Brainscape's Knowledge GenomeTM

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


See full index

Gastrointestinal (LECTURE NOTES) > Small Intestine > Flashcards

Small Intestine Flashcards

1
Q

What are the 3 mechanisms of malabsorption

A

Structural disorder
Mucosal disorder
Abnormal luminal digestion

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

What are the general clinical features of malabsorption

A 
Malaise
Anorexia 
abdominal bloating
diarrhoea 
weight loos
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some specific clinical features of malabsorption

A

Steatorrhoea (fat malabsorption)
Oedema ascites (protein malabsorption)
Skin rash (Zn or Vit B malabsorption)
Cheilitis, glossitis (vitamin B malabsorption)
Neuropathy, psychological effects (vit B12 malabsorption)
Night blindness (vit A malabsorption)
Bruising (vit K or vit C malabsorption)
Bone pain, myopathy, oesteoporosis (vit D malabsorption)

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

What are the 3 aims of investigating malabsorption

A

To establish the condition
To identify the site of abnormality
To identify the severity

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

What is short bowel syndrome

A

This is typically when there is

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

When does short bowel syndrome occur

A

When there is insufficient functioning small intestine to allow normal digestion and absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some causes of short bowel syndrome (intestinal failure)

A 
Extensive surgery 
Crohn's disease
Mesenteric ischaemia 
Radiation damage 
Volvulus 
Congenital abnormalities in children
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the short term management of SBS

A

Correct malnutrition

Reduce gut secretions (PPI, codeine, loperamide)

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

What is the long term management of SBS

A

Monitor nutrition and ensure adequate calorie intake
Monitor hydration status
Replace vitamins and mineral
Reduce gut secretions
Treat small intestinal bacterial overgrowth
Cholecystectomy if gallstones develop
Small bowel transplantation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is Ceoliac disease

A

An immune mediated disorder resulting in small intestinal villous atrophy which resolves on gluten withdrawal from the diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the main toxic antigenic component of fluten

A

Alpha - gliadin

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

What does the protein in gluten cause

A

A T cell mediated inflammatory response of the small bowel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the prevalence of Coeliac disease in the UK

A

1:200

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are clinical features of Coeliac disease

A 
Failure to thrive at weaning time (infants) 
Abdominal pain / bloating 
Lethargy
Anaemia
Diarrhoea or constipation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Coeliac disease linked to

A

HLA-DQ2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is coeliac disease often linked to

A

Other autoimmune diseases such as dematitis herpetiformis, insulin dependent diabetes, thyroid disease, primary biliary cirrhosis

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

What are the investigations to confirm the fiagnosis

A

Duodenal biopsy is GOLD STANDARD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What would be seen on a duodenum biopsy in someone with Coeliac disease

A

Villous atrophy
Crypt hyperplasia
Intraepithelial lymphocytosis

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

What antibody needs to be tested for in Coeliac disease

A

IgA antibodies to Tissue transglutaminase (TTG)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Why might a patient get a false negative result for IgA

A

IgA deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What should be tested when investigating the consequences of Coeliac disease

A

FBC and blood film
Haematinincs
Clotting screen
Bone investigation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the management for Coeliac Disease

A

Life long gluten-free diet to prevent the ongoing antigen provocation of the inflammatory response
Correct deificencies
Aggressive management of any bone disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is tropical sprue

A

A rare condition associated with small intestine villous atrophy and is thought to be post-infectious.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Who does tropical spruce normally affect

A

Residents of tropical countries (not travellers)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are 2 common symptoms of tropical sprue

A

Diarrhoea and abdominal distension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the treatment for Tropical sprue

A

Longterm tetracycline and folic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What 3 things does colonisation of the small intestine by colonic flora result in

A

Deconjugating bile salts (diarrhoea)
Metabolising vitamin B12 (anaemia)
Metabolising carbohydrate (resulting in calorie malnutrition and halitosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What 2 investigations are carried out for the condition of small intestinal bacterial overgrowth?

