. psychosocial dysfunction

Question 31

IBS inflammation some patients have increased __ cells/__ and increased __

Answer 31

IBS inflammation some patients have increased **inflammatory** cells/**cytokines** and increased **permeability**

Question 32

IBS and psychosocial dysfunction

Answer 32

correlation with traumatic life events higher rates of mood disorder, suicidal ideation, anxiety

Question 33

IBS food sensitivities

Answer 33

fructose fructans gliadin sorbitol lactose