year 4 CMS > GIT 1 > Flashcards

GIT 1 Flashcards

(196 cards)

Study These Flashcards
1
Q

What are Koch’s four postulates used for?

A

Guidelines to determine the pathogenicity of an agent

These postulates help establish a causal relationship between a microorganism and a disease.

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

List the four postulates of Koch.

A
  • Organism found in diseased animals only
  • Must be grown in pure culture
  • Must reproduce disease in susceptible animal
  • Found in diseased areas of the new host

These criteria are essential for linking a specific pathogen to a specific disease.

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

True or false: H. Pylori fulfills all of Koch’s postulates to produce histological gastritis.

A

FALSE

Research indicates that H. Pylori only fulfills one of the criteria.

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

What is the trend regarding the prevalence and incidence of Crohn’s disease?

A

Increasing worldwide

This trend highlights the growing concern regarding Crohn’s disease globally.

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

What are the impacts of Crohn’s disease on patients?

A
  • Education
  • Work
  • Social life
  • Family life

Crohn’s disease can significantly affect various aspects of a patient’s life.

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

What is a priority for managing Crohn’s disease?

A

Early diagnosis to induce remission and prevent complications

Timely intervention is crucial for better patient outcomes.

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

What types of assessments are needed for Crohn’s disease management?

A
  • Clinical assessment
  • Biochemical assessment
  • Endoscopic assessment

These assessments guide treatment decisions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Name some drugs used to maintain remission in Crohn’s disease.

A
  • Thiopurines
  • Methotrexate
  • Anti-tumour necrosis factor

These medications are commonly prescribed to manage Crohn’s disease.

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

What are the adverse pregnancy outcomes associated with?

A

Active Crohn’s disease

Disease flares during pregnancy should be treated aggressively.

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

What should be in place to ensure the best outcomes for patients with Crohn’s disease?

A

A systematic programme of surveillance

Monitoring long-term sequelae is essential for patient care.

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

What are the risk factors for a severe Crohn’s disease phenotype?

A
  • Younger age of onset (less than 40 years)
  • Perianal disease
  • Structuring and penetrating disease (i.e.: perforation, intraabdominal abscess, abdominal fistulas, etc)
  • Presence of upper gastrointestinal lesions
  • Need for steroids for treating the first flare
  • Female sex

These factors can indicate a more severe form of Crohn’s disease.

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

How is Crohn’s disease classified by age at diagnosis?

A
  • A1: below 16 years
  • A2: between 17 years and 40 years
  • A3: above 40 years

Age at diagnosis helps in understanding the disease progression and management.

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

What are the locations used to classify Crohn’s disease?

A
  • L1: ileal
  • L2: colonic
  • L3: ileocolonic
  • L4: isolated upper disease

Location classification aids in determining the affected areas of the gastrointestinal tract.

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

What are the behaviors used to classify Crohn’s disease?

A
  • B1: non-stricturing, non-penetrating
  • B2: structuring
  • B3: penetrating
  • ‘p’ added when concomitant perianal disease is present
  • L4 modifier for concomitant upper gastrointestinal disease

Behavior classification reflects the nature of the disease’s progression and complications.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the gastrointestinal tract described as?

A

A continuous tube from the mouth to the anus

This structure facilitates the digestion and absorption of food.

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

What does the gallbladder do?

A

Squirts bile into the duodenum

The liver feeds into the gallbladder, which plays a crucial role in digestion.

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

What does the pancreas contribute to the duodenum?

A

Squirts pancreatic juices

These juices are essential for digestion and nutrient absorption.

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

Where is the appendix located?

A

At the end of the ileum and beginning of the colon, in the right ileac fossa

The right ileac fossa is located just above the right hipbone.

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

What is the role of the appendix in herbivorous animals?

A
  • Contains bacteria that can hydrolyse cellulose
  • Provides nutrition

The appendix was more useful in primitive animals for digesting plant material.

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

True or false: Humans still have a significant need for the appendix.

A

FALSE

Humans have evolved from grazing and now have a more nutrient-rich diet, reducing the appendix’s necessity.

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

What can happen if the appendix becomes necrotic?

A

Leads to inflammation and pain

This condition is commonly known as appendicitis.

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

What is the specialised histological structure of the gut dependent on?

A

The location

Different parts of the gut have unique histological structures.

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

What is the purpose of the large surface area in the gut?

A

To aid absorption

The surface area is increased by villi.

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

What are villi?

