Gastrointestinal System and Coeliac Disease
84 Questions
0 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What are the three components of the small intestine?

  • Cecum, Rectum, and Anal canal
  • Duodenum, Jejunum, and Ileum (correct)
  • Ileum, Jejunum, and Cecum
  • Duodenum, Jejunum, and Rectum
  • What is the dietary source of coeliac disease?

  • Sorbitol malabsorption
  • Lactose intolerance
  • Gluten sensitivity - wheat, barley, rye, and oats (correct)
  • Fructose malabsorption
  • What is the genetic source of coeliac disease?

  • The HLA C7 tissue type
  • The HLA A1 tissue type
  • The HLA B8 tissue type (correct)
  • The HLA D4 tissue type
  • What is a common gastrointestinal symptom of coeliac disease?

    <p>Diarrhea</p> Signup and view all the answers

    What is one of the extra-intestinal symptoms of coeliac disease?

    <p>Anaemia</p> Signup and view all the answers

    How is coeliac disease diagnosed?

    <p>Using antibodies to gliadin, endomysium, and transglutaminase (ttg)</p> Signup and view all the answers

    What is the primary treatment for coeliac disease?

    <p>Gluten restriction</p> Signup and view all the answers

    What is the increased risk of cancer in patients with coeliac disease?

    <p>Lymphoma and adenocarcinoma of the small bowel</p> Signup and view all the answers

    What is the consequence of vitamin K deficiency in coeliac disease?

    <p>Bleeding tendency</p> Signup and view all the answers

    Which inflammatory bowel disease is more common?

    <p>Ulcerative colitis</p> Signup and view all the answers

    What is the immune aetiology of inflammatory bowel diseases?

    <p>Defective immune system</p> Signup and view all the answers

    What is the protective effect of appendicectomy in inflammatory bowel diseases?

    <p>Protects against Ulcerative colitis</p> Signup and view all the answers

    What is the characteristic of Crohn's disease in terms of affected areas?

    <p>Affects anywhere from mouth to anus</p> Signup and view all the answers

    What is the characteristic of the wall of the bowel in Crohn's disease?

    <p>Thickened wall</p> Signup and view all the answers

    What is the microscopic feature of Crohn's disease?

    <p>Chronic inflammatory cells transmurally</p> Signup and view all the answers

    What are the two ways to improve the quality of life of a Crohn's patient?

    <p>Medical and surgical treatments</p> Signup and view all the answers

    What is the potential effect of long-term systemic corticosteroid therapy on dental treatment?

    <p>Increased risk of infection</p> Signup and view all the answers

    Which of the following is a specific dental complication that can occur as a result of Crohn's?

    <p>Cobblestones</p> Signup and view all the answers

    What is the diet used to combat orofacial granulomatosis?

    <p>Cinnamon free diet and Benzoates free diet</p> Signup and view all the answers

    What is the definition of ulcerative colitis?

    <p>Diffuse mucosal inflammation of the colon with backwash involvement of the terminal ileum</p> Signup and view all the answers

    What is the most common family history that predisposes ulcerative colitis?

    <p>Jewish</p> Signup and view all the answers

    What is the potential complication of ulcerative colitis?

    <p>Colorectal cancer</p> Signup and view all the answers

    What is the manifestation of ulcerative colitis that is more prevalent in Crohn's?

    <p>Uveitis</p> Signup and view all the answers

    What is the joint manifestation of inflammatory bowel disease that is more prevalent in Crohn's?

    <p>Type 1 Arthropathy (Pauci)</p> Signup and view all the answers

    In which inflammatory bowel disease do kidney stones occur?

    <p>Crohn's</p> Signup and view all the answers

    What is the bacteria that grows as a result of ulcerative colitis, and what does it cause?

    <p>Pyostomatitis vegetans, oral lesions</p> Signup and view all the answers

    What is the most common presentation of colon cancer on the right colon?

    <p>Anaemia</p> Signup and view all the answers

    What is the dental relevance of carcinoma in the colon?

    <p>Tooth decay and gum disease</p> Signup and view all the answers

    What is the characteristic feature of Osetomas?

    <p>Unexplained pain relieved by analgesics</p> Signup and view all the answers

    What can IBS mask?

    <p>Appendicitis and Endometriosis</p> Signup and view all the answers

    What is the treatment for Diverticular disease?

    <p>High fibre diet and maybe surgery</p> Signup and view all the answers

    What is a common symptom of IBS-C?

    <p>Hard, lumpy stools</p> Signup and view all the answers

    What is a common oral manifestation of ulcerative colitis?

