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Questions and Answers
What is the primary mechanism by which Helicobacter pylori survives in the acidic environment of the stomach?
What is the primary mechanism by which Helicobacter pylori survives in the acidic environment of the stomach?
What is the characteristic pathological feature of acute gastritis?
What is the characteristic pathological feature of acute gastritis?
What is the major stimulant to gastric acid secretion?
What is the major stimulant to gastric acid secretion?
What is the association between Helicobacter pylori infection and gastric mucosa?
What is the association between Helicobacter pylori infection and gastric mucosa?
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What is the primary reason Helicobacter pylori is considered first-line treatment for peptic ulcers?
What is the primary reason Helicobacter pylori is considered first-line treatment for peptic ulcers?
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What is the characteristic of duodenal ulcers?
What is the characteristic of duodenal ulcers?
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What is the initial response to H. pylori infection?
What is the initial response to H. pylori infection?
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What is the primary difference between Crohn's disease and Ulcerative Colitis?
What is the primary difference between Crohn's disease and Ulcerative Colitis?
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What is the primary complication of Ulcerative Colitis that increases the risk of colon cancer?
What is the primary complication of Ulcerative Colitis that increases the risk of colon cancer?
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What is the primary mechanism by which Crohn's disease causes anaemia?
What is the primary mechanism by which Crohn's disease causes anaemia?
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What is the primary characteristic of Ulcerative Colitis that distinguishes it from other inflammatory bowel diseases?
What is the primary characteristic of Ulcerative Colitis that distinguishes it from other inflammatory bowel diseases?
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What is the primary reason why Crohn's disease is difficult to differentiate from Ulcerative Colitis?
What is the primary reason why Crohn's disease is difficult to differentiate from Ulcerative Colitis?
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What is the primary defect in the pathophysiology of gastric ulcers?
What is the primary defect in the pathophysiology of gastric ulcers?
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What is the most common type of peptic ulcer?
What is the most common type of peptic ulcer?
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What is a recognised risk factor in the development of gastric carcinoma?
What is a recognised risk factor in the development of gastric carcinoma?
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What is the role of antacids in the treatment of gastric ulcers?
What is the role of antacids in the treatment of gastric ulcers?
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What is the characteristic morphology of gastric ulcers?
What is the characteristic morphology of gastric ulcers?
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What is the effect of Helicobacter pylori infection on gastric mucosa?
What is the effect of Helicobacter pylori infection on gastric mucosa?
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What is the consequence of replacing muscularis propria with fibrous tissue in gastric ulcers?
What is the consequence of replacing muscularis propria with fibrous tissue in gastric ulcers?
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What is the role of proton pump inhibitors in the treatment of gastric ulcers?
What is the role of proton pump inhibitors in the treatment of gastric ulcers?
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Study Notes
Inflammatory Bowel Disease
- Pathogenesis: Inappropriate mucosal immune activation
- Contributing factors: Genetics, epithelial defects, and microbiota
- Clinical features:
- Diarrhea
- Fever
- Abdominal pain
- Bloody stool
- Weight loss
- Diagnosis:
- Colonoscopy
- Biopsy
Ulcerative Colitis
- Chronic relapsing inflammatory disease
- Unknown aetiology
- Causes ulceration of the colonic mucosa
- Affects sigmoid colon and rectum
- Morphology:
- Diffuse superficial inflammation (mucosa and submucosa)
- Shallow ulcers
- Crypt abscesses
- Crypt atrophy
- Pseudopolyps
- Symptoms:
- Diarrhea (10-20 days)
- Blood in stools
- Cramping
- Treatment:
- Broad-spectrum antibiotics and steroids
- Immunosuppressive agents
- Surgery
- Complications:
- Haemorrhage
- Electrolyte disturbances
- Toxic megacolon
- Extra-GI involvement (skin, liver, eye, and joints)
- Increased risk of colon cancer
Crohn's Disease
- Causes "skip lesions"
- Unknown aetiology
- Affects any part of the digestive tract (mouth to anus)
- Difficult to differentiate from ulcerative colitis
- Morphology:
- Granulomatous colitis
- Ileocolitis or regional enteritis
- Ulcerations can produce longitudinal and transverse inflammatory fissures
- Anaemia may result from malabsorption of vitamin B12 and folic acid
- Can cause transmural inflammation and fistula formation
Peptic Ulcer Disease
- Gastric ulcer: Defective gastric mucosa protects and repairs itself
- Duodenal ulcer: Hypersecretion of acid and pepsin erosion of the duodenal mucosa
- Gastric juice composition:
- Pepsin
- Hydrochloric acid
- Mucus
- Intrinsic factor
- Major stimulant to gastric acid secretion: Protein
- Inhibitors of acid secretion:
- Prostaglandins E2 and I2
- Hormone gastrin, neurotransmitter acetylcholine, and local hormone histamine
Gastritis
- Inflammatory disorder of the gastric mucosa
- Types:
- Acute gastritis: Caused by chemical injury, ischaemia, physical stress, or H.pylori infection
- Chronic gastritis: Chronic fundal gastritis and chronic antral gastritis
- Helicobacter-associated gastritis:
- Gram-negative rod
- Binds to epithelium
- Survives acidic environment due to urease and ammonia production
- Risk factor for developing gastric adenocarcinoma
Helicobacter pylori
- Infection causes chronic active gastritis, gastric and duodenal ulcers, and gastric carcinoma
- Treatment regimens:
- Antibiotics
- Proton pump inhibitors
- H2-receptor antagonists
- Bismuth compounds
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Description
This quiz covers the pathogenesis, clinical features, and diagnosis of ulcerative colitis and inflammatory bowel disease, including contributing factors and treatment options.