A

Finger-like projections on the lining of the intestine

Villi are highly folded and contain microvilli to enhance absorption.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What happens if the **villi** are lost?
It can lead to illness ## Footnote Villi are crucial for nutrient absorption.
26
What type of lining does the **oral cavity** have?
Stratified squamous lining ## Footnote This lining contains mucosal glands that produce mucous and acid, relevant for GORD.
27
What is the role of the **large bowel** in terms of mucous production?
Produces less mucous ## Footnote The large bowel's primary function is nutrient absorption.
28
What is **gut motility** related to?
Peristaltic waves ## Footnote Muscle contractions push food through the gut for maximum nutrient absorption.
29
How do the muscles in the gut contribute to **peristaltic waves**?
They run circumferentially and longitudinally ## Footnote This muscle arrangement helps push food from one end of the gut to the other.
30
What does the **liver** produce that allows for the emulsification of fats in the diet?
Bile salts ## Footnote Bile salts increase absorption of fats and are stored in the gall bladder.
31
Where are **bile salts** stored?
Gall bladder ## Footnote They are released in response to food entering the duodenum.
32
What triggers the release of **bile salts**?
Food in the gastrointestinal tract ## Footnote Specifically, when food enters the duodenum.
33
What does the **pancreas** secrete to aid in digestion?
* Enzymes * Alkali secretion * Proenzymes ## Footnote Enzymes break down complex molecules, alkali secretion neutralizes stomach acid, and proenzymes prevent self-digestion.
34
What is the purpose of the **alkali secretion** produced by the pancreas?
To neutralize the acid from the stomach contents ## Footnote This helps create a suitable environment for enzyme activity.
35
What condition occurs when the **pancreas** starts to digest itself?
Pancreatitis ## Footnote This is an unpleasant condition resulting from self-digestion.
36
Where does the conversion of **proenzymes** into their active form occur?
In the duodenum ## Footnote This is where they begin to hydrolyse proteins and fats.
37
What hormone does the pancreas release into circulation in response to food?
Insulin ## Footnote Insulin is released in response to food in the gastrointestinal tract.
38
What role does the **appendix** play in other mammals?
Storage of gut bacteria that contribute to digestion ## Footnote The appendix is involved in maintaining gut health by storing beneficial bacteria.
39
The appendix is described as a **blind-ended tube** at the start of the colon. What does **blind-ended** mean?
An alley open at one end, like a cul-de-sac ## Footnote This definition highlights the anatomical structure of the appendix.
40
What conditions can the **appendix** develop that may lead to appendicitis?
* Obstruction * Inflammation * Infection ## Footnote These conditions can cause severe abdominal pain and require medical attention.
41
Why does the **gut** need a large blood supply?
Due to the importance of the GI tract ## Footnote A robust blood supply is essential for nutrient absorption and overall digestive health.
42
Arterial blood flows from the **aorta** to the __________.
mesenteric arteries ## Footnote This flow is crucial for supplying blood to the gastrointestinal tract.
43
What are **mesenteries**?
Layers of gut that connect the gut to the posterior abdominal wall ## Footnote Mesenteries support the intestines and contain blood vessels and nerves.
44
Arterial blood flow goes into the **mucous lining** and into the __________.
villi ## Footnote Villi are small, finger-like projections that increase the surface area for absorption in the intestines.
45
The blood supply to the gut allows for the absorption of nutrients into the __________.
portal venous system ## Footnote This system transports absorbed nutrients to the liver for processing.
46
What is the **venous drainage** from the gut called?
portal venous system ## Footnote This system directs blood from the gastrointestinal tract to the liver for processing.
47
Why does blood from the gut not enter the **vena cava** directly?
To avoid toxins, fats, and bacteria in systemic circulation ## Footnote This ensures that nutrient-rich blood is processed by the liver before entering systemic circulation.
48
What does the liver do with the blood it receives from the **portal venous system**?
* Filters toxins * Metabolizes drugs * Processes vitamins/nutrients ## Footnote The liver hepatocytes play a crucial role in detoxifying and metabolizing substances before they enter systemic circulation.
49
After processing, where is the blood released back into?
systemic circulation ## Footnote This allows the body to utilize the filtered and metabolized nutrients and substances.
50
True or false: The **portal venous system** helps in the context of gastroesophageal reflux disease (GORD).
TRUE ## Footnote There are clinically relevant links between GORD and liver disease.
51
What type of **nervous system stimulation** reduces gut motility and secretion?
Sympathetic stimulation ## Footnote The sympathetic system is associated with the fight or flight response and is activated during stress.
52
What are the effects of **sympathetic stimulation** on the body?