    <p>Aphthous-like ulcer</p> Signup and view all the answers

    What is the purpose of pANCA serological tests in diagnosing IBDs?

    <p>To diagnose ulcerative colitis</p> Signup and view all the answers

    What is the recommended frequency for colonoscopy screening in patients with ulcerative colitis?

    <p>Every 2 years after 10 years of disease</p> Signup and view all the answers

    What is the name of the valve located in the colon?

    <p>Ileocaecal valve</p> Signup and view all the answers

    What is the prognosis for ulcerative colitis?

    <p>1/3 single attack, 1/3 relapsing attacks, 1/3 progressively worsen</p> Signup and view all the answers

    What is the purpose of cyclosporin in treating Crohn's disease?

    <p>To treat acute flares</p> Signup and view all the answers

    What is the name of the acronym used to remove infection in IBDs?

    <p>I CHOP</p> Signup and view all the answers

    What is the increased risk of colon cancer associated with?

    <p>Ulcerative colitis</p> Signup and view all the answers

    What is the purpose of aminosalicylates in treating ulcerative colitis?

    <p>To maintain remission</p> Signup and view all the answers

    What is the common dental complication associated with cyclosporin use in Crohn's disease?

    <p>Tenderness, swelling, or bleeding of the gums</p> Signup and view all the answers

    What is the common gastrointestinal symptom of coeliac disease associated with malabsorption?

    <p>Steatorrhea</p> Signup and view all the answers

    What is the type of anaemia commonly associated with coeliac disease?

    <p>Iron deficiency anaemia</p> Signup and view all the answers

    Which antibody is used first in the diagnosis of coeliac disease?

    <p>Antitransglutaminase antibodies</p> Signup and view all the answers

    What is the name of the canal that is one of the three components of the large intestine?

    <p>Anal canal</p> Signup and view all the answers

    What is the name of the part of the small intestine that is affected in coeliac disease?

    <p>All of the above</p> Signup and view all the answers

    What is the name of the procedure used to diagnose coeliac disease?

    <p>Endoscopic biopsy</p> Signup and view all the answers

    What is the percentage of people with coeliac disease that can be cured with gluten restriction?

    <p>95%</p> Signup and view all the answers

    What is the increased risk of cancer associated with coeliac disease?

    <p>All of the above</p> Signup and view all the answers

    What is the dental complication associated with coeliac disease in childhood?

    <p>Enamel defects in the permanent dentition</p> Signup and view all the answers

    What is the age at which Crohn's disease is more common?

    <p>26</p> Signup and view all the answers

    What is the protective effect of appendicectomy in inflammatory bowel diseases?

    <p>Protective of Ulcerative colitis</p> Signup and view all the answers

    What is the characteristic feature of the wall of the bowel in Crohn's disease?

    <p>All of the above</p> Signup and view all the answers

    What is the microscopic feature of Crohn's disease?

    <p>All of the above</p> Signup and view all the answers

    What is the method of diagnosis for Crohn's disease?

    <p>All of the above</p> Signup and view all the answers

    What is the treatment used to improve the quality of life of a Crohn's patient?

    <p>Both medical and surgical treatment</p> Signup and view all the answers

    What is the consequence of vitamin B12 deficiency in coeliac disease?

    <p>All of the above</p> Signup and view all the answers

    What effect may long-term systemic corticosteroid therapy have on dental treatment?

    <p>Increased risk of infection</p> Signup and view all the answers

    Which of the following is a specific dental complication that can occur as a result of Crohn's?

    <p>Gingival enlargement</p> Signup and view all the answers

    What is the oral manifestation of ulcerative colitis that appears as benign, multiple small white and yellow pustules?

    <p>Snail track ulcers</p> Signup and view all the answers

    What is the diet used to combat orofacial granulomatosis?

    <p>Cinnamon-free and Benzoates-free diet</p> Signup and view all the answers

    What is the purpose of sigmoidoscopy in diagnosing IBDs?

    <p>To check sigmoid colon</p> Signup and view all the answers

    What is the definition of ulcerative colitis?

    <p>Diffuse mucosal inflammation of the colon with backwash involvement of the terminal ileum</p> Signup and view all the answers

    What is the blood investigation used to diagnose the type of anaemia in IBD patients?

    <p>Haematemics</p> Signup and view all the answers

    What is the potential aetiology of ulcerative colitis?

    <p>Dysregulated interaction between mucosal immunology and intestinal microflora</p> Signup and view all the answers

    What is the purpose of azathioprine in treating IBDs?

    <p>To maintain remission in Ulcerative colitis</p> Signup and view all the answers

    What is the complication/risk associated with ulcerative colitis?

