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Y1 - Gatrointestinal > Small Intestine Conditions > Flashcards

Small Intestine Conditions Flashcards

1
Q

Describe the pathophysiology of coeliac disease

A

Proteins containing gluten are resistant to absorption so remain in the lumen
This triggers immune response
Immune response causes inflammation
Inflammation leads to villous atrophy and crypt hyperplasia
This causes malabsorption of other nutrients

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2
Q

What are the diseases associated with coeliac disease?

A

Type 1 diabetes
IBD
IgA deficiency

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3
Q

Signs and symptoms of coeliac disease

A 
Abdominal pain
Weight loss
Diarrhoea/steatorrhoea
Angular stomatitis
Dermatitis herpetiformis on the extensor surface of elbows
Anaemia
Malnutrition
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4
Q

What are the long term problems of coeliac disease?

A

Iron or folate deficiency

Osteoporosis

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5
Q

What are the first line investigations for coeliac disease?

A

Serology - either:

  • tTG antibodies
  • EMA
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6
Q

What are the second line investigations for coeliac disease?

A

Endoscopic biopsy

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7
Q

Which additional investigations may be done for coeliac disease?

A

HLA by specialists if necessary
Iron and folate levels to check for deficiency
Bone scan

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8
Q

What are the steps taken for management in coeliac disease?

A 
Gluten free diet
Vitamin supplements
Pneumococcal vaccines when patients have splenic atrophy
Annual blood tests
Screen for autoimmune conditions
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9
Q

What are the symptoms of GI malabsorption?

A

Diarrhoea
Weight loss
Bloating
Abdo pain

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10
Q

What are some common causes of malabsorption?

A 
Coeliac
Crohn's
Lactose intolerance
Chronic pancreatitis
Biliary obstruction
Liver cirrhosis
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11
Q

What are signs of GI malabsorption?

A

Anaemia
Oedema
Steatorrhoea

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12
Q

What is tropical sprue?

A

A rare disease that affects small bowel absorption

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13
Q

What is the pathophysiological effect in tropical sprue?

A

Atrophy of villi of the digestive wall, which causes malabsorption

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14
Q

What are the symptoms of tropical sprue?

A

Fatigue
Diarrhoea
Anorexia

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15
Q

What is the management for tropical sprue?

A

Antibiotics

Supplements

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16
Q

What does vitamin C deficiency cause, and what are the symptoms?

A

Scurvy

  • Gum disease
  • Anorexia
  • Weakness
17
Q

What does vitamin D deficiency cause?

A

Osteomalacia

Rickets

18
Q

What is malnutrition?

A

The state of nutrition where a deficiency or imbalance of energy and nutrients lead to adverse effects on body tissue, function and clinical outcome

19
Q

What is enteric nutrition?

A

Nutrients are delivered into the stomach or small intestine via a tube

20
Q

What is parenteral nutrition?

A

Nutrient solution is delivered via a central or peripheral vein

21
Q

Where can secondary tumours in the small bowel metastasise from?

A

Ovary
Colon
Stomach

22
Q

Where do adenocarcinomas of the small intestine occur most often?

A

Duodenum and jejunum

23
Q

Which is the most common type of tumour in the small intestine?

A

Adenocarcinoma

24
Q

What is the management for adenocarcinomas and lymphomas?

A

Surgical resection + radiotherapy + chemotherapy

25
Q

Where do lymphomas of the small intestine occur most often?

A

Ileum

26
Q

Where do carcinoid tumours of the small intestine metastasise to?

A

Liver

27
Q

Where are carcinoid tumours of the small intestine most commonly found?

A

Terminal ileum and appendix

28
Q

Are carcinoid tumours mainly asymptomatic?

A

Yes

29
Q

When does carcinoid syndrome occur?

A

If a carcinoid tumour has metastasised

30
Q

What is a key hormone that is overproduced in carcinoid syndrome, and what effects does it cause?

A

Serotonin

Increased motility, bronchospasm, production of collagen via fibroblasts in the heart

31
Q

What are the symptoms of carcinoid syndrome?

A

Diarrhoea
Spontaneous flushing
Shortness of breath/wheezing
Pulmonary stenosis or tricuspid incompetence

32
Q

What are the investigations used for carcinoid tumours?

A

Serum chromogranin A
24 hour urine secretion of 5-hydroxyindoleacetic acid
Radiological imaging for metastases

33
Q

What is the management for carcinoid tumours?

A

Surgical resection

Octreotide pr lanreotide to alleviate symptoms

Y1 - Gatrointestinal (31 decks)

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