* Increased blood pressure * Vasoconstriction * Increased heart rate * Reduced blood flow to the gut ## Footnote These changes encourage blood to go to the muscles during stress.
53
What does **parasympathetic stimulation** promote in the gastrointestinal tract?
* Gut motility * Gut secretion ## Footnote This system increases peristaltic waves and enhances digestion after the fight or flight response ends.
54
True or false: The **sympathetic nervous system** stimulates peristaltic waves and secretion of juices.
FALSE ## Footnote The sympathetic nervous system reduces peristaltic waves and secretion in the gut.
55
Fill in the blank: The **parasympathetic system** stimulates the gut, while the _______ depresses it.
sympathetic nervous system ## Footnote The sympathetic system is activated during stress, leading to reduced gut function.
56
What happens to peristaltic waves during **sympathetic stimulation**?
They reduce ## Footnote This reduction slows down gut function and digestion.
57
What is the primary role of the **parasympathetic nervous system** in digestion?
To increase peristaltic waves and gut function ## Footnote This system is activated once the fight or flight response ends.
58
59
What are some **gastrointestinal symptoms** that suggest there is a concern?
* Nausea and vomiting * Heartburn/epigastric pain * Loss of appetite * Abdominal pain * Unintentional weight loss * Malabsorption * Vitamin deficiency * Anaemia ## Footnote These symptoms can indicate underlying gastrointestinal issues.
60
What is the **normal pattern of bowel movements**?
Ranges between three movements a day up to one movement every three days ## Footnote Any sustained change lasting longer than two weeks is potentially significant.
61
What are some **other bowel symptoms** that may indicate a problem?
* Painful bowel motions * Blood and/or mucous in the bowel movement * Tenesmus ## Footnote Tenesmus is the feeling of not having emptied the bowel.
62
True or false: **Tenesmus** can be caused by damage in the rectum.
TRUE ## Footnote Damage in the rectum can lead to tenesmus, as the rectum lacks proper nerve fibres.
63
What conditions can lead to **tenesmus**?
* Rectal tumours * Inflammation caused by diseases like ulcerative colitis ## Footnote These conditions can cause discomfort and the sensation of incomplete bowel evacuation.
64
What does **Gastroesophageal reflux disease (GORD)** affect?
Almost everyone at some point in their life ## Footnote Factors include diet, stress, and other lifestyle factors.
65
Why is GORD **dentally relevant**?
NSAIDs can influence the symptoms ## Footnote Dentists need to be aware of this connection.
66
What is the pH level of the **stomach contents**?
Around 1-2 ## Footnote This acidity can digest food and human tissue.
67
What protects the stomach from its own acidity?
Mucous ## Footnote Produced by goblet cells in the stomach lining.
68
What is the role of **thick, sticky mucous** in the stomach?
It acts as a barrier between the acid and the epithelial lining ## Footnote This prevents damage to the stomach lining.
69
Why can the **oesophagus** be damaged by stomach acid?
It has no mucous secretion ## Footnote Damage can extend as far as the pharynx.
70
What anatomical feature helps protect against GORD?
Thicker circumferential muscle around the lower oesophagus ## Footnote This muscle helps maintain the lower oesophageal sphincter.
71
How does the **diaphragm** contribute to GORD protection?
Forms the lower oesophageal sphincter ## Footnote It has a ring of muscle that aids in sphincter formation.
72
What mechanical advantage does the **sharp bend** in the oesophagus provide?
Helps prevent reflux ## Footnote This bend is part of the anatomical adaptations against GORD.
73
In health, should there be any **reflux** into the oesophagus?
No ## Footnote If the sphincter weakens, reflux can occur.
74
What can happen in severe cases of GORD?
Stomach contents can reach the pharynx ## Footnote This indicates a significant failure of the lower oesophageal sphincter.
75
What are the **symptoms of GORD**?
* Reflux of acidic stomach contents into the oesophagus * Heartburn * Acid reflux * Belching * Erosion of the teeth * Inflammation of the pharynx ## Footnote Erosion of the teeth occurs in unexpected areas, differentially removing the dentine.
76
What can **acid in the larynx or pharynx** cause?
* Thickening * Hoarse voice * Sensation of having a lump in the throat ## Footnote Usually, if the ENT surgeon can’t find any lumps, the first thing they will try is antacid medication.
77
What are the **mechanical factors** that increase the likelihood of certain health risks?
* Reduced tone of the lower oesophageal sphincter * Increased intra-abdominal pressure * Decreased stomach pH * Increased stomach contents ## Footnote Examples of increased intra-abdominal pressure include being overweight, pregnant, and lying flat.
78
List the **lifestyle factors** that can increase health risks.
* Smoking * Alcohol * Diet * Stress ## Footnote These factors can contribute to various health issues, including gastrointestinal problems.
79
What types of **drugs** are mentioned as risk factors?
* Non-steroidals * Tri-cyclic antidepressants * SSRIs ## Footnote These medications can have side effects that may increase health risks.