    <p>Colorectal cancer</p> Signup and view all the answers

    What is the cutaneous manifestation of ulcerative colitis that appears as a haemorrhagic lesion?

    <p>Pyoderma Gangrenosum</p> Signup and view all the answers

    What is the eye manifestation that is more prevalent in Crohn's?

    <p>Uveitis</p> Signup and view all the answers

    What is the joint manifestation that is more prevalent in Crohn's?

    <p>Type 1 Arthropathy (Pauci)</p> Signup and view all the answers

    What is the dental complication associated with cyclosporin use in Crohn's disease?

    <p>Tenderness, swelling, or bleeding of the gums</p> Signup and view all the answers

    What is the name of the valve located in the colon?

    <p>Ileocaecal valve</p> Signup and view all the answers

    What is the liver/billary manifestation that is more prevalent in ulcerative colitis?

    <p>Sclerosing cholangitis</p> Signup and view all the answers

    What is the bacteria that grows as a result of ulcerative colitis?

    <p>Pyostomatitis vegetans</p> Signup and view all the answers

    What is the purpose of pANCA serological tests in diagnosing IBDs?

    <p>To diagnose IBDs</p> Signup and view all the answers

    What is the increased risk of cancer associated with?

    <p>Ulcerative colitis</p> Signup and view all the answers

    What is the treatment for inducing remission in Crohn's disease?

    <p>Enteral nutrition</p> Signup and view all the answers

    What is the characteristic feature of pain in Osetomas?

    <p>Relieved by the intake of analgesics</p> Signup and view all the answers

    What is the common feature of colon cancer presentation on both colons?

    <p>Obstruction</p> Signup and view all the answers

    What is the consequence of anaemia on dental health?

    <p>Both a and b</p> Signup and view all the answers

    What is the primary treatment for Diverticular disease?

    <p>High fibre diet</p> Signup and view all the answers

    What is the characteristic feature of IBS-C?

    <p>All of the above</p> Signup and view all the answers

    What is the relevance of Virchow's node to colon cancer?

    <p>Lymphatic drainage occurs here</p> Signup and view all the answers

    Study Notes

    Gastrointestinal System Components

    • The small intestine consists of three components: Duodenum, Jejunum, and Ileum
    • The large intestine consists of three components: Cecum, Rectum, and Anal canal

    Coeliac Disease

    • Causes:
      • Dietary source: Gluten sensitivity (wheat, barley, rye, and oats)
      • Genetic source: HLA B8 tissue type
    • Symptoms:
      • Change of bowel habit (COBH)
      • Gastrointestinal symptoms:
        • Diarrhea
        • Flatulence
        • Borborygmi
        • Weight loss
        • Weakness, fatigue
        • Abdominal pain
        • Secondary lactose intolerance
        • Steatorrhoea
      • Extra-intestinal symptoms:
        • Anaemias (10-15%), especially Fe and B12 deficiency
        • Neurological symptoms (8-14%)
        • Skin disorders (10-20%)
        • Endocrine disturbances (infertility, impotence, amenorrhoea, delayed menarche)
    • Diagnosis:
      • Using antibodies to gliadin, endomysium, and transglutaminase (ttg)
      • Endoscopic biopsy
      • Pillcam camera for non-invasive inspection
    • Treatment:
      • Gluten restriction (cures 95%)
      • Corticosteroids for the remaining 5%

    Complications of Coeliac Disease

    • Increased risk of lymphoma and adenocarcinoma of the:
      • Pancreas
      • Oesophagus
      • Small bowel
      • Biliary tract
      • T and B cell non-Hodgkin lymphoma
    • Malabsorption problems:
      • B12, folate, ferritin deficiency leading to:
        • Glossitis
        • Angular cheilitis
        • Anaemia
        • Burning mouth
        • Smooth tongue
      • Vitamin K deficiency leading to bleeding tendency
      • Vitamin D deficiency leading to osteomalacia and rickets in children
    • Dental problems:
      • Enamel defects in permanent dentition, like hypoplasia, if onset is in childhood

    Inflammatory Bowel Diseases

    • Two main types: Crohn's disease and Ulcerative colitis
    • More common: Ulcerative colitis
    • Age of onset: Crohn's (26 years), Ulcerative colitis (34 years)
    • Gender ratio: Females: 1.2:1, Males: 1.2:1
    • Aetiology: Defective immune system, leading to autoimmunity
    • Hygiene: Crohn's occurs in good hygiene and developed countries, while Ulcerative colitis has no relation to hygiene
    • Protective factor: Appendicectomy is protective of Ulcerative colitis
    • Maternal act: Breastfeeding reduces the risk of developing IBD

