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?

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
What are some complications of Appendicitis?
- Abscess formation - Necrosis - Perforation - Septicaemia
26
What is Diverticular Diseases?
Pouch formation due to weakness of muscles in wall and high intra-lumenal pressure in large intestine (commonly sigmoid part)
27
What condition often mimics Diverticular colitis?
Inflammatory Bowel Disease
28
What are some risk factors to Crohn's Disease?
- Cigarette smoking - Oral contraceptive pill - Mycobacteria / Measles
29
What are three common sites which Crohn's Disease affects?
- Terminal Ileum - Small bowel alone - Colon alone
30
Crohn's Disease has a bi-modal age incidence - what is it?
- 15-30 years | - 60-80 years
31
A granuloma is a collection of..?
Macrophages
32
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)
33
An appendectomy may be protective against which one: Crohn's Disease or Ulcerative Colitis?
Crohn's Disease
34
Which condition has increased concordance with twins? Crohn's Disease or Ulcerative Colitis?
Crohn's Disease
35
Out of Crohn's Disease or Ulcerative colitis, is fistulas common?
Crohn's Disease
36
Which condition is less likely to cause obstruction to the small intestine - Crohn's Disease or Ulcerative Colitis?
Crohn's Disease
37
Which condition is more rectal sparing, Ulcerative Colitis or Crohn's Disease?
Crohn's Disease
38
What are microscopic ulcer types in Ulcerative Colitis and Crohn's Diease?
Ulcerative Colitis: Undermining (horizontal) Crohn's Disease: Fissuring (vertical)
39
In which condition, are Polyps more common, Ulcerative Colitis or Crohn's Disease?
Ulcerative Collitis
40
Ulcerative Colitis has a bi-modal age distribution, what is it?
- 15-30 years | - 60-80 years
41
Smoking is protective for which condition: Ulcerative colitis or Crohn's Disease?
Ulcerative Colitis