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2 GIT symposium > Lower GIT > Flashcards

Lower GIT Flashcards

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1
Q

what are the components of the lower GIT?

A

small intestine - jejunum, ileum

large intestine - colon

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2
Q

what occurs in the small intestine?

A

digestion and absorption of nutrients

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3
Q

what is absorbed in the duodenum?

A

iron

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4
Q

what is absorbed in the jejunum? 2

A

iron
folate

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5
Q

what is absorbed in the ileum?

A

vitamin B12

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6
Q

what occurs in the large intestine? 3

A

absorption of water and electrolytes
faeces is formed and stored temporarily
bacteria ferment indigestible material

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7
Q

what is required for vitamin B12 absorption?

A

intrinsic factor produced by the gastroparietal cells

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8
Q

how does lower GIT bleeding present?

A

fresh blood mixed with stool - haematochezia
may not be visible - occult blood

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9
Q

what radiological investigations are used to look at the GIT?

A

Barium swallow
Barium meal
Barium enema

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10
Q

what is the difference between barium swallow and meal?

A

barium meal follows through to the small intestine

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11
Q

what is a barium enema?

A

administered by a tube inserted into rectum
for imaging of the colon

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12
Q

how can the small intestine be imaged visually?

A

endoscopy

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13
Q

how can the large intestine be examined?

A

sigmoidoscopy
colonoscopy

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14
Q

what is the difference between a sigmoidoscopy and colonoscopy

A

colonoscopy - the whole colon is explored
sigmoidoscopy - lower 1/3 of colon

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15
Q

name 4 lower GI disorders

A

coeliac disease
inflammatory bowel disease
diverticular disease
irritable bowel syndrome

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16
Q

what is coeliac disease?

A

autoimmune condition where gluten activated an abnormal mucosal response with chronic inflammation and damage to the lining of the small intestine

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17
Q

what is gluten found in? 3

A

wheat
barley
rye

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18
Q

what results from the inflammatory response from coeliac disease? 2

A

villous atrophy
crypt hyperplasia

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19
Q

what is villous atrophy?

A

villi of small intestine erode away leaving a virtually flat surface

20
Q

what is crypt hyperplasia?

A

when the intestinal crypts are longer than normal

21
Q

what factors increase the risk of developing coeliac disease? 3

A

genetic
autoimmune thyroid gland disease
type 1 diabetes

22
Q

what are the symptoms of coeliac disease? 4

A

malaise - general feeling of illness/fatigue
abdominal discomfort
diarrhoea
weight loss

23
Q

coeliac disease can cause malabsorption so leads to deficiencies in? 3

A

iron
folate
B12

24
Q

how is coeliac disease managed? 3

A

gluten free diet
correct any deficiencies
asses osteoporosis risk

25
Q

how is coeliac disease monitored?

A

annual review with blood tests

26
Q

what is dermatitis herpetiformis?

A

immunobullous disease linked to coeliac disease may affect the oral mucosa

27
Q

what are the most common oral manifestations of coeliac disease? 2

A

oral ulceration
enamel hypoplasia

28
Q

patients with coeliac disease who have osteoporosis may be taking bisphosphonates, what dental affect does this have?

A

increase risk of developing osteonecrosis of the jaws after certain dental treatment

29
Q

irritable bowel disease includes what two diseases?

A

Crohn’s disease
ulcerative colitis

30
Q

where in the body is ulcerative colitis found?

A

large intestine

31
Q

where in the body is Crohn’s disease found?

A

entire GI tract

32
Q

what is inflammatory bowel disease?

A

chronic inflammatory diseases of unknown cause

33
Q

what are the differences in inflammation between Crohn’s and ulcerative colitis?

A

ulcerative colitis the inflammation is continuous and mucosal

Crohn’s the inflammation is not continuous and transmural

34
Q

oral features of Crohn’s disease 5

A

oral ulceration
mucosal tags
lip swelling
gingival inflammation
cobblestone mucosa

35
Q

how is inflammatory bowel disease investigated? 3

A

blood test
stool sample
colonoscopy

36
Q

how is Crohn’s disease managed? 3

A

corticosteroids
immunosuppressants
biological therapy

37
Q

how is ulcerative colitis managed? 4

A

aminosalicylates
corticosteroids
immunosuppressants
biological therapy

38
Q

how is IBD treated?

A

surgery (Crohn’s not curative)
parenteral nutrition (IV) - bowel resting
antibiotics for complications

39
Q

what does diverticula mean?

A

they are pouches of the colonic mucosa which have passed through the muscular wall of the colon

40
Q

what is diverticulosis?

A

Diverticula are present but asymptomatic

41
Q

what is diverticular disease?

A

Symptoms, e.g. lower abdominal pain, are present

42
Q

what is diverticulitis

A

The diverticula are inflamed and infected, the patient may feel generally unwell, feverish and suffer from acute abdominal pain

43
Q

name 3 functional GI disease

A

irritable bowel syndrome
functional dyspepsia
functional consitpation

44
Q

what is IBS

A

abdominal pain with altered bowel habit

45
Q

how is IBS treated? 4

A

fibre
anti-spasmodics
amitriptyline
SSRIs

46
Q

what drugs can exacerbate IBD and IBS

A

NSAID’s

47
Q

name some symptoms associated with GIT diseases secondary to aneamia/haematinic deficiency as a result of malabsorption and blood loss 5

A

aphthous like ulceration
angular cheilitus (corners of mouth)
oral candidosis (thrush)
glossitis (tongue)
burning sensation in mouth

2 GIT symposium (3 decks)

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