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Medicine, Year 2, Block 15 (Gastrointestinal Pathophysiology) > Inflammation of the Bowel > Flashcards

Inflammation of the Bowel Flashcards

1
Q

The small intestine has folds called?

A

Plicae circulares

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2
Q

The small intestine is divided into three parts called..?

A

Duodenum
Jejunum
Ileum

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3
Q

State a list of things which are absorbed by the small intestine (mnemonic)

A

“Dude I’m just feeling ill bro”

Duodenum: Iron
Jejunum: Folate, fatty acids
Ileum: B12, bile salts

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4
Q

What is the histology cell type in the small intestine? Which cells are they?

A

Columnar epithelium (goblet cells and enterocytes)

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5
Q

What is the role of endocrine cells in the small intestine?

A

They secrete gut hormones

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6
Q

Where are Paneth cells found in the small intestine? What is their role?

A

Found at the base of crypt, contains eosinophillic lysozyme-rich graniles. Role in cell proliferation / differentiation

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7
Q

How many intra-epithelial lymphocytes are there per enterocytes?

A

20 per 100

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8
Q

What are the main intestinal absorptive cells of the small intestine?

A

Enterocytes

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9
Q

What are Brunner’s glands? Where are they found?

A

Secretion of alkaline-rich fluid which coats the duodenum

They empty into the intestinal glands

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10
Q

The large intestine does secrete digestive enzymes: True or false?

A

False

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11
Q

What is the toxic component within Gluten which Coeliacs cannot tolerate?

A

Gliaden

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12
Q

Which HLAs are Coeliacs associated with?

A

HLA-DQ2 - 90%

HLA-DQ8 - 10%

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13
Q

Which region of the digestive tract does Coeliac disease affect?

Therefore, what symptoms are likely to present?

A

Small intestine

Weight loss, chronic diarrhoea, FTT, IBS, abdominal pain, altered bowel habit, anaemia (iron deficiency)

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14
Q

Give examples of serology tests which could confirm diagnosis for Coeliac Disease

A
  • Tissue transglutamase (tTG) antibody
  • Endomysial antibody (EMA)
  • Deaminated glaidin peptide (DGP) antibody
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15
Q

In the small intestine, there are usually 20 intra-epithelial lymphocytes per 100 enterocytes. How is this different in Coeliac Disease?

A

> 20 per 100

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16
Q

Give some histological features of the small intestine for patients with Coeliac disease

A
  • > 20 intra-epithelial cells per 100 enterocytes
  • Atrophy of mucosa
  • Crypt hyperplasia
  • Increased lamina propria chronic inflammatory cells
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17
Q

Why does Coeliac’s disease lead to malabsorption?

A
  • Mucosal damage
  • Immature enterocytes incapable of normal absorption
  • Disaccharidase deficiency
  • Reduced hormone production
18
Q

Coeliacs have a 4-fold risk of developing what condition?

A

Non-Hodgkin Lymphoma (Enteropathy-associated T-cell lymphoma)

19
Q

Which COX isozyme protects the lining of the stomach?

A

COX-1

20
Q

What is Diaphragm Disease?

A

Rare complication of bowel disorders associated with use of NSAIDs

21
Q

Where does Pseudomembranous Colitis occur? What is it caused by?

A

Swelling / inflammation of Large Intestine, caused by C. diff overgrowth

22
Q

Is C. diff gram positive or gram negative?

A

Gram positive

23
Q

What is a faecolith?

A

A hard discreet mass of faeces

24
Q

Appendicitis is caused by inflammation often precipitated by..? 8 examples

A 
Faecoliths
Food residue
Lymphoid hyperplasia
Diverticulosis 
Neoplasia
Yersinia infection
TB infection
IBD
25
Q

What are some complications of Appendicitis?

A
  • Abscess formation
  • Necrosis
  • Perforation
  • Septicaemia
26
Q

What is Diverticular Diseases?

A

Pouch formation due to weakness of muscles in wall and high intra-lumenal pressure in large intestine (commonly sigmoid part)

27
Q

What condition often mimics Diverticular colitis?

A

Inflammatory Bowel Disease

28
Q

What are some risk factors to Crohn’s Disease?

A
  • Cigarette smoking
  • Oral contraceptive pill
  • Mycobacteria / Measles
29
Q

What are three common sites which Crohn’s Disease affects?

A
  • Terminal Ileum
  • Small bowel alone
  • Colon alone
30
Q

Crohn’s Disease has a bi-modal age incidence - what is it?

A
  • 15-30 years

- 60-80 years

31
Q

A granuloma is a collection of..?

A

Macrophages

32
Q

What is the pattern of how Ulcerative Colitis affects the GI tract?

A

It always begins in the rectum (Proctitis) and extends proximally in length. Can involve the entire large intestine (Pancolitis)

33
Q

An appendectomy may be protective against which one: Crohn’s Disease or Ulcerative Colitis?

A

Crohn’s Disease

34
Q

Which condition has increased concordance with twins? Crohn’s Disease or Ulcerative Colitis?

A

Crohn’s Disease

35
Q

Out of Crohn’s Disease or Ulcerative colitis, is fistulas common?

A

Crohn’s Disease

36
Q

Which condition is less likely to cause obstruction to the small intestine - Crohn’s Disease or Ulcerative Colitis?

A

Crohn’s Disease

37
Q

Which condition is more rectal sparing, Ulcerative Colitis or Crohn’s Disease?

A

Crohn’s Disease

38
Q

What are microscopic ulcer types in Ulcerative Colitis and Crohn’s Diease?

A

Ulcerative Colitis: Undermining (horizontal)

Crohn’s Disease: Fissuring (vertical)

39
Q

In which condition, are Polyps more common, Ulcerative Colitis or Crohn’s Disease?

A

Ulcerative Collitis

40
Q

Ulcerative Colitis has a bi-modal age distribution, what is it?

A
  • 15-30 years

- 60-80 years

41
Q

Smoking is protective for which condition: Ulcerative colitis or Crohn’s Disease?

A

Ulcerative Colitis

Medicine, Year 2, Block 15 (Gastrointestinal Pathophysiology) (20 decks)

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