GI Diseases - Lower GI

Question 1

What is diverticulosis of the colon?

Answer 1

-protusion of mucosa and submucosa through the bowel wall.
-between mesenteric and anti mesenteric taenia coli.
commonly occurs in the sigmoid colon

Question 2

What causes diverticulosis of the colon?

Answer 2

1) Increase Intra Luminal Pressure

2) Points of weakness in bowel wall

Question 3

What are the clinical features of Diverticular disease?

Answer 3

• commonly asymptomatic
• camping abdo pain
• alternating constipation and diarrhoea

Question 4

What are the complications of acute and chronic diverticular disease?

Answer 4

Acute:

• Diverticulitis
• Perforation
• Haemorrhage

Chronic:

• Stricture causing obstruction
• Fistula into bladder/vagina
• Diverticular colitis (inflammation)

Question 5

What is the incidence of Crohn’s disease and Ulcerative Collitis?

Answer 5

CD is more common in females.

UC is equally common in males and females.

Question 6

What is the clinical presentation of Ulcerative Colitis?

Answer 6

Diarrhoea
Constipation
Rectal Bleeding
Abdo Pain
Weight loss
Anaemia

Question 7

What are the complications of Ulcerative Colitis?

Answer 7

• Toxic Megacolon
• perforation
• haemorrhage
• carcinoma

Question 8

What are the clinical features of Crohns Disease?

Answer 8

Crohn’s Disease :

• affects from mouth to anus
• Colicky Abdo Pain
• palpable adbo mass
• weight loss
• fever
• oral ulcer
• anaemia
• (bloody) Diarrhoea

Question 9

What are the complications of Crohn’s Disease?

Answer 9

• Toxic Megacolon
• Perforation
• fistula
• Stricture (common)
• Haemorrhage
• Carcinoma
• Short Bowel Syndrome

Question 10

What is the pathology of Ulcerative Colitis?

Answer 10

• Affects colon, appendix, terminal ileum
• continuous disease
• rectum always involved
• granula, red mucosa with ulcers.
• strictures are rare.
• no fistulae

Question 11

What is the pathology of Crohn’s Disease?

Answer 11

• Mouth to anus
• patchy
• rectum normal 50% of cases
• Serositis
• Strictures are common
• Fistualae
• Anal Lesions

Question 12

Which condition has mainly mucosal inflammation and which has transmural inflammation?

Ulcerative colitis or Crohns disease?

Answer 12

Mainly Mucosal Inflammation = Ulcerative Colitis

Transmural inflammation = Crohn’s disease

Question 13

Fistulas and strictures are present in which of the following :
Ulcerative colitis or Crohn’s

Answer 13

Crohn’s

Question 14

Out of UC / Crohns which is more prone to polyps?

Answer 14

Ulcerative Colitis

Question 15

What are the risk factors of Colon Rectal Cancer in Ulcerative Colitis?

Answer 15

1) Early age of onset
2) increased duration of disease
3) Family history of Colon Rectal cancer

Question 16

What are Hyperplastic Polyps?

Answer 16

Hyperplastic Polyps are benign outgrowths in the rectum and sigmoid colon.

Question 17

What are Juvenile polyps?

Answer 17

• polyps that occur in rectum / distal colon.
• associated with increased risk of CRC and Gastric C.
• commonest type of polyp in children

Question 18

What is Peutz-Jeghers Syndrome?

Answer 18

Autosomal Dominant Condition.

Multiple GI polyps

Question 19

What are adenomas?

Answer 19

Benign epithelial tumours. (can become malignant)

Question 20

What are the risk factors of colorectal cancer?

Answer 20

• Diet
• Obesity
• Alcohol
• NDAIDs
• Schistosomiasis
• UC and CD