80
Fill in the blank: **Increased intra-abdominal pressure** can be caused by _______.
[overweight, pregnant, lying flat] ## Footnote These conditions can contribute to increased pressure in the abdomen.
81
True or false: **Decreased stomach pH** can be caused by very acid stomach content and delayed emptying due to alcohol, fatty food, or caffeine.
TRUE ## Footnote These factors can lead to a more acidic environment in the stomach.
82
What can lead to **increased stomach contents**?
* Large meals ## Footnote Consuming large meals can contribute to various gastrointestinal issues.
83
What are the **risk factors** to address in the management of GORD?
* Less smoking * Less alcohol/caffeine * Better diet * Lower stress ## Footnote Addressing these factors can help reduce symptoms of GORD.
84
What is the purpose of **neutralising stomach contents** in GORD management?
To reduce acidity ## Footnote For example, Gaviscon contains bicarbonate which neutralises the acid.
85
What role does **alginate** play in GORD management?
Forms a barrier above to stop acid going up into the oesophagus ## Footnote This helps prevent acid reflux.
86
What surgical procedure can be performed to manage GORD?
Tightening the lower oesophageal sphincter ## Footnote This surgery aims to prevent acid reflux by strengthening the sphincter.
87
What is an **ulcer**?
A pathological break in the epithelial lining ## Footnote This definition applies to various conditions, including skin conditions.
88
What occurs when the lining of the stomach becomes inflamed?
Gastritis ## Footnote Gastritis is a condition that can result from damage to the stomach lining.
89
What is **peptic ulcer disease** caused by?
* Stress * Steroids * NSAIDs * SSRIs ## Footnote These factors can lead to the acid/enzymes overcoming the defenses of the stomach and duodenum.
90
Patients admitted to the intensive care unit following severe trauma may develop what type of ulcer?
Gastric ulcers ## Footnote Patients are usually started on medication to prevent gastric ulcers upon admission.
91
True or false: Patients on medication for arthritis are at risk of **peptic ulcer disease**.
TRUE ## Footnote Medications for arthritis, particularly NSAIDs, can increase the risk of developing peptic ulcers.
92
What are **Koch's postulates** designed to establish?
A causal relationship between a microbe and a disease ## Footnote They prove whether or not a microorganism is responsible for a particular disease.
93
List the **four criteria** of Koch's postulates.
* Microorganism found in abundance in diseased organisms, not in healthy ones * Must be isolated and grown in pure culture * Should cause disease when introduced into healthy organism * Must be reisolated and identified as identical to the original agent ## Footnote These criteria are essential for establishing a link between a microbe and a disease.
94
True or false: A microorganism must be found in healthy organisms according to Koch's postulates.
FALSE ## Footnote The microorganism should not be found in healthy organisms.
95
What is the significance of **Helicobacter Pylori** in relation to Koch's postulates?
It is discussed whether it fulfills Koch's postulates ## Footnote An individual intentionally gave himself a peptic ulcer by drinking H. Pylori to prove the relationship.
96
What are the **signs and symptoms** of peptic ulcer disease?
* Upper abdominal pain * Burning in the upper abdomen * Bloating * Nausea and vomiting * Heartburn * Dark stools (severe cases) * Unexplained weight loss (severe cases) ## Footnote Symptoms can vary, and chronic gastritis may lead to complications such as scarring and restricted outflow of food.
97
Fill in the blank: Peptic ulcer disease causes upper abdominal pain, also known as __________.
epigastric pain ## Footnote This pain differs from the burning chest associated with GORD.
98
What can dark stools indicate in severe cases of peptic ulcer disease?
Bleeding from ulcers ## Footnote These stools can be tested for ‘faecal occult blood’.
99
What is the first step in the **management of peptic ulcer disease**?
Confirm diagnosis with an upper gastrointestinal endoscopy ## Footnote This procedure involves placing a flexible telescope down the mouth through the oesophagus.
100
What symptoms are more significant than **peptic ulcer disease** and **gastroesophageal reflux disease**?
Symptoms are a little more significant ## Footnote Pain with peptic ulcer disease radiates slightly and is harder to ‘pin down’. Dark stools should always be investigated.
101
What can be tested for during an upper gastrointestinal endoscopy?
Microbes such as **H. Pylori** ## Footnote A biopsy can be taken during the procedure to test for these microbes.
102
What should be corrected in the management of peptic ulcer disease?
* Stress * Diet * Medications ## Footnote Addressing these risk factors is crucial for effective management.
103
How can you **increase the stomach pH** in peptic ulcer disease management?
Use **protein-pump inhibitors** ## Footnote These medications increase the pH of the stomach contents.
104
If peptic ulcer disease is linked to **H. Pylori**, what is the treatment?
* A course of antibiotics such as amoxicillin * Clindamycin and metronidazole if allergic to amoxicillin ## Footnote Eradicating H. Pylori is essential for treatment.
