Session 7- Large Intestine and IBS Flashcards
what is IBS
a group of conditons characterised by idiopathic inflammation of th GI tract
extraintestinal problems
MSK pain
-arthiritis
Skin
-erythma nodusum
Liver
-primary sclerosing cholangitis
eye problems
which is more likely to have blood in stool
UC
where does crohns affect
terminal ileum hence RLQ pain
pathology of crohns
skip lesions hyperaemia mucosal oedema discrete superficial ulcers deeper ulcers transmural inflammation -thickening of bowel wall -narrowing of lumen
appearance of crohns
cobblestone appearance
fistulae- bowel/ bladder, bagina and skin
microscopic pathology - crohns
granuloma formation
-organised collection of epitheliod macrophages
how do we investigate crohns - CT MRI
CT/MRI
- thickened bowel wall
- obstruction
- extramural problems
how would crohns present on a blood test
anaemia
what is present in stool of UC
mucus- large intestine
blood - involves mucosa
pathogical changes of UC
Chronic inflamation infiltrate of lamina propria crypt abcesses crypt distortion -irregular shaped glands -darker crowded nuclei reduced goblet cells pseudoplyps loss of haustra
how does uc present in blood work
anaemia
serum markers increased
where does UC affect compared to crohns
uc- rectum colon
crohns- anywhere
are there fistulas in uc or crohns
just crohns
string sign of kantour
long strictures in crohns
how does mucosal inflammation appear on doubke contrast enema
granular apparance `
how do we treat uc
curative
remove colon- colectomy
in classic presentation of appendicitis which of the following causes the pain to be felt in the right iliac fossa
the first stage of pain is caused by the distension of the inflamed appendix triggering visceral afferents (by irritation and distension of the visceral peritoneum surrounding the appendix) to relay info back to the T10 dermatome
the brain interprets this as peri-umbilical pain
once the appendix is inflamed enough to come into contact with parietal peritoneum the pain will be felt in right iliac fossa which approximats the location of the appendix
