S7 L1 Inflammatory Bowel Disease - Crohns, Ulcerative colitis (and some extra info on large intestine)

Question 1

Large intestine

• Where does it start?
• Type of epithelium
• What happens to water here?
• Role (think about nutrients) of large intestine
• Much bacteria here?
• Storage?

Answer 1

Question 2

Large intestine - peritoneum
- Go through each part of the large intestine and state if they are: retroperitoneal, intra-peritoneal, no peritoneum

Answer 2

Question 3

Arterial supply to midgut

Answer 3

Question 4

Arterial supply to the Hindgut

Answer 4

Question 5

Venous drainage of:

• Midgut
• Hindgut
• Rectum

Answer 5

Question 6

Large intestine vs small intestine

• Length
• Width
• Difference in the lumen (‘shapes’)
• Muscles
• Bands…

Answer 6

Question 7

Water absorption in the colon
- How does this work?

Answer 7

Question 8

Inflammatory bowel disease

• What is this?
• Charaterised by…
• 2 main types…

Answer 8

Question 9

Introduction to:

• Crohn’s disease
• • what does it affect?
• • How much does it affect?
• • Pattern of tissue it affects…
• • Can lead to formation of…
• Ulcerative colitis
• • what does it affect?
• • How much does it affect?
• • Pattern of tissue it affects…

Answer 9

Question 10

Crohn’s:

• List Extra-intestinal problems it can cause
• Causes

Answer 10

Causes:
• Genetic
• 1st degree relative increased risk
• Identical twins concordance 70%
• Gut organisms (altered interaction) ((If not a good balance of microorganisms
in microbiome - could cause it))
• Immune response
• ? Trigger
• Antibiotics
• Infections
• Smoking
• Diet

Question 11

Crohn’s:

• Symptoms
• Complications

Answer 11

Question 12

Crohn’s:

• Why is the stool watery?
• Bloody?
• Which anatomical is most likely to be affected?

Answer 12

Question 13

Crohn’s
- Macroscopic appearance

Answer 13

Bit covered up:
Transmural inflammation:
– Thickening of bowel wall
– Narrowing of lumen

When get healing following the inflammation - because it the damage is so deep. get fibrosis. Fibrosis can thicken the bowel wall and narrow it, leading to strictures and fistula

Question 14

Crohn’s
- Microscopic appearance

Answer 14

Question 15

Crohn’s
- Investigating Crohn’s

Answer 15

Question 16

• *Ulcerative Colitis**
• Typical presentation of someone with UC

Answer 16

Question 17

Pathological changes in UC
- Microscopic changes

Answer 17

Question 18

Pathological changes in UC
- Macroscopic appearance

Answer 18

Question 19

Investigating UC
- Tests…

Answer 19

Question 20

Cross-over in IBD…

Answer 20

Question 21

Comparing Crohn’s and UC

Answer 21

Question 22

Comparing Crohn’s and UC:
- Pathological features

Answer 22

Question 23

Comparing Crohn’s and UC:

Answer 23

Question 24

Comparing Crohn’s and UC
- Radiology appearance

Answer 24

Question 25

Treatment options

• Medical
• Surgical

Answer 25