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Phase 2a LM > GI Diseases > Flashcards

GI Diseases Flashcards

1
Q

What two conditions are included under inflammatory bowel disease

A

Crohns and ulcerative colitis

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2
Q

Does crohns affect a specific part of the gi tract or not

A

No it can form anywhere in the gi tract

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3
Q

Does crohns affect all layers of the bowel wall or just a certain layer

A

Crohns is transumural so can affect any layer in the bowel wall

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4
Q

What triggers crohns

A

Pathogens

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5
Q

What part of the gi tract does crohns most commonly affect

A

Ileum and colon

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6
Q

Is the inflammation in crohns scattered or continuous

A

Scattered

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7
Q

What are the symptoms of crohns

A

Right lower quadrant pain
Blood in stool
Malabsorption of nutrients
Diarrhoea

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8
Q

Briefly describe why crohns is called granulomatous

A

Big masses of immune cells form in the bowel wall trying to encapsulate what they think is foreign

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9
Q

Why do ulcers form in crohns

A

Crohns can affect all layers of the bowel wall so effectively make a hole right through it, or ulcers form around the granulomas due to infl and cell damage

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10
Q

Does surgical removal of bowel cure crohns

A

No because it can come back in another part of the bowel

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11
Q

What are the treatment options for crohns

A

Anti-infl
Abx to control gut bacterial and reduce the immune response
Immunosuppressants if severe

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12
Q

What are some common complications of crohns

A 
Malabsorption 
Obstruction 
Perforation 
Neoplasia
Fistula formation
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13
Q

Which bit of the gi tract does ulcerative colitis affect

A

Large intestine

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14
Q

Does ulcerative colitis affect the entire bowel wall or only a specific part

A

A specific part - only the mucosa

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15
Q

What causes ulcerative colitis

A

Autoimmune - T cells target the tissue

Mainly unknown cause

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16
Q

What are the symptoms of ulcerative colitis

A

Pain in left lower quadrant (rectum)

Severe and frequent diarrhoea with blood

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17
Q

Give some treatments for ulcerative colitis

A

Anti-inflammatory drugs
Immunosuppressant drugs
Colectomy

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18
Q

Does a colectomy in ulcerative colitis cure the disease or not

A

Yes it cures it

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19
Q

Where does ulcerative colitis start

A

Rectum

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20
Q

Symptoms and signs of malabsorption

A

Unintended weight loss
Pale stools more often
Anaemia

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21
Q

What malabsorption leads to microcytic anaemia

A

Iron deficiency

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22
Q

What malabsorption leads to macrocytic anaemia

A

B12/folate deficiency

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23
Q

Define malabsorption

A

Not absorbing enough food from the diet

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24
Q

What are the 6 causes of malabsorption

A
  1. Insufficient intake
  2. Defective intraluminal digestion
  3. Insufficient absorptive area
  4. Lack of digestive enzymes
  5. Lymphatic obstruction
  6. Defective epithelial transport
25
Q

Name 3 things that can cause defective intraluminal digestion (malabsorption)

A
  1. Pancreatic insufficiency (not enough enzymes from the pancreas)
  2. Defective bile secretion (lack of fat solubilisation)
  3. Bacterial overgrowth
26
Q

Name 4 things that will cause an insufficient absorptive area (malabsorption) and how they cause it

A
  1. Coeliac - villous atrophy and crypt hyperplasia
  2. Crohns - damage to small bowel mucosa
  3. Giardia - parasite
  4. Small bowel intestinal resection or bypass
27
Q

Name two diseases that will cause a lymphatic obstruction (malabsorption)

A

TB

Lymphoma

28
Q

What are the symptoms of GORD

A

Heartburn
Burping
Acid brash (acid/bile regurgitation)
Water brash (excess saliva)

29
Q

What is the pathophysiology behind GORD

A

Dysfunction of the lower oesophageal sphincter pre-disposes to the gastro-oesophageal reflux of acid

30
Q

What is the management of GORD

A

Life style - weight loss, small and regular meals
Drugs - antacids
Surgery - only if severe

31
Q

Risk factors for GORD

A 
Smoking 
Alcohol
Hiatus hernia
Pregnancy 
Obesity 
Big meals 
Drugs
32
Q

What is the leading risk factor for oesophageal adenocarcinoma

A

GORD

33
Q

What is the pathophysiology behind GORD leading to oesophageal adenocarcinoma

A

Continuous stomach acid reflux destroys squamous cells and leads to ulceration, the adaptive change is to produce glandular epithelium that produces mucin to try and protect the oesophagus from the acid. This metaplasia leads to dysplasia then neoplasia.