A

Jejunal aspirate

Hydrogen breath test after ingesting glucose or lactulose

29
Q

How is the cause of small intestinal bacterial overgrowth investigated

A

Small bowel radiology (identifies structural or communication abnormalities )

30
Q

What is a complication of Small intestinal bacterial overgrowth investigated

A

Low B12 and normal folate

31
Q

What 3 things are required in the management of small intestinal bacterial overgrowth

A

Antibiotics directed towards colonic flora
Replace vitamin B12
Definiteive treatment if poosible - surgery or prokinetics

32
Q

What is bile acid malabsorption characterised by

A

Postprandial diarrhoea due to osmotic effect of bile salts in the colon or steatorrhoea

33
Q

If bile acid malabsorption is a secondary abnormality, what is it most commonly due to

A

Crohn’s disease
ileal resection
intestinal failure

34
Q

What is teh treatment for bile acid malabsorption

A

Cholestyramine - a bile acid sequestrant

35
Q

What is Whipple’s disease

A

A rare disease characterised by malabsorption, finger clubbing, fevers, skin pigmentation, seronegative large-joint arthropathy

36
Q

How is the diagnosis of Whipple’s disease established

A

By identifying foamy fmacrophagses which stain positive with periodic acid-Schniff on jejunal biopsy

37
Q

What is the treatment for Whipple’s disease

A

Cotrimoxazole or tetracycline for 1 year

38
Q

What is protein-losing enteropathy

A

Gut loss of protein sufficient to reduce serum albumin

39
Q

How common are small intestine tumours

A

Very rare - account for

40
Q

What are the 2 important types of small intestine tumours

A

Carcinoid and lymphoma

41
Q

Describe carcinoid tumours

A

Slow growing and arise from the appendix, small intestine or rectum

42
Q

When does carcinoid syndrome occur

A

Only if the tumour metastasises

43
Q

What is carcinoid syndrome caused by

A

Systemic release of serotonn, prostaglandins and bradykinins

44
Q

How are carcinoid tumours diagnosed

A

By measuring urinary 5-HIAA

45
Q

What is the treatment for carcinoid tumours

A

Surgical resection

46
Q

What are 3 main presentations of carcinoid syndrome

A

Wheezing
Flushing
Diarrhoea

47
Q

What is the diagnostic test for lymphoma

A

Abdominal CT

48
Q

What is the treatment of choice for lymphoma

A

Surgical resection

49
Q

What is immunoproliferative small intestinal disease

A

A rare condition also known as alpha heavy chain disease

50
Q

Who does immunoproliferative small intestinal disease normally affect

A

Mediterranean and Arab races

51
Q

How do patients with immunoproliferative small intestinal disease typically present

A

With diarrhoea
malabsorption
clubbing
weight loss

52
Q

What shows the alpha heavy chains in immunoproliferative small intestinal disease

A

Serum electrophoresis

53
Q

What is the treatment for immunoproliferative small intestinal disease

A

Long term antibiotics

Only some need chemotherapy

54
Q

What is more common: single polyp or multiple polyps

A

Multiple polyps

55
Q

What are the 3 types of multiple polyps

A

Nodular lymphoid hyperplasia
Hamartomas
Andeomatous

56
Q

What is chronic intestinal pseudo-obstruction

A

Refers to a dpectrum of rare disorders characterised by the signs and symptoms of intestinal obstruction in the absence of true obstruction

57
Q

What is required to determine the diagnosis of chronic intestinal pseudoobstruction

A

Radiological demonstation of a dilated proximal small bowel

58
Q

What is Meckel’s diverticulum

A

The commonest congenital gut abnormality resulting from failure to close the vitelline duct

59
Q

If a patient is symptomatic with Meckel’s diverticulum, at what age would they present?

A

Before the age of 2

60
Q

Males are twice as likely to be affected. True or False

A

True

61
Q

What are the classic symptoms of Meckel’s diverticulum

A

Painless melaena with intestinal obstruction or intussusception being rare

62
Q

How is Meckel’s diverticulum diagnosed

A

Using a Meckel’s scan - injecting a radioisotope which is taken up by ectopic parietal cells

63
Q

Who is most likely to have hypolactasia

A

Africans and Asians

64
Q

What might secondary causes of lactase deficiency result in

A

Osmotic diarrhoea, abdominal pain
borborygmi after eating milk products
Flatulence

65
Q

How is diagnosis of lactase deficiency made

A

Using a lactose substrate hydrogen breath test

66
Q

What is the treatment for lactase deficiency

A

Minimising milk products

67
Q

In food allergy, what type of hypersensitivity reaction occurs

A

Type 1

68
Q

What is the treatment for food allergy

A

Dietary avoidance

Gastrointestinal (LECTURE NOTES) (29 decks)

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