GI Disease

Question 1

What is the two primary strategies for preventing colorectal cancer?

Answer 1

1. detect and remove precancerous polyps

2. detect and treat cancer in it’s early stages

Question 2

Define the term “screening”

Answer 2

detection of asymptomatic disease in healthy individuals at average risk (no identifiable risk factors except age)

Question 3

Define the term “surveillance”

Answer 3

search for asymptomatic disease among higher risk individuals (PHx, FHx etc.)

Question 4

Bowel cancer affects how many men and women in Australia each year?

Answer 4

1 in 18 men; 1 in 24 women

Question 5

What is the cancer risk for polyps sized 1cm and 2 cm respectively?

Answer 5

1cm = <1% cancer risk
2cm = 40% cancer risk

Question 6

How long does it take for a polyp to develop into a cancer?

Answer 6

approx. 5 years

Question 7

Describe an individual at average risk of developing colorectal cancer

Answer 7

asymptomatic
>40yoa
no personal Hx of colorectal cancer or polyps
no FHx of colorectal cancer or polyps
no personal Hx of IBD, breast, uterine or ovarian cancer

Question 8

Which GI disease continues to spread and cause further damage when found in the small intestine?

Answer 8

Crohn’s Disease

Question 9

Where may secondary lesions associated with Crohn’s disease occur?

Answer 9

lymph nodes, liver, skin, eyes and joints

Question 10

At what age does Crohn’s disease most commonly occur?

Answer 10

late teens - twenties

Question 11

Describe 6 symptoms of Crohn’s disease

Answer 11

Options:
diarrhoea
fatigue
fever
pain and cramping in abdomen
bloody stools
mouth sores
weight loss and lack of appetite
sores and abscesses around the anus
skin, eye, joint or bile duct inflammation
iron deficiency due to blood loss and poor absorption
delayed growth in puberty

Question 12

List 5 diagnostic methods for Crohn’s disease

Answer 12

Options:
radiography
biopsies
blood tests
colonoscopy
CT
MRI
capsule endoscopy
flexible sigmoidoscopy
small bowel imaging

Question 13

What is the recurrence rate per year of Crohn’s after surgical intervention?

Answer 13

15%

Question 14

GI disease can result in deficiencies in which vitamins/minerals due to malabsorption?

Answer 14

Vitamin C
Vitamin B12
Folic Acid
Zinc

Question 15

Describe the aetiology of ulcerative colitis

Answer 15

Chronic inflammation and ulceration of the mucosa and large intestine

Question 16

List 5 common signs of ulcerative colitis

Answer 16

rectal bleeding
diarrhoea
nutritional oedema
fever
anorexia/malnutrition
anaemia
avitaminosis
dehydration
negative nitrogen balance

Question 17

What are the secondary inflammatory symptoms associated with ulcerative colitis?

Answer 17

polyarthritis
polyarthralgia
uveitis
skin changes

Question 18

What is Coeliac Disease?

Answer 18

Autoimmune disease where the lining of the small intestine is damaged by gluten

Question 19

Describe common symptoms associated with coeliac disease

Answer 19

Diarrhoea or constipation
Steatorrhoea
Nausea and vomiting
Flatulence
Pain or discomfort in abdominal area
Iron deficiency or anaemia
Weight loss or gain
Frequent tiredness and fatigue
Failure to thrive, or delayed puberty
Bone and joint pain/stiffness
Swelling of the mouth or tongue
Recurrent mouth ulcers and other dental issues
Itchy and blistering skin rash
Easy bruising

Question 20

What is the diagnostic process for coeliac disease?

Answer 20

blood test
biopsy - gastroscopy
genetic testing
* gluten must be consumed for at least 6 weeks prior to testing; equivalent to 4 slices wheat bread/day)

Question 21

List the red flags associated with coeliac disease

Answer 21

early onset osteoporosis
unexplained infertility
liver disease
FHx coeliac disease
Other AI disease

Question 22

Describe the aetiology of diverticular disease

Answer 22

herniations form along digestive tract that form pouches when weak spots in intestinal wall balloon out

Question 23

What are the risk factors associated with diverticular disease?

Answer 23

Age
FHx
Low fibre intake
Obesity
Physical Inactivity

Question 24

Describe the treatment methods for diverticulitis

Answer 24

Dependent upon the severity of the bout
May be managed at home or may require hospitalization with IV fluids and antibiotics
Acute phase - clear liquids and low fibre diet
Long term - high fibre foods