105
What does **IBD** stand for?
inflammatory bowel diseases ## Footnote IBD is a group of conditions characterized by inflammation of the intestine.
106
Define **inflammatory bowel diseases**.
A group of conditions characterised by inflammation of the intestine, such as the small intestine, large intestine, rectum, and anus ## Footnote Common examples include ulcerative colitis and Crohn’s disease.
107
What are the two main types of **inflammatory bowel diseases**?
* Ulcerative colitis * Crohn’s disease ## Footnote Coeliac disease is also considered an inflammatory bowel disease but is autoimmune.
108
True or false: **Irritable bowel syndrome** and **inflammatory bowel disease** are the same.
FALSE ## Footnote These are two separate conditions with similar clinical presentations.
109
List the characteristics of **inflammatory bowel diseases**.
* Inflammation * Ulceration * Variable thickness * Abdominal pain * Change in bowel habit * Blood loss or anaemia * Oral signs, recurrent aphthous stomatitis ## Footnote These symptoms are often associated with IBD.
110
What age range is commonly affected by **inflammatory bowel diseases**?
15-30 years ## Footnote There is a similar frequency of occurrence in males and females.
111
What additional symptoms can **ulcerative colitis** and **Crohn’s disease** be associated with?
* Fever * Malaise * Arthritis * Skin/eye lesions ## Footnote These symptoms can accompany the primary symptoms of IBD.
112
113
What is **ulcerative colitis** more common than?
Crohn’s disease ## Footnote Ulcerative colitis is a type of inflammatory bowel disease.
114
Where does **ulcerative colitis** start?
At the anus/rectum ## Footnote It may affect more proximal large bowel but never the ileum.
115
What are the symptoms of **rectal inflammation** in ulcerative colitis?
* Bleeding (bloody diarrhoea) * Tenesmus ## Footnote Tenesmus is the feeling that you need to pass stools, even though your bowels are already empty.
116
True or false: **Smoking** reduces the risk of getting ulcerative colitis.
TRUE ## Footnote Smoking has been shown to have a protective effect against ulcerative colitis.
117
In diagnosing **ulcerative colitis**, where does the condition always start?
At the very end of the colon (i.e.: the anus) ## Footnote Some patients may only be affected near the rectum.
118
What type of colitis may some patients with ulcerative colitis develop?
* Left-sided colitis * Total colitis ## Footnote Fewer patients will get total colitis, but it does not go into the small bowel.
119
What happens to ulcerative colitis if a **smoker** tries to quit?
The condition will destabilise ## Footnote This is commonly observed in patients with stable ulcerative colitis.
120
Is **Crohn’s disease** more or less common than ulcerative colitis?
Less common ## Footnote Crohn's disease is a type of inflammatory bowel disease.
121
What part of the gut can **Crohn’s disease** affect?
Any part of the gut ## Footnote This condition is also known as 'regional ileitis'.
122
List the **symptoms** of Crohn’s disease.
* Abdominal pain * Constipation/diarrhoea * Change in bowel habit * Full thickness involvement * Fistula formation ## Footnote Symptoms can vary widely among individuals.
123
What can **full thickness involvement** in Crohn’s disease lead to?
Stick loops of bowel together ## Footnote This can complicate the condition and lead to further issues.
124
What lifestyle factor increases the risk of **Crohn’s disease**?
Smoking ## Footnote Smoking is a known risk factor for many gastrointestinal diseases.
125
How does the inflammation in **Crohn’s disease** differ from that in ulcerative colitis?
Deeper into the lining ## Footnote This deeper inflammation can cause complications such as fistula formation.
126
What is a typical feature of **Crohn’s disease**?
Fistula formation ## Footnote Fistulas can occur when parts of the gut stick together.
127
What methods are used to **differentiate** between Crohn’s disease and ulcerative colitis?
* Blood tests * Endoscopy ## Footnote These methods help observe the affected gut region for accurate diagnosis.
128
What is the first step in the **diagnosis of irritable bowel disease**?
Endoscopy ## Footnote Endoscopy is performed if the patient has abdominal pain, bloody diarrhoea, weight loss, and other symptoms.
129
What symptoms might lead a GP to refer a patient for **endoscopy**?
* Abdominal pain * Bloody diarrhoea * Weight loss * Occasional fever/malaise/lethargy * Skin/eye signs ## Footnote These symptoms indicate potential irritable bowel disease.
130
What is the purpose of a **biopsy** in the diagnosis of irritable bowel disease?
To determine if the diagnosis is Crohns or ulcerative colitis ## Footnote The biopsy results depend on the pattern of gut involvement.
131
What imaging technique is mentioned for the diagnosis of irritable bowel disease?
CT scan ## Footnote CT scans can provide additional information about the condition.
132
What type of **steroids** is commonly used in the treatment of irritable bowel disease?
Prednisolone ## Footnote Prednisolone is used for managing symptoms of ulcerative colitis.
133
What is a **sterol emena** used for?
To control rectal ulcerative colitis ## Footnote Sterol emena helps avoid the need for systemic steroids.
134
What are **aminosalicylates** related to?
Aspirin ## Footnote Commonly used aminosalicylates include sulphasalazine and mesalazine.
135
What are the **potent anti-inflammatory drugs** mentioned for treating irritable bowel disease?
* Methotrexate * Azathioprine ## Footnote These drugs are used when standard treatments are insufficient.
136
What are the **biological response modifiers** used if the condition does not respond to standard treatments?
Infliximab ## Footnote Infliximab is a monoclonal antibody used in severe cases.
137
What is **coeliac disease**?
An autoimmune reaction to gluten, causing inflammation of the small bowel ## Footnote It can lead to various symptoms and complications.
138
List the **symptoms** of coeliac disease.
* Abdominal pain * Bloating * Failure to thrive * Skin and mouth vesicles ## Footnote Symptoms are related to gluten intake and include malabsorption issues.
139
What happens to the **villi** in coeliac disease?
Reduction in height of villi ## Footnote This leads to a decreased surface area for food absorption.
140
At what stages of life does coeliac disease typically peak?
* Infancy * Later life ## Footnote The later peak may be due to late diagnosis.
141
True or false: Coeliac disease is the same as Crohn's disease and ulcerative colitis.
FALSE ## Footnote Coeliac disease is a proper autoimmune disease, while Crohn's and ulcerative colitis are different conditions.
142
What triggers the **autoimmune reaction** in coeliac disease?
One of the molecules in gluten ## Footnote This reaction leads to inflammation of the small bowel.
143
What is the consequence of the inflammation caused by gluten in coeliac disease?
Damage to the small bowel ## Footnote This damage results in symptoms such as malabsorption.
144
Fill in the blank: Coeliac disease can lead to **__________** due to malabsorption.
Failure to thrive ## Footnote This includes not gaining weight or growing properly.
145
What are the two main methods for **diagnosing coeliac disease**?
* Blood tests * Endoscopy with biopsy ## Footnote The biopsy looks for histological evidence of coeliac disease.
146
What is the primary **management** strategy for coeliac disease?
Gluten-free diet ## Footnote This dietary change is essential for managing coeliac disease.
147
True or false: **Irritable bowel syndrome (IBS)** is an inflammatory bowel disease.
FALSE ## Footnote IBS is not classified as an inflammatory bowel disease.
148
What percentage of the population is estimated to have **irritable bowel syndrome (IBS)**?
20-50% ## Footnote Many people with IBS do not report it to their GP.
149
List some **risk factors** for developing irritable bowel syndrome (IBS).
* Diet * Lifestyle ## Footnote These factors can contribute to the onset of IBS.
150
What are common **symptoms** of irritable bowel syndrome (IBS)?
* Abdominal pain * Urgency or straining * Symptoms worse after eating * Possible bladder symptoms * Lethargy * Fatigue * Relief after bowel movement ## Footnote These symptoms can vary in intensity among individuals.
151
What conditions must be differentiated from **irritable bowel syndrome (IBS)**?
* Crohn's disease * Ulcerative colitis * Coeliac disease * Bowel cancer ## Footnote Accurate diagnosis is crucial to avoid mismanagement.
152
What questions should be asked in the history to assess for IBS? Name one.
* Do you have any blood or mucous in your poo? ## Footnote Other questions may include weight loss and checking for anaemia.
153
What should be checked if there is doubt about **anaemia** in a patient?
Arrange a full blood count and check for haemoglobin levels ## Footnote This helps in assessing the patient's overall health.
154
What is the **commonality** of **ulcerative colitis** in the population?
100-200 per 100k of the population ## Footnote This indicates the prevalence of the condition in the general population.
155
What age group is most commonly affected by **ulcerative colitis**?
15-30 years ## Footnote The condition affects both males and females equally.
156
What is a **risk factor** that reduces the risk of **ulcerative colitis**?
Smoking ## Footnote Interestingly, smoking is known to reduce the risk of developing ulcerative colitis.
157
List the **symptoms** of **ulcerative colitis**.
* Relapsing/remitting disease * Diarrhea +/- blood, mucus * Abdominal pain * Fever, malaise, weight loss ## Footnote These symptoms can vary in intensity and frequency.
158
What are the **signs** of active **ulcerative colitis**?
* Fever * Tachycardia * Abdominal distension * Clubbing * Oral ulceration * Arthritis * Conjunctivitis * Skin lesions * Malabsorption ## Footnote These signs indicate a more severe manifestation of the disease.
159
What is the **intestinal feature** of **ulcerative colitis**?
Rectum only in 50%, may extend proximally ## Footnote It does not extend beyond the ileocecal valve and does not involve the small bowel.
160
What is the **diagnosis** method for **ulcerative colitis**?
Colonoscopy and biopsy showing mucosal ulceration, inflammation, crypt abscesses ## Footnote This diagnostic approach is crucial for confirming the disease.
161
List the **treatments** for **ulcerative colitis**.
* Prednisolone * Mesalazine * Sulfasalazine ## Footnote These medications are used to manage symptoms and inflammation.