    Crohn's Disease

    • Definition: Lifelong condition where parts of the digestive system become inflamed
    • Areas affected:
      • Any part of the digestive tract from mouth to anus
    • Phenotypes:
      • Stricturing: gradual thickening of intestinal wall, leading to stenosis/obstruction
      • Penetrating: intestinal fistulas between GI tract and other organs
      • Non-penetrating: anal fissures, abscesses
    • Macroscopic changes:
      • Thickened bowel
      • Narrowed lumen
      • Deep ulcers
      • Mucosal fissures
      • Cobblestone appearance
      • Fistulae
      • Abscesses
      • Apthoid ulceration
    • Microscopic changes:
      • Chronic inflammatory cells occurring transmurally
      • Lymphoid hyperplasia
      • Granulomas in Langhans cells
    • Diagnosis:
      • Barium enema, showing rose thorn, skip lesion, or string sign
      • Sigmoidoscopy, biopsy, colonoscopy
      • Differential diagnosis includes TB and sarcoidosis
    • Treatment:
      • Medical: glucocorticoids, immunomodulators, biologics
      • Surgical: intestinal resection
    • Complications:
      • Dental: Many dental patients are receiving long-term systemic corticosteroid therapy, which may have a profound effect on risk of infection, wound healing, and ability to handle stress
      • Specific dental lesions:
        • Diffuse labial and buccal swelling
        • Cobblestones
        • Mucosal tags
        • Linear ulcers
        • Mucogingivitis
        • Granulomatous Cheilitis
        • Gingival enlargement
        • Oral ulceration
        • Staghorn calculus in submandibular ducts
      • Non-specific dental lesions:
        • Aphthous ulcers
        • Angular cheilitis
        • Glossitis
        • Dental caries
        • Gingivitis/Periodontitis

    Ulcerative Colitis

    • Definition: Diffuse mucosal inflammation of the colon with backwash involvement of the terminal ileum
    • Areas affected:
      • Rectum is always involved
    • Conditions:
      • Proctitis
      • Left-sided colitis
      • Pancolitis
      • Backwash ileitis
    • Microscopic changes:
      • Chronic inflammatory cells occurring on the lamina propria
      • Goblet cell depletion
      • Crypt abscess
    • Aetiology:
      • Dysregulated interaction mucosal immunology
      • Intestinal microflora
      • Genetic predisposition (Jewish)
    • Symptoms:
      • Painless
      • Bloody diarrhoea with mucus
      • Associated fevers and remissions to near normal
      • Surviving mucosa
      • Crypt distortion
      • Loss of haustra
      • Absence of goblet cells
    • Diagnosis:
      • Colonoscopy and biopsy
      • Exudates, ulcerations, loss of vascular pattern, friability, continuous granularity, superficial inflammation with loss of haustration
    • Treatment:
      • High protein and high fibre diet
      • 5-ASA (5-amino salicyclic acid)
      • Sulphasalazine and mesalazine
      • Thiopurines
      • Corticosteroids
      • Surgery
    • Complications:
      • Colorectal cancer

    Gastrointestinal System Components

    • The small intestine consists of three components: Duodenum, Jejunum, and Ileum
    • The large intestine consists of three components: Cecum, Rectum, and Anal canal

    Coeliac Disease

    • Causes:
      • Dietary source: Gluten sensitivity (wheat, barley, rye, and oats)
      • Genetic source: HLA B8 tissue type
    • Symptoms:
      • Change of bowel habit (COBH)
      • Gastrointestinal symptoms:
        • Diarrhea
        • Flatulence
        • Borborygmi
        • Weight loss
        • Weakness, fatigue
        • Abdominal pain
        • Secondary lactose intolerance
        • Steatorrhoea
      • Extra-intestinal symptoms:
        • Anaemias (10-15%), especially Fe and B12 deficiency
        • Neurological symptoms (8-14%)
        • Skin disorders (10-20%)
        • Endocrine disturbances (infertility, impotence, amenorrhoea, delayed menarche)
    • Diagnosis:
      • Using antibodies to gliadin, endomysium, and transglutaminase (ttg)
      • Endoscopic biopsy
      • Pillcam camera for non-invasive inspection
    • Treatment:
      • Gluten restriction (cures 95%)
      • Corticosteroids for the remaining 5%

