Ulcerative Colitis and Inflammatory Bowel Disease
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Questions and Answers

What is the primary mechanism by which Helicobacter pylori survives in the acidic environment of the stomach?

  • Histamine and gastrin stimulation of acid secretion
  • Urease and ammonia buffering mechanism (correct)
  • Production of mucus and intrinsic factor
  • Prostaglandins E2 and I2 inhibition of acid secretion
  • What is the characteristic pathological feature of acute gastritis?

  • Intestinal metaplasia
  • Surface epithelial degeneration (correct)
  • Regenerative hyperplasia of pit-lining epithelium
  • Chronic fundal gastritis
  • What is the major stimulant to gastric acid secretion?

  • Protein (correct)
  • Prostaglandins E2 and I2
  • Histamine and gastrin
  • Acetylcholine and hormone gastrin
  • What is the association between Helicobacter pylori infection and gastric mucosa?

    <p>Helicobacter pylori is associated with intestinal metaplasia</p> Signup and view all the answers

    What is the primary reason Helicobacter pylori is considered first-line treatment for peptic ulcers?

    <p>It vastly improves the odds of non-recurrence of the ulcer</p> Signup and view all the answers

    What is the characteristic of duodenal ulcers?

    <p>Hypersecretion of acid and pepsin</p> Signup and view all the answers

    What is the initial response to H. pylori infection?

    <p>Acute gastritis</p> Signup and view all the answers

    What is the primary difference between Crohn's disease and Ulcerative Colitis?

    <p>Crohn's disease causes 'skip lesions', while Ulcerative Colitis causes diffuse superficial inflammation</p> Signup and view all the answers

    What is the primary complication of Ulcerative Colitis that increases the risk of colon cancer?

    <p>Chronic inflammation</p> Signup and view all the answers

    What is the primary mechanism by which Crohn's disease causes anaemia?

    <p>Malabsorption of vitamin B12 and folic acid</p> Signup and view all the answers

    What is the primary characteristic of Ulcerative Colitis that distinguishes it from other inflammatory bowel diseases?

    <p>It is limited to the sigmoid colon and rectum</p> Signup and view all the answers

    What is the primary reason why Crohn's disease is difficult to differentiate from Ulcerative Colitis?

    <p>Both diseases have similar morphology</p> Signup and view all the answers

    What is the primary defect in the pathophysiology of gastric ulcers?

    <p>Increased mucosal permeability to hydrogen ions</p> Signup and view all the answers

    What is the most common type of peptic ulcer?

    <p>Duodenal ulcer</p> Signup and view all the answers

    What is a recognised risk factor in the development of gastric carcinoma?

    <p>Helicobacter pylori infection</p> Signup and view all the answers

    What is the role of antacids in the treatment of gastric ulcers?

    <p>Neutralise acid secretion</p> Signup and view all the answers

    What is the characteristic morphology of gastric ulcers?

    <p>Clear-cut edges with overhanging base</p> Signup and view all the answers

    What is the effect of Helicobacter pylori infection on gastric mucosa?

    <p>Increase mucosal permeability to hydrogen ions</p> Signup and view all the answers

    What is the consequence of replacing muscularis propria with fibrous tissue in gastric ulcers?

    <p>Shrinkage of tissue and deformities</p> Signup and view all the answers

    What is the role of proton pump inhibitors in the treatment of gastric ulcers?

    <p>Inhibit acid secretion</p> Signup and view all the answers

    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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    SBI241 - Week 8.docx

    Description

    This quiz covers the pathogenesis, clinical features, and diagnosis of ulcerative colitis and inflammatory bowel disease, including contributing factors and treatment options.

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