162
What is the **commonality** of **Crohn’s disease** in the population?
50-100 per 100k of the population ## Footnote This indicates the prevalence of Crohn's disease compared to ulcerative colitis.
163
What age group is most commonly affected by **Crohn’s disease**?
15-30 years ## Footnote Similar to ulcerative colitis, it affects both genders equally.
164
What is a **risk factor** that increases the risk of **Crohn’s disease**?
Smoking increases risk x 3 ## Footnote Smoking has a significant impact on the likelihood of developing Crohn's disease.
165
What dietary factors are associated with **Crohn’s disease**?
High sugar, low fibre diet ## Footnote These dietary habits may contribute to the onset of the disease.
166
List the **symptoms** of **Crohn’s disease**.
* Chronic inflammatory disease * Diarrhea +/- blood, mucus * Abdominal pain ## Footnote Symptoms can vary widely among individuals.
167
What are the **signs** of **Crohn’s disease**?
* Abdominal tenderness * Right iliac fossa mass * Perianal abscesses and fistulae * Clubbing * Skin lesions * Eye lesions * Arthritis * Malabsorption ## Footnote These signs indicate complications and severity of the disease.
168
What is the **intestinal feature** of **Crohn’s disease**?
Unaffected 'skip lesions' between affected areas, can affect any part of the GI tract, favours terminal ileum ## Footnote This characteristic differentiates it from ulcerative colitis.
169
What is the **diagnosis** method for **Crohn’s disease**?
Colonoscopy and biopsy showing granulomatous disease and deep ulcers ## Footnote This diagnostic approach is essential for confirming Crohn's disease.
170
List the **treatments** for **Crohn’s disease**.
* Prednisolone * Infliximab (immune suppressant) * Azathioprine * Sulfasalazine * Methotrexate ## Footnote These treatments aim to reduce inflammation and manage symptoms.
171
What is the **prevalence** of **Coeliac disease** in the population?
100-300/100k of population ## Footnote This indicates how common Coeliac disease is among the general population.
172
At what **ages** does **Coeliac disease** peak?
* Infancy * 50-60 years ## Footnote The disease shows a peak incidence in these age groups, with a higher prevalence in females.
173
What are the **risk factors** for **Coeliac disease**?
* HLA DQ2 * Intolerance to protein in wheat, barley, rye ## Footnote These factors increase the likelihood of developing Coeliac disease.
174
List the **symptoms** of **Coeliac disease**.
* Abdominal pain * Bloating * Nausea/vomiting * Steatorrhoea (fatty stools) * Weight loss ## Footnote These symptoms are commonly associated with Coeliac disease.
175
What **signs** may be associated with **Coeliac disease**?
* Skin/oral vesicles * Dermatitis herpetiformis * Anaemia ## Footnote These signs can indicate the presence of Coeliac disease.
176
Which part of the intestine is primarily affected by **Coeliac disease**?
Proximal small bowel ## Footnote This area is most affected due to contact with gluten molecules.
177
What is the **diagnosis** method for **Coeliac disease**?
* Duodenal or jejunal biopsy * Blood antibodies to alpha-gliadin IgA antibody ## Footnote These tests are crucial for confirming Coeliac disease.
178
What is the **treatment** for **Coeliac disease**?
Gluten free diet ## Footnote Adhering to a gluten-free diet is essential for managing Coeliac disease.
179
How common is **Irritable bowel syndrome** in the population?
20-50% of population ## Footnote This indicates that a significant portion of the population may experience IBS.
180
Who is more likely to be affected by **Irritable bowel syndrome**?
F>M, any age ## Footnote IBS is more prevalent in females and can affect individuals of any age.
181
What are the **risk factors** for **Irritable bowel syndrome**?
May be related to diet/lifestyle ## Footnote Lifestyle choices and dietary habits can influence the development of IBS.
182
List the **symptoms** of **Irritable bowel syndrome**.
* Abdominal pain, relieved by bowel movement * Altered bowel frequency * Straining OR urgency ## Footnote These symptoms characterize IBS and can vary in severity.
183
What are the **signs** associated with **Irritable bowel syndrome**?
No specific signs ## Footnote The focus is on excluding other conditions like IBD, coeliac, infections, and bowel cancer.
184
What are the **intestinal features** of **Irritable bowel syndrome**?
Normal on colonoscopy ## Footnote This indicates that IBS does not typically show abnormalities in the colon.
185
What is the **diagnosis** method for **Irritable bowel syndrome**?
Clinical, can also consider faecal calprotectin test ## Footnote Diagnosis is primarily clinical, with additional tests to rule out other conditions.
186
What is the **treatment** approach for **Irritable bowel syndrome**?
Address diet and lifestyle, supportive management of symptoms ## Footnote Management focuses on dietary adjustments and symptom relief.
187
How is the **mucosa** of the stomach, small intestine, and colon adapted to its function?
