58 Questions
What is the primary function of the lower oesophageal sphincter (LES) in the oesophagus?
To prevent the reflux of HCl into the esophagus
What is the typical length of the oesophagus in humans?
25cm
What is the primary cause of obstruction in the oesophagus?
Carcinoma
What is the term for the inability to swallow due to obstruction in the oesophagus?
Dysphagia
What is the name of the condition characterized by the reflux of HCl into the esophagus?
Gastro-oesophageal reflux disease (GORD)
What is the term for the inflammation of the oesophageal mucosa?
Oesophagitis
What is the primary mechanism of damage caused by H. pylori infection in gastritis?
Direct damage to epithelium through disruption of the mucus layer
What is the primary diagnostic test for chronic infection with H. pylori?
All of the above
What is the consequence of immunologic loss of parietal cell function in gastritis?
Achlorhydria with loss of mucosa
What is the primary mechanism of damage caused by NSAIDs in gastritis?
Reduced production of mucus and bicarbonate
What is the characteristic of chronic gastritis?
Long-term changes in cell types, lymphocytes, intestinal metaplasia, and atrophy
What is the complication of gastritis that can lead to acute GI bleeding?
Ulcer
What prevents backflow of bacteria from the colon into the small intestine?
Ileocaecal valve
What is the primary cause of fat malabsorption in Abetalipoproteinaemia?
Inability to form chylomicrons
Which of the following conditions is characterized by the malabsorption of bile acids?
Primary bile acid malabsorption
What is the result of bacterial overgrowth in the small intestine?
Malabsorption of fats and carbohydrates
What is the term for the inability to digest lactose due to a deficiency of a specific enzyme?
Disaccharidase deficiency
What is the sensitivity of anti-gliadin antibodies IgA and tTG by blood test for diagnosing Coeliac disease?
95 %
What is the characteristic appearance of skin manifestations of Coeliac disease in 15-25 % of patients?
Fluid filled blisters
What is the effect of a gluten-free diet on mucosal histology in Coeliac disease?
Mucosal histology reverts to near-normal
What is the most common cause of intestinal obstruction in the small intestine?
Herniation of a segment
What is the result of peritonitis in the context of intestinal obstruction?
Formation of fibrous bridges
What is the process by which a segment of intestine becomes 'telescoped' within a distal segment during peristalsis?
Intussusception
What is the characteristic feature of the mucosal surface in ulcerative colitis?
Flattening of the mucosal surface
What is the percentage of patients with ulcerative colitis who will require colectomy within the first three years?
30%
What is the primary mechanism of diverticulitis formation?
All of the above
What is the characteristic feature of hyperplastic polyps?
Decreased cell turnover
What is the name of the gene mutation associated with familial adenomatous polyposis (FAP)?
Adenomatous Polyposis Coli (APC) gene
What is the term for the blind pouch leading from the GI tract lined with mucosa?
Diverticulum
Perforation of the stomach and duodenum can be diagnosed using endoscopy.
True
Al/Mg hydroxide reduces HCL production in the stomach.
False
The small intestine is approximately 6-7 meters long.
False
The narrow lumen of the small intestine makes it prone to obstruction from scarring and swelling.
True
Villi and microvilli in the small intestine decrease the surface area for digestion and absorption.
False
Neutrophils are a marker of severe injury in the oesophagus.
True
Gastroscopy is used to detect gastroesophageal reflux disease (GORD).
False
Barrett's oesophagus is a complication of long-term damage in 50% of GORD patients.
False
Oesophageal varices are secondary to liver disease, such as cirrhosis.
True
The stomach produces 3 litres of HCl per day.
False
The main function of the stomach is to absorb nutrients.
False
Bile insufficiency can cause steatorrhea due to the lack of fat emulsification in the small intestine.
True
Pancreatic lipase deficiency is diagnosed using the faecal elastase enzyme test (FE-1).
True
Coeliac disease is primarily seen in people of Other Ethnic Groups.
False
Dermititis herpetiformis is a skin blistering lesion seen in 100% of patients with Coeliac disease.
False
Lactase is a brush border enzyme with high activity in adults.
False
Mucosal defects can cause fat malabsorption due to the inability to assemble chylomicrons.
True
The only method to diagnose Coeliac disease with 100% accuracy is by blood test.
False
In Coeliac disease, the overall mucosal thickness is decreased.
