Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Exam - M - GI Diseases > let's get the bowel rolling > Flashcards

let's get the bowel rolling Flashcards

1
Q

what is inflammatory bowel disease

A

umbrella term for ulcerative colitis and chron’s disease
chronic relapsing and remitting disease
dysbiosis in microbes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the risk factors for inflammatory bowel disease

A 
autoimmune conditions 
NSAIDS
SSRIs
diet 
history of gastroenteritis
genetics + environment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how may inflammatory bowel disease present

A 
watery diarrhoea 
frequency and urgency 
abdominal pain 
passing blood 
weight loss
20-40yrs 
extra-intestinal - primary biliary cholangitis, skin rashes, mouth ulcers, arthritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the main features of chron’s disease

A

chron’s nests
cobblestone ulcerations
No/less blood or mucous
Entire GI tract - inc perianal chrons disease
Skip lesions on endoscopy
Terminal ilium most effected, Transmural
Smoking is a risk factor

vitamin deficiency
anaemia
wrapping mesenteric fat, thick mesentery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the main features of ulcerative colitis

A 
U C CLOSEUP
continuous inflammation 
limited to colon and rectum - proctitis 
only superficial mucosa effected 
smoking is protective 
excrete blood and mucous 
use aminosalicylates 
primary sclerosing cholangitis (strong association) + pseudopolyps

can present with acute severe colitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what investigations could you do for inflammatory bowel disease

A 
faecal calprotectin - good marker of intestinal inflammation >200
endoscopy 
colonoscopy 
biopsy 
bloods - anaemia, infection, thyroid function
CRP, WCC, platelets raised 
albumin low 
CT
MRI
stool culture 
pANCA - positive in 75% of UC
sexual health history
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how would you manage chron’s disease

A 
for relapse - steroids, prednisolone or IV hydrocortisone
infliximab 
methotrexate 
surgery to remove strictures
manage any malabsorption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how would you manage ulcerative colitis

A

aminosalicylates/5 ASA analogues - mesalazine
corticosteroids - IV if severe
immunosuppressants - azathioprine
panproctocolectomy - colon + rectum removed leaving permanent ilieostomy or J-pouch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are complications of ulcerative colitis

A 
toxic megacolon 
colon cancer risk 
osteoporosis due to steroids 
block bile flow (paucities)
perforation 
haemorrhage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are complications of chron’s disease

A 
small bowel obstruction 
fistula
strictures
anaemia 
osteoporosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is irritable bowel syndrome

A

functional bowel disorder - cause is not clear

diagnosis made by excluding other pathologies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are risk factors for IBS

A 
female 
age 
stress 
hypermotility 
visceral sensitivity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how does IBS present

A 
abdominal pain/discomfort relieved by opening bowels/associated with change in bowel habit
2 of:
abnormal stool passage 
bloating 
worse after eating 
PR mucous
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what investigations can you do for IBS

A 
stool culture 
bloods - CRP
faecal calprotectin 
sigmoidoscopy, colonoscopy 
rectal examination
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

how could you treat IBS

A 
laxatives 
loperamide for diarrhoea
antispasmodics 
 tricyclic antidepressants 
SSRIs 
dietician
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is coeliac disease

A

when gluten causes an immune response in the gut (usually duodenum) resulting in the gut walls getting destroyed - villi are damaged, crypts can atrophy etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are symptoms of coeliac disease

A 
distention 
abdominal pain 
steatorrhea 
vomiting 
weight loss
clubbing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what investigations can you do for coeliac disease

A

duodenal biopsy
bloods
anti-TTG IgA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how do you manage coeliac disease

A

gluten free diet

20
Q

what is diverticulosis

A

when the walls of the colon form an outpouching (like an aneurysm)
outpouching is usually where the blood vessels transverse the muscular layer because the tissue is weaker here
all layers dilated = true diverticulum

21
Q

what causes diverticulosis

A

abnormal contractions cause increased pressure so the walls balloon out
connective tissue disorders like marfan’s syndrome are risk factors

22
Q

how may diverticulosis present

A

usually asymptomatic

can cause painless rectal bleeding due to blood vessel rupture at the diverticulum

23
Q

what is diverticulitis

A

inflammation of diverticulum

24
Q

what can cause diverticulitis

A

faecal matter becoming lodged in the pouch

erosion of the wall due to high pressures

25
Q

how may diverticulitis present

A

pain in LLQ

not associated with bleeding

26
Q

what are complications of diverticulitis

A

can burst and form a fistula with the bladder

27
Q

how could you treat diverticulitis

A

antibiotics in case of bacterial involvement
high fibre diet after recovery
surgical removal in severe cases

28
Q

what is appendicitis

A

inflammation of the appendix

29
Q

what can cause appendicitis

A

faecal matter blocking the appendix - traps the gut bacteria in and the bacteria multiply and build pressure, WBCs become involved and the whole thing goes to shit, ischaemia
lypmhoid hyperplasia - the lymph nodes enlarge and block off the appendix, common in children

30
Q

how may appendicitis present

A 
RLQ pain 
fever 
mcburney's sign 
nausea 
vomiting
31
Q

what tests could you do for appendicitis

A

FBC
US
pregnancy test to rule out ectopic pregnancy

32
Q

how would you treat appendicitis

A

remove the appendix and give antibiotics

33
Q

what is ischaemic enteritis

A

inflammation and injury of the large intestine result from inadequate blood supply - acute occlusion of coeliac, inferior and superior mesenteric arteries
mucosa becomes damaged and gangrenous can cause dehydration and shock

34
Q

what can cause ischaemic enteritis

A

hypoperfusion - hypotension, shock, dehydration
thrombus
inflammation
ulceration

35
Q

what are risks for ischaemic enteritis

A 
atherosclerosis 
vasculitis 
aneurysm 
oral contraceptives 
cardiac failure 
shock 
vasoconstrictors
36
Q

what part of the bowel is vulnerable to ischaemia

A

splenic flexure

37
Q

how can ischaemic enteritis present

A

abdominal pain, cramping, tenderness

38
Q

what are complications of colonic ischaemia

A 
mucosal inflammation 
ulceration 
submucosal inflammation 
fibrosis 
stricture
39
Q

radiation colitis

A

abdominal irradiation can impair the normal proliferative activity
usually rectum-pelvic radiotherapy
damage depends on dose

40
Q

what are symptoms of radiation colitis

A

anorexia
abdominal cramps
diarrhoea
malabsorption

41
Q

what is acute severe colitis

A

inflammation effecting entire colon

42
Q

how does ASC present

A 
pain 
diarrhoea 
bleeding 
fever 
inability to eat
43
Q

how do you manage ASC

A

bloods
4 stool cultures for c diff
XR

IV glucocorticoids
rehydration therapy
stop problem drugs
GI review by specialist
low molecular weight heparin if thrombus
surgery if it is not responding - colectomy or rectal preserving ileostomy

44
Q

what is coeliac disease

A

autoimmune condition where gluten causes an immune response in the small bowel - mostly jejunum
causes atrophy of villi - malabsorption
anti-TTG and anti-EMA antibodies

45
Q

how does coeliac disease present

A 
failure to thrive 
diarrhoea 
fatigue 
weight loss 
mouth ulcers 
anaemia 
Dermatitis herpetiformis
can cause peripheral neuropathy, cerebellar ataxia, epilepsy
46
Q

what investigations could you do in coeliac disease

A

exclude IgA deficiency - total plasma IgA
endoscopy with biopsy - crypt hypertrophy, villi atrophy
HLA

47
Q

how do you manage coeliac disease

A

life long gluten free diet

refer to dietician

Exam - M - GI Diseases (35 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions