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GI PATHOLOGY > Small Intestinal Disease > Flashcards

Small Intestinal Disease Flashcards

1
Q

What are the barrier functions of the small intestine?

A

Immune sampling
Monitoring the presence of pathogens
Translocation of bacteria
GALT

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2
Q

What is GALT?

A

Gut associated lymphoid tissue

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3
Q

What elements cause the lumen of the small intestine to be toxic?

A

Digestive enzymes
Bile salts
IgA presence

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4
Q

How are proteins broken down in digestion?

A

Breakdown to oligopeptides and AAs
Trypsin, chymotrypsin
Hydrolysis at brush border

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5
Q

What are the symptoms of small bowel disorder?

A 
Weight loss
Increased appetite
Diarrhoea
Bloating
Fatigue
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6
Q

How does diarrhoea present in small bowel disorder?

A

Watery

Sometimes steatorrhoea

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7
Q

What causes steatorrhoea?

A

Fat malabsorption

High fat content stool

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8
Q

What are the signs of small bowel disorder?

A

Weight loss

Falling/low BMI

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9
Q

What are the signs of Ca, Mg and Vit D deficiency?

A

Tetany

Osteomalacia

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10
Q

What is the sign of vitamin A deficiency?

A

Night blindness

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11
Q

What is the sign of vitamin K deficiency?

A

Raised Proton transfer reaction

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12
Q

What is the sign of thiamine (B1) deficiency?

A

Memory loss

Dementia

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13
Q

What is the sign of Niacin (B3) deficiency?

A

Dermatitis

Unexplained Heart Failure

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14
Q

What is the sign of vitamin C deficiency?

A

Scurvy

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15
Q

Scleroderma is suggestive of what?

A

Systemic sclerosis

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16
Q

Aphthous ulceration is suggestive of what?

A

(mouth ulcer)
Coeliac
Crohns

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17
Q

What is dermatitis herpetiformis?

A

Cutaneous manifestation of Coeliac disease

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18
Q

How does dermatitis herpetiformis present?

A

Itchy, blistering IgA deposits in skin

Scalp, shoulders, elbows, knees

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19
Q

What investigations can be used to test the structure of the small bowel?

A

Biopsy
Meal study
CT Scan
MRI/capsule enterography

20
Q

How can bacterial overgrowth of the small bowel be tested?

A

H2 breath test

Duodenal/jejunal aspirate culture

21
Q

How is a Bacterial overgrowth breath test performed?

A

Lactulose or glucose substrate peaking in breath just after consumption

22
Q

Why is Coeliac serology not 100% useful in a coeliac diagnosis?

A

Whilst IgA is more useful than IgG, not all patients actually make IgA (higher in Coeliacs patients)

23
Q

What must also be tested in combination with IgA TTG?

A

Plasma IgA levels

24
Q

How is a Coeliac disease diagnosis confirmed?

A

Positive serology
HLA status
Distal duodenal biopsy

25
Q

What Coeliac-positive result is observed in a duodenal biopsy?

A

Villous atrophy

partial, subtotal or total

26
Q

Coeliac-positive patients will likely present with which HLA haplotypes?

A

DQ2 or DQ8

27
Q

Coeliac disease patients are allergic to which fraction of gluten?

A

Gliadin

28
Q

Why must you be careful of when diagnosing Coeliac disease?

A

It can mask other diseases

29
Q

What factors are looked for in coeliac serology?

A

Anti endomysial IgA

Anti Tissue transglutaminease

30
Q

How is Coeliac’s disease treated?

A

Stop eating Gluten

Refer to dietician

31
Q

What is refractory coeliac disease?

A

Coeliac disease symptoms in patients on a gluten free diet (common in later age)

32
Q

What are common complications of Coeliac’s disease?

A

Refractory Coeliacs disease

Cancers

33
Q

Which inflammatory bowel diseases cause malabsorption?

A

Coeliac disease

Crohns disease

34
Q

Which infective bowel disease causes malabsorption?

A

Tropical sprue
HIV
Gardia lamblia

35
Q

What does tropical sprue cause?

A

Folate (B9) deficiency

36
Q

What is Gardia lamblia?

A

Waterborne Unicellular parasite

37
Q

Gardia lamblia is more common in patients suffering from what?

A

Hypogammaglobulinaemia

38
Q

What is the treatment for Gardia lamblia infection?

A

Metronidazole

39
Q

What does Gardia lamblia infection cause?

A

Gardiasis

40
Q

Whipple’s disease is caused by what?

A

Tropheryma whippelii

41
Q

What are the symptoms of Whipples disease?

A

Weight loss
Malabsorption
Abdominal pain
Skin, brain, joint, heart effects

42
Q

Whipple’s disease typically effects whom?

A

Middle aged men

43
Q

Small bowel overgrowth can occur in conditions that effect what?

A

Motility
Gut structure
Immunity

44
Q

What is the main test used in small bowel overgrowth?

A

H2 breath test (unreliable)

45
Q

What treatment is given in small bowel overgrowth?

A 
Rotating antibiotics for 2 weeks:
Metronidazole
Tetracycline
Amoxycillin
Vit/nutritional supplements

GI PATHOLOGY (20 decks)

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