False
Intussusception is a common cause of intestinal obstruction in the large intestine.
False
Dermititis Herpetiformis is a skin manifestation of Coeliac disease in all patients.
False
Gluten-free diet can completely cure Coeliac disease.
False
Surgical adhesions are a common cause of intestinal obstruction in the large intestine.
False
Crohn's disease typically affects the terminal ileum, resulting in malabsorption of Vitamin C.
False
Fistulas in Crohn's disease often connect with the skin, bladder, or vagina.
True
Flagellin is a dominant antigen in Ulcerative Colitis (UC) but not in Crohn's disease.
False
Crohn's disease typically presents with continuous colonic involvement beginning in the rectum.
False
Repeated surgery in Crohn's disease can lead to a higher risk of colon cancer.
True
Crohn's disease is characterized by a sustained viral-induced inflammatory response.
False
Study Notes
Here is the summary of the text:
• The GI tract is divided into four functional segments: oesophagus, stomach, small intestine, and large intestine.
• The oesophagus is a four-layered structure with squamous epithelium, two sphincters (upper and lower), and an acute angle, and it moves food bolus via peristalsis coordinated by the oesophageal plexus.
• Disorders of the oesophagus include obstruction, which can cause dysphagia, and oesophagitis, which is inflammation of the oesophageal mucosa.
• Oesophagitis can be caused by central nervous system depressants, pregnancy, alcohol, and anatomical changes, leading to symptoms such as bloody diarrhea, lower abdominal pain, and systemic inflammatory complications.
• Ulcerative colitis (UC) is a clinical feature of oesophagitis, characterized by bloody diarrhea, lower abdominal pain, and similar systemic inflammatory complications to Crohn's disease.
• Differential features of Crohn's disease (CD) and UC include distribution (UC LI, CD SI&LI), wall appearance (CD thick vs UC thin), depth of inflammation (CD high vs UC low), and fistulae (CD).
• Diverticulitis is a rare condition in people under 30, but common in people over 60, and is characterized by a blind pouch leading from the GI tract lined with mucosa, causing infection and serious abdominal infection.
• Treatment for diverticulitis includes a low-fibre diet, reduced stool bulk, increased peristaltic activity, and pressure.
• Polyps are tumorous masses arising from the epithelium protruding into the gut lumen, and can be classified into hyperplastic polyp (non-neoplastic) and adenoma (neoplastic).
• Familial adenomatous polyposis (FAP) is a familial syndrome characterized by a mutation in the Adenomatous Polyposis Coli (APC) gene.
• Coeliac disease is a condition characterized by normal atrophy and loss of villi, intra-epithelial lymphocytes, and crypts elongated, and can be diagnosed by SI biopsy and treated with a gluten-free diet.
• Coeliac intestinal obstruction is a rare condition that can be caused by herniation of segment, surgical adhesions, intussusception, and tumour.
• Gastritis is inflammation of the gastric mucosa due to HCl, which can be acute or chronic, and can lead to ulceration, breach of the 4-layer structure, and stomach content leakage into the peritoneum.
• Disorders of the stomach include chronic infection with H.Pylori, chronic alcohol and tobacco use, immunologic loss of parietal cell function, and achlorydia.
• Malabsorption syndromes can be caused by defective intraluminal digestion, mucosal defects, and reduced SI surface area, leading to symptoms such as chronic diarrhea, steatorrhea, weight loss, anorexia, abdominal distension, and borborygami.
• Disaccharide deficiency is a common condition characterized by lactase deficiency, which can be treated by removing lactose from food.
• Fat malabsorption can be caused by bile insufficiency, pancreatic lipase deficiency, and mucosal defects, leading to symptoms such as greasy stools, weight loss, and abdominal distension.
• Coeliac disease is a gluten-sensitive enteropathy characterized by sensitivity to gluten, T-cell mediated inflammatory reaction, and autoimmune conditions, and can be treated with removal of gluten from the diet.
• Disorders of the oesophagus include gastroscopy to detect oesophagitis, LES reflux oesophagitis, Barrett's oesophagus, and oesophageal varices, which can be secondary to liver disease.
This quiz covers the pathology and medicine of the gastrointestinal tract, including the oesophagus, stomach, small intestine, and large intestine. It builds on the physiology of the GI tract and covers the pathophysiology of diseases in this area. Revision questions on the structure and function of the oesophagus are also included.
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