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block 15 anna > lecture 1 inflammation of the bowel > Flashcards

lecture 1 inflammation of the bowel Flashcards

1
Q

where are most nutrients absorbed

A

small intestine

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2
Q

divisions of the small intestine

A

duodenum
jejunum
ileum

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3
Q

what does the duodenum do to proteins

A

peptidases which breaks them down into amino acids

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4
Q

what does the duodenum do to fat

A

emulsifies it

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5
Q

what happens in the jejunum

A

absorption of smaller molecules like sugars, amino acids and fatty acids

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6
Q

where is vitamin B12 absorbed

A

ileum

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7
Q

small intestine epithelium

A

columnar

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8
Q

absorption cells in the small intestine

A

enterocytes

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9
Q

where are endocrine cells in the small intestine

A

in the crypts

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10
Q

what do the endocrine cells in the small intestine secrete

A

hormones for motility

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11
Q

where are brunners glands found

A

duodenum

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12
Q

what are brunners glands

A

submucosal glands which have alkaline secretions to neutralise stomach acids

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13
Q

lymphoid tissue found in the small intesting

A

preyers patch

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14
Q

where would you find preyers patches

A

terminal ilieum

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15
Q

what is the large intestine for

A

storage and elimination of food residues

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16
Q

where is water absorbed

A

large intestine

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17
Q

when do you find paneth cells

A

right colon

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18
Q

where in the wall of the large intestine is the nerve plexuses

A

muscularis propria and subserosa

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19
Q

what is coeliac disease

A

inflammatory disorder due to intolerance in genetically susceptible individuals of gluten

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20
Q

when does coeliac disease present

A

childhood

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21
Q

men or women coeliac

A

women

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22
Q

strong association of coeliac disease and what gene

A

HLA-DQ2

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23
Q

what can sensitivity to gliadin in coeliac disease be triggered by

A

viral infection

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24
Q

classical presentation of coeliac disease

A

weight loss, chronic diarrhoea and failure to thrive

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25
Q

non classic presentation of coeliac disease

A

IBS, abdominal pain, altered bowel habit and anaemia

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26
Q

why might you be anaemic with coeliac disease

A

duodenum is the site of iron absorption

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27
Q

what skin condition can glidin cause

A

dermatitis herpetiformis

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28
Q

what would the clinician do if they suspected coeliac diseaee

A

tissue transglutaminase antibody blood test

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29
Q

how do the villi in coeliac disease appear

A

blunted and broad
ratio between the villus height and the crypts is reduced
crypt hyperplasia

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30
Q

what does coeliac disease increase your risk of

A

developing a lymphoma

31
Q

how do NSAIDs have adverse affects on the GI tract

A

reduce prostoglandin production

32
Q

what do prostoglandins do

A

increase vascular permeability, cause vascular dilation and coagulation

33
Q

what enzymes do NSAIDs block

A

cox

34
Q

what do cox enzymes convert

A

arachadonic acid into prostoglandins

35
Q

affect of blocking prostoglandins in the GI

A

reduces blood flow in the mucosa, reduces gastric acid secretion and increases bicarbonate

36
Q

with NSAIDs why is the body bad at coagulation

A

no thromboxane

37
Q

common place for GI NSAID ulcers

A

duodenum and ileum

38
Q

what are the

A

thin mucosal septas in the lumen

39
Q

Pseudomembranous colitis

A

inflammation of the bowel due to use of antibiotics

40
Q

example where antibiotics cause disease

A

C diff

41
Q

describe Cdiff

A

spore forming
gram pos
anaeobe

42
Q

what is diverticular disease due to

A

increased intraluminal pressure

43
Q

what might you get with diverticular disease

A

constipation

44
Q

what happens to the bowel in diverticular disease

A

hypertrophy of the muscular layer

herniation in points of weakness

45
Q

in diverticular disease where are the areas of weakness

A

where the vessels enter and exit the mucosa

46
Q

commonest site for diverticular disease

A

sigmoid colon

47
Q

presentatioon of diverticular disease

A

Abdominal pain, altered bowel habit, bleeding and constipation

48
Q

two diseases that affects the terminal ilieum and cause granulomas

A

TB and yersiniosis

49
Q

chronic inflammatory bowel disease

A

crohns and ulcerative colitis

50
Q

genetic predisposition of chronic inflammatory bowel disease

A

HLA-DR1 and DQw5

51
Q

other things which increase the risk of chronic inflammatory bowel disease

A

pill

smoking

52
Q

triggers for CIBD

A

mycobacteria and measles virus

53
Q

what delays the onset of ulcerative colitis

A

appendectomy

54
Q

someothing which prevents ulcerative colitis

A

smoking

55
Q

how can smoking be preventative of CIBD

A

ncreased glycoprotein synthesis maintaining the mucosal layer

56
Q

something which initiate ulcerative colitis

A

NSAIDs

57
Q

most common place for crohns to affect

A

ileocolic junction

58
Q

age when crohsn presents

A

20-30 and 60-70

59
Q

colon crohns syptom

A

bloody diarrhoea

60
Q

upper GI crohns symptoms

A

abdominal pain, vomiting, weight loss and small intestinal obstruction due to strictures

61
Q

perineal crohns presentation

A

ulcers, fissures and abscesses

62
Q

when do you get serosal fat wrapping

A

crohns disease

63
Q

direction of the ulecrs in crohns

A

longituudinal

64
Q

what are the ulcers in crohns called

A

serpiginous ulcers

65
Q

transverse ulcers on the oedema in crohns

A

cobblestone appearance

66
Q

inflammation in crohns

A

patchy

67
Q

crohns and the bowel wall

A

affects all the layers

68
Q

where does ulcerative colitis begin

A

rectum

69
Q

what is it when ulcerative colitis is limited to the rectum

A

Ulcerative proctitis

70
Q

what does ulcerative colitis affect

A

the mucosa only

71
Q

what can form in severe ulcerative colitis

A

filiform polyps

72
Q

name a biliary tract disease

A

Primary sclerosing cholangitis

73
Q

when do you get Primary sclerosing cholangitis

A

with pancolitis

block 15 anna (15 decks)

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