week 9 - metabolic disorders 1

Question 1

What is the GI tract responsible for?

Answer 1

Absorbing dietary water, minerals and digestive products

Conserving water, minerals to maintain body fluid/physiological homeostasis

Question 2

What is the distal colon involved in?

Answer 2

It is involved with the storage/elimination of undigested foods, bile, bacteria

Question 3

What is cholestasis?

Answer 3

Any condition in which the flow of bile from the liver is slowed or blocked

Question 4

What is gastroparesis?

Answer 4

A chronic condition where the stomach cannot empty in the normal way

Question 5

What is Ogilvie’s syndrome?

Answer 5

distension of the colon that is similar to that occurring as a consequence of bowel construction but in which no physical obstruction exists

Question 6

What is peptic ulcer disease? STOMACH DISEASE

Answer 6

It is a break in the lining of the GI tract extending to the muscular layer of the GI wall.

It occurs when there is an imbalance between factors that protect the mucosa of stomach/duodenum.
Can be caused by too much acid in the stomach

This imbalance is commonly caused by presence of H. pylori or NSAID use

Question 7

What symptoms can generate from ulcers?

Answer 7

Vomiting or vomiting blood

Breathing issues
severe anaemia

High pulse or low blood pressure

Faeces with dark blood

Weight loss

Appetite changes

Question 8

What is the most common complication caused by ulcers?

Answer 8

Internal bleeding - Can happen when an ulcer develops at the site of a blood vessel.
Can lead to anaemia

Question 9

What are the main types of NSAIDS

Answer 9

Ibuprofen
High dose aspirin

Question 10

How can NSAIDS damage the epithelium?

Question 11

What is H. Pylori?

Answer 11

Gram negative spiral shaped bacillus found in mucous layers of those that have the ulcers.

Transmitted person to person by saliva. Also by faecal contamination of food an water.

Question 12

How can H. Pylori actually cause issues in the body?

Question 13

How can you diagnose peptic ulcer disease?

Answer 13

Endoscopy
Patient history
Non invasive H. pylori testing: carbon 13 urea breath test, serum antibodies to H. pylori., stool antigen test.

Question 14

What is the stool antigen test?

Answer 14

It looks for antigens associated with H. pylori infection in the stool.

Question 15

What is a stool PCR test?

Answer 15

Can detect H. pylori infection in stool, can also identify mutations that maybe resistant to antibiotics that are used to treat H. pylori

Question 16

How can you treat peptic ulcer disease?

Answer 16

Lifestyle advise such as stopping smoking.
Avoiding NSAIDS
Patients can be started on Proton Pump inhibitor for 4-8 weeks to reduce acid production
Positive H. pylori requires eradication therapy

Question 17

What is eradication therapy aka triple therapy?

Answer 17

Treatment consists of:
1. proton pump inhibitor
2. oral amoxycillin
3. clarithromycin or metronidazole

Question 18

What does the hormone gastrin do?

Answer 18

It controls the amount of acid in the stomach

Question 19

What is a gastrinoma? (IN THE STOMACH)

Answer 19

It is a rare tumour that start in the cells that make the gastrin hormone,

Question 20

How do gastrinomas arise?

Answer 20

Due to uncontrolled cell division of G cells (secrete gastrin) in the gut

Question 21

How does gastrinoma cause disease?

Answer 21

1. The tumour cells release excessive amounts of gastrin
2. This leads to hyperplasia (too much growth) of parietal cells so increases amount of gastric acid
   3., Too much gastric acid breaches the mucosal defences of the gut etc
3. This causes ulcers etc

Question 22

What is Zollinger - Ellison syndrome (ZES)?

Answer 22

It is the combination of 3 things:
1. High levels of gastrin
2. too much acid
3. stomach or small bowel ulcers

Increases the chance of peptic ulcers

Question 23

How are gastrinomas diagnosed?

Answer 23

One things that may indicate that one has a gastrinoma is an elevation of FSG levels, indicating high gastric acid secretion,

Another way is where the individual is administered with secretin. Then FSG levels are measure at specific time points. This is because secretin stimulates gastrin release if one has a gastrinoma, but in patients without gastrinoma, secretin inhibits the release of gastrin.

Another way is carrying out the calcium infusion test, this is because calcium has been known to produce an increase in gastrin levels in patients with a gastrinoma. Therefore, after taking the calcium, if the gastrin levels increase then it’s most likely the patient has a gastrinoma.

Can also use CT scans and biopsies

Question 24

What are the treatments for gastrinoma?

Answer 24

Surgery
Chemotherapy if the tumour has spread to other parts of the body.
Toi stop you from making too much gastric acid you can have drugs called proton pump inhibitotrs

Question 25

What are some diseases of the large intestine?

Answer 25

Colonic polyps - extra tissue that grows in the colon, can become cancerous

Colorectal cancer

Ulcerative colitis - ulcers of the colon and rectum

Diverticulitis - inflammation or infection of the pouches in the colon

Irritable Bowel Syndrome (IBS) - uncomfortable condition causing abdominal cramping

Question 26

What are some symptoms of ulcerative colitis (UC)?

Answer 26

Weight loss
Abdominal/rectal pain
Blood in stool
Diarrhoea
Anaemia

Question 27

Pathophysiology of ulcerative colitis?

Question 28

How can you diagnose ulcerative colitis?

Question 29

How can you treat ulcerative colitis?

Answer 29

Mesalazine drugs
Corticosteroids
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Question 30

What is a disease of the small intestine?

Answer 30

Coeliac disease