Inflammatory Disorders of the GI Tract Flashcards
what is metaplasia and give example in GI tract
change from one differentiated cell type to another
Barrett’s
what system is used to classify gastritis
the sydney system
dermatitis herpatiformis is associated with what disease
coeliac
chronic and acute gastritis is often caused by what
h.pylori
what are you at increased risk of if coeliac disease is not diagnosed and treated
cancer
(small bowel adenoma
enteropathy associated t-cell lymphoma)
histological features of coeliac disease
villous atrophy
chronic inflammation
increased CD8+ T-lymphocytes in epithelium
epithelial damage
crypt hyperplasia
what infection can cause pseudomembranous colitis
c.difficile
causes of IBD
infection?
genetics
loss of tolerance to commensal bacteria
smoking - crohn’s
food antigens
where should you biopsy in IBD
multiple sites - helps to distinguish Crohn’s from UC
how does UC typically present
with recurrent episodes of rectal bleeding
which age does UC present in typicallt
15-25
smaller peak at 60-70
what layers of the mucosa are inflamed in UC
usually confined to mucosa unless severe
what part of the GI tract is affected in UC
rectum and left colon most commonly but can be whole colon
affected in continuous distribution
except sometimes discontinuous involvement of caecum and appendix
what is a pseudopolyp
where ulceration has occurred on both sides so what is left looks like a growth but isn’t
is there usually a gradual or sharp change from normal and diseased colon in UC
sharp
how does chronic UC affect the mucosa
leads to irregular, shortened crypts and increased inflammatory cells in mucosa
what age is Crohn’s disease present in typically
20-30
smaller peak at 60-70
how does Crohn’s present
depends on part of GI tract affected
e.g. diarrhoea, weight loss, strictures and obstruction, fistulae
what layers of the GI wall does Crohn’s affect and what is this type of inflammation called
full thickness
(transmural inflammation)
describe distribution of Crohn’s
patchy and discontinuous
skip lesions
what part of GI tract involvement is more common in children
upper
what are most common sites of involvement in crohn’s
anus
small intestine and colon
what is seen in 70% of Crohn’s cases
granulomas
is subacute intestinal absorption seen in UC or Crohn’s or both
Crohn’s
are fistulae seen in UC or Crohn’s or both
Crohn’s
is toxic dilatation seen in UC or Crohn’s or both
both
is perforation seen in UC or Crohn’s or both
both
is malabsorption seen in UC or Crohn’s or both
Crohn’s
is haemorrhage seen in UC or Crohn’s or both
both
is amyloidosis seen in UC or Crohn’s or both
both
is neoplasia seen in UC or Crohn’s or both
both
what is amyloidosis
protein plaques deposited
why might a patchy distribution be seen in UC
due to treatment and different parts responding at different rates
how does microscopic colitis usually present
chronic watery diarrhoea
how does microscopic collitis appear on endoscopy
notmal
what is seen in histology of microscopic colitis
increase in chronic inflammatory cells in lamina propria
what are the two types of microscopic colitis
lymphocytic colitis
collagenous colitis
what type of microscopic colitis is associated with coeliac disease
lymphocytic
treatment of microscopic collitis
steroids
(removal of cause if known)
what drugs can cause microscopic colitis
NSAIDs
lansoprazole