* Large surface area to aid absorption * Increased surface area by villi * Villi are finger-like projections on the lining of the intestine * Epithelial linings are highly folded to form microvilli * Contains mucosal glands which produce mucous and acid * Gut absorbs nutrients in small and large bowel * Large bowel produces less mucous * Gut motility involves peristaltic waves ## Footnote The muscle runs circumferentially and longitudinally to push food through the gut.
188
What promotes **gut motility** and how is peristaltic movement controlled?
* Parasympathetic stimulation promotes gut motility * Increases capacity for digestion * Activated after fight or flight response ends * Increases peristaltic waves * Stimulates gut and peristaltic movement ## Footnote This system ensures the gut functions properly for digestion.
189
What is **Hirschsprung’s disease**?
A rare condition causing poo to become stuck in the bowels ## Footnote Occurs when nerve cells in the colon don't form completely, leading to a lack of peristaltic movement.
190
How does the underlying cause of **Hirschsprung’s disease** produce its clinical features?
Lack of nerve cells leads to lack of peristaltic movement, causing poo to get stuck ## Footnote Nerves in the colon control muscle contractions that move food through the bowels.
191
Without prescribing any medication, how would you advise a patient who has **GORD** to manage their disease?
* Lifestyle and dietary modifications are key: * Dietary changes: Avoid trigger foods such as caffeine, chocolate, alcohol, spicy/fatty foods, citrus, and carbonated drinks. * Meal habits: Eat smaller meals, avoid lying down within 2–3 hours of eating, avoid late-night meals. * Body positioning: Elevate the head of the bed by 15–20 cm; avoid bending or lying down after meals. * Weight management: Encourage weight loss if overweight, as excess abdominal pressure worsens reflux. * Smoking cessation: Smoking reduces lower oesophageal sphincter tone. * Clothing: Avoid tight belts or waistbands that increase intra-abdominal pressure. ## Footnote This question requires a specific management strategy for gastro-oesophageal reflux disease.
192
How do **protein pump inhibitors (PPIs)** work?
* PPIs (e.g., omeprazole) irreversibly inhibit the H⁺/K⁺ ATPase proton pump on parietal cells of the stomach. * This blocks the final step of gastric acid secretion, reducing acid production regardless of stimulus (histamine, gastrin, or acetylcholine). * *Effect: Less gastric acid → less mucosal damage → symptom relief and healing of oesophagitis or ulcers ## Footnote This question requires an explanation of the mechanism of action of PPIs.
193
What are **Koch’s postulates**?
* _Koch’s postulates are criteria to link a microorganism to a disease: 1. The microorganism must be found in all cases of the disease. 1. It must be isolated and grown in pure culture. 1. It should cause the disease when introduced into a susceptible host. 1. It must then be re-isolated from the experimentally infected host. Application to dental caries: Microorganism: Streptococcus mutans Steps: Found in patients with active caries. Isolate S. mutans in pure culture. Introduce to a suitable animal model (e.g., germ-free rats) → development of carious lesions. Re-isolate S. mutans from carious lesions in the animal. ## Footnote This question requires a definition of Koch's postulates and their application to dental caries.
194
What diagnoses should you consider for a 17-year-old patient with **bloody diarrhoea**, abdominal pain, and weight loss?
Likely causes: Inflammatory bowel disease (IBD): Ulcerative colitis: bloody diarrhoea, urgency. Crohn’s disease: may involve entire GI tract, weight loss, abdominal pain. Infectious colitis: e.g., Shigella, Salmonella (less likely if chronic). Other: Juvenile polyps, malignancy (rare), ischemic colitis (uncommon at this age). Investigations: Blood tests: CBC (anaemia), CRP/ESR (inflammation), albumin (nutrition). Stool studies: Culture, C. difficile toxin, ova & parasites. Endoscopy: Colonoscopy with biopsy to distinguish UC vs Crohn’s. Imaging: MRI/CT enterography if Crohn’s suspected. ## Footnote This question requires consideration of differential diagnoses and potential investigations.
195
How would you grade your last bowel motion on the **Bristol stool chart**?
Type 1: Separate hard lumps → constipation Type 2: Sausage-shaped but lumpy → mild constipation Type 3: Sausage-shaped with cracks → normal Type 4: Smooth, soft sausage or snake → ideal/normal Type 5: Soft blobs with clear-cut edges → slightly loose Type 6: Fluffy pieces with ragged edges → mild diarrhoea Type 7: Watery, no solid pieces → severe diarrhoea_______ ## Footnote This question requires knowledge of the Bristol stool chart classifications.
196
How do **NSAIDs** put patients at risk of GORD and PUD?
NSAIDs inhibit cyclooxygenase (COX-1 and COX-2) → reduce prostaglandin synthesis. Prostaglandins normally: Protect gastric mucosa by stimulating mucus & bicarbonate. Promote mucosal blood flow and repair. Result: Reduced mucosal defense → higher risk of erosions, ulcers, and reflux symptoms. NSAIDs can also increase gastric acid secretion and decrease LES pressure → worsening GORD. ## Footnote This question requires an explanation of the mechanisms by which NSAIDs affect the gastrointestinal tract.
year 4 CMS
flashcards
Decks in class (55)
# Cards
Brainscape helps you reach your goals faster, through stronger study habits.
© 2026 Bold Learning Solutions. Terms and Conditions