lecture 1 inflammation of the bowel Flashcards
where are most nutrients absorbed
small intestine
divisions of the small intestine
duodenum
jejunum
ileum
what does the duodenum do to proteins
peptidases which breaks them down into amino acids
what does the duodenum do to fat
emulsifies it
what happens in the jejunum
absorption of smaller molecules like sugars, amino acids and fatty acids
where is vitamin B12 absorbed
ileum
small intestine epithelium
columnar
absorption cells in the small intestine
enterocytes
where are endocrine cells in the small intestine
in the crypts
what do the endocrine cells in the small intestine secrete
hormones for motility
where are brunners glands found
duodenum
what are brunners glands
submucosal glands which have alkaline secretions to neutralise stomach acids
lymphoid tissue found in the small intesting
preyers patch
where would you find preyers patches
terminal ilieum
what is the large intestine for
storage and elimination of food residues
where is water absorbed
large intestine
when do you find paneth cells
right colon
where in the wall of the large intestine is the nerve plexuses
muscularis propria and subserosa
what is coeliac disease
inflammatory disorder due to intolerance in genetically susceptible individuals of gluten
when does coeliac disease present
childhood
men or women coeliac
women
strong association of coeliac disease and what gene
HLA-DQ2
what can sensitivity to gliadin in coeliac disease be triggered by
viral infection
classical presentation of coeliac disease
weight loss, chronic diarrhoea and failure to thrive
non classic presentation of coeliac disease
IBS, abdominal pain, altered bowel habit and anaemia
why might you be anaemic with coeliac disease
duodenum is the site of iron absorption
what skin condition can glidin cause
dermatitis herpetiformis
what would the clinician do if they suspected coeliac diseaee
tissue transglutaminase antibody blood test
how do the villi in coeliac disease appear
blunted and broad
ratio between the villus height and the crypts is reduced
crypt hyperplasia
what does coeliac disease increase your risk of
developing a lymphoma
how do NSAIDs have adverse affects on the GI tract
reduce prostoglandin production
what do prostoglandins do
increase vascular permeability, cause vascular dilation and coagulation
what enzymes do NSAIDs block
cox
what do cox enzymes convert
arachadonic acid into prostoglandins
affect of blocking prostoglandins in the GI
reduces blood flow in the mucosa, reduces gastric acid secretion and increases bicarbonate
with NSAIDs why is the body bad at coagulation
no thromboxane
common place for GI NSAID ulcers
duodenum and ileum
what are the
thin mucosal septas in the lumen
Pseudomembranous colitis
inflammation of the bowel due to use of antibiotics
example where antibiotics cause disease
C diff
describe Cdiff
spore forming
gram pos
anaeobe
what is diverticular disease due to
increased intraluminal pressure
what might you get with diverticular disease
constipation
what happens to the bowel in diverticular disease
hypertrophy of the muscular layer
herniation in points of weakness
in diverticular disease where are the areas of weakness
where the vessels enter and exit the mucosa
commonest site for diverticular disease
sigmoid colon
presentatioon of diverticular disease
Abdominal pain, altered bowel habit, bleeding and constipation
two diseases that affects the terminal ilieum and cause granulomas
TB and yersiniosis
chronic inflammatory bowel disease
crohns and ulcerative colitis
genetic predisposition of chronic inflammatory bowel disease
HLA-DR1 and DQw5
other things which increase the risk of chronic inflammatory bowel disease
pill
smoking
triggers for CIBD
mycobacteria and measles virus
what delays the onset of ulcerative colitis
appendectomy
someothing which prevents ulcerative colitis
smoking
how can smoking be preventative of CIBD
ncreased glycoprotein synthesis maintaining the mucosal layer
something which initiate ulcerative colitis
NSAIDs
most common place for crohns to affect
ileocolic junction
age when crohsn presents
20-30 and 60-70
colon crohns syptom
bloody diarrhoea
upper GI crohns symptoms
abdominal pain, vomiting, weight loss and small intestinal obstruction due to strictures
perineal crohns presentation
ulcers, fissures and abscesses
when do you get serosal fat wrapping
crohns disease
direction of the ulecrs in crohns
longituudinal
what are the ulcers in crohns called
serpiginous ulcers
transverse ulcers on the oedema in crohns
cobblestone appearance
inflammation in crohns
patchy
crohns and the bowel wall
affects all the layers
where does ulcerative colitis begin
rectum
what is it when ulcerative colitis is limited to the rectum
Ulcerative proctitis
what does ulcerative colitis affect
the mucosa only
what can form in severe ulcerative colitis
filiform polyps
name a biliary tract disease
Primary sclerosing cholangitis
when do you get Primary sclerosing cholangitis
with pancolitis
