week 1 - common disease processes affecting each part of the gut

Question 1

what is dysphagia? caused by?

Answer 1

Difficultly swallowing. May be caused by problems with the oesophagus, e.g. musculature, obstruction by tumour or neurological, e.g. a stroke. Tumours of the oesophagus, high up are Squamous Cell Carcinoma, lower down are Adenocarcinomas.

Question 2

what is acid reflux? caused by?

Answer 2

Sphincter between the oesophagus and the stomach is weak, acid refluxes into the oesophagus and causes irritation and pain (heartburn)

Question 3

what is Barrett’s oesophagus?

Answer 3

Metaplasia of the lower oesophageal squamous epithelium to gastric columnar. This is to protect against acid reflux

Question 4

what is oesophageal varices?

Answer 4

Portal venous system is overloaded due to cirrhosis, blood is diverted to the oesophagus through connecting vessels. This leads to the dilation of sub mucosal veins in the lower part of the oesophagus

Question 5

what is peptic ulceration?

Answer 5

Area of damage to the inner mucosa of the stomach or duodenum, usually due to irritation from gastric acid

Question 6

pancreatitis? characterised by?

Answer 6

Inflamed pancreas, causes considerable pain. Characterised by the release of amylases into the blood stream

Question 7

Jaundice?

Answer 7

Liver cannot excrete bilirubin, which accumulates in the blood. If build up of bilirubin is due to excess haemoglobin breakdown it is Pre-hepatic Jaundice. If build up of bilirubin is due to bile duct obstruction and back up of bile causing liver damage it is Post-hepatic or Obstructive Jaundice

Question 8

Gallstones?

Answer 8

Precipitation of bile acids and cholesterol in the bladder forms gall stones. Often asymptomatic, but may move within the gall bladder causing painful Biliary Colic, or move to obstruct biliary outflow. Tumours of the pancreas may also obstruct outflow

Question 9

malabsorption?

Answer 9

Several conditions affect how well the intestines can absorb things

Question 10

appendicitis?

Answer 10

Inflammation of the appendix, presents as a sharp pain in the side at the same level as T10, which then localises to the right lower quadrant

Question 11

peritonitis?

Answer 11

Inflammation of the peritoneum

Question 12

inflammatory bowel disease?

Answer 12

E.g. ulcerative colitis and Crohn’s disease

Question 13

acute blockage of small intestines presents with?

Answer 13

Present with Pain (in their back), vomiting and bloating

Question 14

haemorrhoids?

Answer 14

Vascular structures in the anal canal that aid with stool control. When they become swollen and inflamed they are painful, itchy and blood may be present in stool (dilated veins around anal canal)

Question 15

Prolapse?

Answer 15

Literally means ‘to fall out of place’. Prolapse is a condition where organs fall down or slip out of place. E.g. the rectum can prolapse

Question 16

diverticula?

Answer 16

Pressure is too high in the colon, producing an abnormal ‘outpouching’ to form a hollow. The sigmoid colon is the area most prone as the blood supply causes an area of weakness (?)

Question 17

Meckels’ diverticulum?

Answer 17

A pouch in the lower part of the small intestine, a vestigial remnant of the yolk sac. It can produce ectopic gastric mucosa that may then produce gastric acid, causing irritation

Question 18

Colo-rectal cancer?

Answer 18

The large intestine is a common site of malignancies, and colo-rectal cancer is a major cause of mortality