Inflammation of the Bowel Flashcards
The small intestine has folds called?
Plicae circulares
The small intestine is divided into three parts called..?
Duodenum
Jejunum
Ileum
State a list of things which are absorbed by the small intestine (mnemonic)
“Dude I’m just feeling ill bro”
Duodenum: Iron
Jejunum: Folate, fatty acids
Ileum: B12, bile salts
What is the histology cell type in the small intestine? Which cells are they?
Columnar epithelium (goblet cells and enterocytes)
What is the role of endocrine cells in the small intestine?
They secrete gut hormones
Where are Paneth cells found in the small intestine? What is their role?
Found at the base of crypt, contains eosinophillic lysozyme-rich graniles. Role in cell proliferation / differentiation
How many intra-epithelial lymphocytes are there per enterocytes?
20 per 100
What are the main intestinal absorptive cells of the small intestine?
Enterocytes
What are Brunner’s glands? Where are they found?
Secretion of alkaline-rich fluid which coats the duodenum
They empty into the intestinal glands
The large intestine does secrete digestive enzymes: True or false?
False
What is the toxic component within Gluten which Coeliacs cannot tolerate?
Gliaden
Which HLAs are Coeliacs associated with?
HLA-DQ2 - 90%
HLA-DQ8 - 10%
Which region of the digestive tract does Coeliac disease affect?
Therefore, what symptoms are likely to present?
Small intestine
Weight loss, chronic diarrhoea, FTT, IBS, abdominal pain, altered bowel habit, anaemia (iron deficiency)
Give examples of serology tests which could confirm diagnosis for Coeliac Disease
- Tissue transglutamase (tTG) antibody
- Endomysial antibody (EMA)
- Deaminated glaidin peptide (DGP) antibody
In the small intestine, there are usually 20 intra-epithelial lymphocytes per 100 enterocytes. How is this different in Coeliac Disease?
> 20 per 100
Give some histological features of the small intestine for patients with Coeliac disease
- > 20 intra-epithelial cells per 100 enterocytes
- Atrophy of mucosa
- Crypt hyperplasia
- Increased lamina propria chronic inflammatory cells
Why does Coeliac’s disease lead to malabsorption?
- Mucosal damage
- Immature enterocytes incapable of normal absorption
- Disaccharidase deficiency
- Reduced hormone production
Coeliacs have a 4-fold risk of developing what condition?
Non-Hodgkin Lymphoma (Enteropathy-associated T-cell lymphoma)
Which COX isozyme protects the lining of the stomach?
COX-1
What is Diaphragm Disease?
Rare complication of bowel disorders associated with use of NSAIDs
Where does Pseudomembranous Colitis occur? What is it caused by?
Swelling / inflammation of Large Intestine, caused by C. diff overgrowth
Is C. diff gram positive or gram negative?
Gram positive
What is a faecolith?
A hard discreet mass of faeces
Appendicitis is caused by inflammation often precipitated by..? 8 examples
Faecoliths Food residue Lymphoid hyperplasia Diverticulosis Neoplasia Yersinia infection TB infection IBD
What are some complications of Appendicitis?
- Abscess formation
- Necrosis
- Perforation
- Septicaemia
What is Diverticular Diseases?
Pouch formation due to weakness of muscles in wall and high intra-lumenal pressure in large intestine (commonly sigmoid part)
What condition often mimics Diverticular colitis?
Inflammatory Bowel Disease
What are some risk factors to Crohn’s Disease?
- Cigarette smoking
- Oral contraceptive pill
- Mycobacteria / Measles
What are three common sites which Crohn’s Disease affects?
- Terminal Ileum
- Small bowel alone
- Colon alone
Crohn’s Disease has a bi-modal age incidence - what is it?
- 15-30 years
- 60-80 years
A granuloma is a collection of..?
Macrophages
What is the pattern of how Ulcerative Colitis affects the GI tract?
It always begins in the rectum (Proctitis) and extends proximally in length. Can involve the entire large intestine (Pancolitis)
An appendectomy may be protective against which one: Crohn’s Disease or Ulcerative Colitis?
Crohn’s Disease
Which condition has increased concordance with twins? Crohn’s Disease or Ulcerative Colitis?
Crohn’s Disease
Out of Crohn’s Disease or Ulcerative colitis, is fistulas common?
Crohn’s Disease
Which condition is less likely to cause obstruction to the small intestine - Crohn’s Disease or Ulcerative Colitis?
Crohn’s Disease
Which condition is more rectal sparing, Ulcerative Colitis or Crohn’s Disease?
Crohn’s Disease
What are microscopic ulcer types in Ulcerative Colitis and Crohn’s Diease?
Ulcerative Colitis: Undermining (horizontal)
Crohn’s Disease: Fissuring (vertical)
In which condition, are Polyps more common, Ulcerative Colitis or Crohn’s Disease?
Ulcerative Collitis
Ulcerative Colitis has a bi-modal age distribution, what is it?
- 15-30 years
- 60-80 years
Smoking is protective for which condition: Ulcerative colitis or Crohn’s Disease?
Ulcerative Colitis