34
Q

What is the change in epithelium seen in Barrett’s oesophagus

A

Squamous epithelium becomes glandular epithelium

35
Q

What are the symptoms of oesophageal adenocarcinoma

A 
Difficulty swallowing 
Weight loss
Regurgitation of food or vomiting 
Pain when swallowing 
Persistent heartburn
36
Q

What is the % 5 year survival rate for oesophageal adenocarcinoma

A

10%

37
Q

What is the typical age someone with oesophageal adenocarcinoma presents

A

60-70s

38
Q

What are the commonly linked associates of gastric adenocarcinoma

A

H. Pylori (metaplasia)
Smoked/picked food diet
Pernicious anaemia

39
Q

What are the symptoms of gastric oesophageal cancer

A 
Poor appetite
Feeling full after a small meal
Weight loss
Abdominal pain
Heartburn 
Nausea 
Vomiting with or without blood
40
Q

What are the symptoms of colorectal adenocarcinoma

A 
Change in bowel habits 
Rectal bleeding or blood in the stool 
Persistent abdominal discomfort 
Unexplained weight loss
Fatigue/weakness
41
Q

Where is the most common colorectal cancer found

A

Rectum and lower part of sigmoid colon

42
Q

Name 3 predisposes to colorectal adenocarcinoma

A
  1. Polyps
  2. Familial adenomatous polyposis (FAP)
  3. Hereditary nonpolyposis colorectal cancer (HNPCC)
43
Q

Briefly describe the tumour resection coding for colorectal adenocarcinomas

A 
R0 = tumour completely excised locally 
R1 = microscopic involvement of margin by tumour 
R2 = macroscopic involvement of margin by tumour
44
Q

What are the 5 causes of gastroduodenal ulceration

A
  1. Mucosal ischaemia
  2. Increased acidity
  3. Bile reflux
  4. Alcohol
  5. Helicobacter pylori
45
Q

How does H Pylori cause ulceration

A

Live in the mucous layer and secrete chemicals causing inflammation, attract neutrophil polymorphs which enter and damage the epithelium
Increases acid production in stomach and causes intestinal metaplasia

46
Q

Name 3 complications of gastroduodenal ulceration

A
  1. Peritonitis
  2. Pancreatitis
  3. Haemorrhage
47
Q

What are the symptoms of gastroduodenal ulceration

A 
Nighttime upper abdominal pain 
Burping 
Vomiting
Weight loss
Anorexia
48
Q

When food is eaten, how can you tell if the ulcer is gastric or duodenal

A

If duodenal - eating relieves the pain

If gastric - eating worsens the pain

49
Q

What is the most common cause of appendicitis and name some things that cause that

A 
Obstruction:
Fecalith
Undigested seeds
Pinworm infection 
Lymphoid hyperplasia
50
Q

What are the symptoms of appendicitis

A 
Pain that migrates from the umbilicus to the RIF
Pain worse on movement 
Off food
Nausea and vomiting 
Fever
51
Q

What is the Tx for appendicitis

A

Appendectomy

52
Q

What is an intestinal obstruction

A

Blockage to the lumen of the gut

53
Q

What can block the lumen of the gut

A

Tumours
Diaphragm disease - caused by NSAIDs
Gallstone ileus - stone erodes through the gallbladder into the bowel

54
Q

What can occur in the wall of the GI tract to cause an obstruction

A

Inflammation
Diverticular disease
Tumours - of nerve is most common
Hirschprungs disease - chronic, huge dilation of bowel loops

55
Q

What can occur outside of the GI tract to cause obstruction

A

Adhesions
Volvulus
Peritoneal tumours

56
Q

What are the two main symptoms of a small bowel obstruction

A
  1. Nausea and vomiting

2. Pain - colicky to constant

57
Q

In Europe, what is the most common cause of large bowel obstruction

A

Colorectal malignancy 90%

58
Q

What is intersussuption and who is it more common in

A

One bit of bowel going into another bit

More common in children

Phase 2a LM (7 decks)

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