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F1 and Stage 5 > GI conditions: intestines > Flashcards

GI conditions: intestines Flashcards

1
Q

Does UC or Crohn’s have a greater risk of developing colon cancer

A

UC

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2
Q

Differentiating between UC and Crohn’s via symptoms

A

UC: usually bloody diarrhoea

Crohn’s: usually non-bloody diarrhoea

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3
Q

Differentiating between UC and Crohn’s via histology

A

UC: superficial inflammation. Crypt abscesses.

Crohn’s: transmural inflammation. Granulomas

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4
Q

Differentiating between UC and Crohn’s via endoscopy

A 
UC: affected from rectum to ileocaecal valve. 
Get pseudopolyps (widespread ulceration)

Crohn’s: affected anywhere from mouth to anus. Get cobblestone appearance (deep ulcers + skip lesions)

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5
Q

What causes crypt abscesses? What GI condition is associated with this

A

Crypt abscess = neutrophils migrating through the wall of glands

UC

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6
Q

What causes granulomas? What GI condition is associated with this

A

Collection of macrophages to ward off “foreign bodies” during inflammation

Crohn’s

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7
Q

AXR features of UC

A
  1. leadpipe colon (narrow short colon, loss of haustra)
  2. loss of haustra
  3. pseudopolyps
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8
Q

AXR features of Crohn’s

A
  1. Kantor’s string sign (bowel strictures)

2. Rose thorn ulcers (deep ulcers)

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9
Q

What causes thumbprinting on AXR

A

Wall thickening of colon, due to inflammation/ infection

–> colitis

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10
Q

What causes loss of haustra on AXR

A
  1. Chronic UC

2. Toxic megacolon

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11
Q

Features of mild flare up of UC

A

Diarrhoea <4 times

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12
Q

Features of moderate flare up of UC

A

Diarrhoea 4-6 times a day

No systemic features

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13
Q

Features of severe flare up of UC

A

Diarrhoea >6 times a day

Systemic features eg fever, tachycardia, raised CRP

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14
Q

Best cancer marker to monitor patients with colon cancer

A

CEA

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15
Q

What surgery is done for colon cancer in

caecum - proximal transverse colon
distal transverse - descending colon
sigmoid colon
upper/middle rectum
distal 1/3 of rectum
A

caecum - proximal transverse colon = R hemicolectomy

distal transverse - descending colon = L hemicolectomy

sigmoid colon = Hartmann’s (sigmoidectomy + end colostomy)

upper/middle rectum = anterior resection

distal 1/3 of rectum = abdominal-perineal excision of rectum

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16
Q

Describe grades 1-4 of internal haemarrhoids

A
  1. No prolapse, but promiment blood vessels
  2. Prolapse which can spontaneously reduce
  3. Prolapse which requires manual reduction
  4. Permanent prolapse
17
Q

Chronic treatment for mild-moderate UC that only affects distal colon

A

Rectal sulfasalazine

18
Q

Chronic treatment for mild-moderate UC that is widespread

A

Oral + rectal sulfasalazine

19
Q

Chronic treatment for moderate-severe UC

A
  1. Oral + rectal sulfasalazine
  2. Biologics eg infliximab
  3. Azathioprine if >2 exacerbations a year/ severe relapse
20
Q

Management of an acute flare of UC

A
  1. IV corticosteroids for 72h
  2. IV ciclosporin
  3. Infliximab
  4. Surgery
21
Q

Indications for surgery in acute flare of UC

A
  1. Stools frequency >8/day
  2. Fever, tachycardia
  3. AXR: colon dilation
  4. low, albumin, low Hb, high platelets, high CRP
22
Q

When would a UC patient be put on regular oral azathioprine/ mercaptopurine

A
  • severe relapse of UC

- 2 or more exacerbations in a year

23
Q

Management of mild-moderate flare of UC

A

Oral corticosteroids

24
Q

First line investigation for acute mesenteric ischaemia

A

Lactate (would get lactic acidosis)

25
Q

Most common site of diverticulitis

A

Sigmoid colon

26
Q

What does a positive C Diff antigen mean

A

Exposure to bacteria (does not necessarily indicate current infection)

27
Q

Most common cause of hereditary colon cancer

A

HNPCC (Lynch syndrome)

28
Q

What drug may reduce the risk of colon cancer in those with HNPCC (Lynch syndrome)

A

Aspirin daily

29
Q

HNPCC (Lynch syndrome)

-What cancers are associated with this

A

Colon cancer
Endometrial cancer
Pancreatic cancer
Gastric cancer

30
Q

FAP

-What cancers are associated with this

A

Colon cancer
Breast cancer
Ovarian cancer
Gardner’s syndrome (osteomas of skull and mandible)

31
Q

Difference in presentation between large and small bowel obstruction

A

Small bowel:
Present with vomiting early and absolute constipation late

Large bowel:
Present with constipation earlier

32
Q

Inheritance of FAP

A

Autosomal dominant

33
Q

2 most common watershed areas in colon

What arteries are involved?

A

Splenic flexure: SMA + IMA

Rectosigmoid junction: IMA + hypogastric artery

34
Q

UC is associated with which HBP condition?

A

UC is associated with PSC

F1 and Stage 5 (29 decks)

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