    Complications of Coeliac Disease

    • Increased risk of lymphoma and adenocarcinoma of the:
      • Pancreas
      • Oesophagus
      • Small bowel
      • Biliary tract
      • T and B cell non-Hodgkin lymphoma
    • Malabsorption problems:
      • B12, folate, ferritin deficiency leading to:
        • Glossitis
        • Angular cheilitis
        • Anaemia
        • Burning mouth
        • Smooth tongue
      • Vitamin K deficiency leading to bleeding tendency
      • Vitamin D deficiency leading to osteomalacia and rickets in children
    • Dental problems:
      • Enamel defects in permanent dentition, like hypoplasia, if onset is in childhood

    Inflammatory Bowel Diseases

    • Two main types: Crohn's disease and Ulcerative colitis
    • More common: Ulcerative colitis
    • Age of onset: Crohn's (26 years), Ulcerative colitis (34 years)
    • Gender ratio: Females: 1.2:1, Males: 1.2:1
    • Aetiology: Defective immune system, leading to autoimmunity
    • Hygiene: Crohn's occurs in good hygiene and developed countries, while Ulcerative colitis has no relation to hygiene
    • Protective factor: Appendicectomy is protective of Ulcerative colitis
    • Maternal act: Breastfeeding reduces the risk of developing IBD

    Crohn's Disease

    • Definition: Lifelong condition where parts of the digestive system become inflamed
    • Areas affected:
      • Any part of the digestive tract from mouth to anus
    • Phenotypes:
      • Stricturing: gradual thickening of intestinal wall, leading to stenosis/obstruction
      • Penetrating: intestinal fistulas between GI tract and other organs
      • Non-penetrating: anal fissures, abscesses
    • Macroscopic changes:
      • Thickened bowel
      • Narrowed lumen
      • Deep ulcers
      • Mucosal fissures
      • Cobblestone appearance
      • Fistulae
      • Abscesses
      • Apthoid ulceration
    • Microscopic changes:
      • Chronic inflammatory cells occurring transmurally
      • Lymphoid hyperplasia
      • Granulomas in Langhans cells
    • Diagnosis:
      • Barium enema, showing rose thorn, skip lesion, or string sign
      • Sigmoidoscopy, biopsy, colonoscopy
      • Differential diagnosis includes TB and sarcoidosis
    • Treatment:
      • Medical: glucocorticoids, immunomodulators, biologics
      • Surgical: intestinal resection
    • Complications:
      • Dental: Many dental patients are receiving long-term systemic corticosteroid therapy, which may have a profound effect on risk of infection, wound healing, and ability to handle stress
      • Specific dental lesions:
        • Diffuse labial and buccal swelling
        • Cobblestones
        • Mucosal tags
        • Linear ulcers
        • Mucogingivitis
        • Granulomatous Cheilitis
        • Gingival enlargement
        • Oral ulceration
        • Staghorn calculus in submandibular ducts
      • Non-specific dental lesions:
        • Aphthous ulcers
        • Angular cheilitis
        • Glossitis
        • Dental caries
        • Gingivitis/Periodontitis

    Ulcerative Colitis

    • Definition: Diffuse mucosal inflammation of the colon with backwash involvement of the terminal ileum
    • Areas affected:
      • Rectum is always involved
    • Conditions:
      • Proctitis
      • Left-sided colitis
      • Pancolitis
      • Backwash ileitis
    • Microscopic changes:
      • Chronic inflammatory cells occurring on the lamina propria
      • Goblet cell depletion
      • Crypt abscess
    • Aetiology:
      • Dysregulated interaction mucosal immunology
      • Intestinal microflora
      • Genetic predisposition (Jewish)
    • Symptoms:
      • Painless
      • Bloody diarrhoea with mucus
      • Associated fevers and remissions to near normal
      • Surviving mucosa
      • Crypt distortion
      • Loss of haustra
      • Absence of goblet cells
    • Diagnosis:
      • Colonoscopy and biopsy
      • Exudates, ulcerations, loss of vascular pattern, friability, continuous granularity, superficial inflammation with loss of haustration
    • Treatment:
      • High protein and high fibre diet
      • 5-ASA (5-amino salicyclic acid)
      • Sulphasalazine and mesalazine
      • Thiopurines
      • Corticosteroids
      • Surgery
    • Complications:
      • Colorectal cancer

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Description

    This quiz covers the components of the small and large intestine, as well as the causes and symptoms of coeliac disease, including dietary sources and genetic predispositions.

    More Like This

    Celiac Sprue and Gastrointestinal Diseases
    18 questions
    Coeliac Disease Pathophysiology
    2 questions
    Peptic Ulcer and Celiac Disease Overview
    45 questions
    Use Quizgecko on...
    Browser
    Browser