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Pathology And Medicine > GI track diseases II > Flashcards

GI track diseases II Flashcards

1
Q

How is small intestinal bacterial overgrowth minimised?

A

peristalsis

acidic chyme leaving stomach

immunoglobulins

ileocaecal value

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2
Q

peristalsis

A

movement in one direction

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3
Q

acidic chyme leaving stomach

A

moderates bacteria growth

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4
Q

Key indicator of small intestinal bacterial overgrowth

A

SI bacteria ferment CHO producing gas

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5
Q

What improves symptoms in small intestinal bacteria overgrowth?

A

antibiotics

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6
Q

What worsens symptoms in small intestinal bacteria overgrowth?

A

Prebiotics

Carbohydrates

Dietary Fibre

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7
Q

Does increasing dietary fibre improve constipation demo small intestinal bacteria overgrowth?

A

no

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8
Q

Inflammatory bowl disease examples

A

Crohn’s disease

Ulcerative Colitis

Diverticulitis

Polyp

Familial Syndrome

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9
Q

Crohn’s disease

A

delimited (skip lesions, patch inflammation, pockets are inflamed) involvement of bowl in inflammatory process with mucosal damage, granulomas, formation of fistulae

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10
Q

What happens during Crohn’s disease?

A

Intestinal wall is thickened due to oedema, inflammation, fibrosis and hypertrophy of the muscular propria

Mesenteric fat wraps around bowel surface

lumen is narrowed - strictures (blockage)

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11
Q

What does repeated surgery on Crohn’s disease do?

A

causes short bowl syndrome
(maintain normal nutrition not possible)

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12
Q

Crohn’s disease clinical features - symptoms

A

vague and overlapping
- fever
- abdominal pain
- diarrhoea

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13
Q

Crohn’s disease complications

A

risk very high
- strictures, fistulas

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14
Q

What can Crohn’s disease affect?

A

terminal ileum
- resulting in loss of protein
- malabsorption of Vitamin B12 and bile salts

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15
Q

Crohn’s disease problems

A

extra-intestinal problems

polyarthritis

cubbing of finger tips

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16
Q

When does crohn’s disease infection occur?

A

abnormal track connecting 2 epithelial surfaces

often become infected forming an abscess

only present in Crohn’s disease and can help with differential diagnosis

17
Q

Crohn’s disease as sustained microbial-induced inflammatory response

A

bacterial flagellum made up of protein flagellin

major antigen of salmonella and e.coil

E.coil flagellum (whip) for motility

flagellin dominant antigen in CD not found in UC or healthy control

however - only 50% of CD patients are antibody positive

18
Q

Ulcerative Colitis

A

continuous colonic involvement beginning in rectum

affects mucosa and submucosa

extensive ulceration of mucosa - isolating islands o regeneration mucosa

19
Q

Ulcerative Colitis - Clinical Features

A

bloody diarrhoea with lots of mucus

lower abdominal pain

similar systemic inflammatory complication to CD

20
Q

Ulcerative Colitis - Percentage of Patients that will require colectomy within first 3 years

A

30%

21
Q

Diverticulitis

A

blind pouch leading from GI tract lined with mucosa

22
Q

Diverticulitis causes

A
  1. focal weakness in colon wall
  2. increased intraluminal pressure due to constipation

fragments of faecal matter stays in pouch, causes infection

23
Q

Diverticulitis - treatment

A

low-fibre diet

reduced stool bulk

increased peristaltic activity and pressure

24
Q

What are the two types of polyp?

A

hyperplastic and adenoma

25
Q

Polyp

A

tumours mass arising from epithelium protruding into the gut lumen

26
Q

Hyperplastic Polyp

A

decreased cell turnover

non-neoplastic - no cancer potential

do not have malignant potential

90% of all polyps

sporadic

27
Q

Adenoma

A

epithelial proliferative dysplasia

neoplastic - turns into cancer

precursor of adenocarcinoma

familial predisposition

28
Q

Familial Syndromes

A

familial adenomatous polyposis (FAP)

29
Q

where is the mutation in familial adenomatous polyposis (FAP)

A

mutation in the adenomatous polyposis coil (APC) gene

Pathology And Medicine (15 decks)

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