8. DIGESTIVE SYSTEM II - PATHOLOGIES Flashcards
The signs, symptoms, investigation procedures and key orthodox treatments of digestive system pathologies.
What is the difference between a disease and a syndrome?
In a disease, there is a clearly defined disease process, with the cause and the pathophysiology well established. Whereas a syndrome is when a patient presents with a collection of symptoms and signs, but the underlying cause might be different for each person.
What is oral thrush?
A fungal infection of the mouth which is a sign of low immunity in the body.
Explain how broad-spectrum antibiotics contribute to the development of oral thrush?
broad-spectrum antibiotics destroys healthy microflora like lactobacillus and allows for opportunistic fungal overgrowth of candida albicans.
Name TWO possible causes, other than antibiotics, for oral thrush?
- compromised immunity (cancer, HIV / AIDS)
- nutritional deficiencies (iron, zinc, vit B12)
- oral steroid inhaler use
List two characteristic signs / symptoms of oral thrush
- White patches (cottage cheese consistency) on the oral mucosa that can be wiped off
- Red raw appearance to the underlying tissue
- Loss of taste or unpleasant taste in the mouth
Define mouth ulcers
Ulceration of areas of the oral mucosa that are generally painful due to loss of the mucosal layer.
Name two gastrointestinal pathologies that may cause mouth ulcers
Crohn’s Disease and Coeliac’s Disease
What causes cold sores?
Cold sores are caused by Herpes Simplex Virus type I that lies dormant in the trigeminal nerve and gets triggered when immunity is low. Other triggers are UV light (sunlight exposure), stress, steroid use, trauma and local infections.
Name five foods that can trigger GORD
Chocolate, citrus, tomatoes, onions, spicy foods, dairy, fatty foods, coffee, alcohol, carbonated drinks
Using definitions, compare an abscess with gingivitis
An abscess is a localised pocket of pus caused by bacterial infection, surrounded by inflammation which commonly affects the oral cavity and intestines. Gingivitis is a bacterial infection of the gums which get inflamed and bleed.
Explain why poor nutrition contributes to gingivitis
A low level of nutrients and anti-oxidants resulting from a poor diet will hamper the body’s ability to maintain an innate state of wellbeing in the oral environment (and systemically).
List two causes, other than nutritional, for gingivitis.
Long term steroid use, smoking, poor dental hygiene, amalgams, diabetes mellitus
How does periodontal disease differ from gingivitis?
Whilst gingivitis is a bacterial infection of the gums, periodontal disease is a serious bacterial infection of the gums and bone surrounding the teeth and usually develops when gingivitis is left untreated.
Name three nutritional deficiencies associated with angular stomatitis
Vitamin B2 (Riboflavin), B9 (Folic Acid) and Iron
Name one infection that can contribute to angular stomatitis
Staphylococcus Aureus
Candida Albicans
Define xerostomia
Dry mouth caused by reduced or absent flow of saliva
Name one autoimmune cause of xerostomia
Sjögren’s syndrome (Autoimmune attack on exocrine glands)
List two signs/symptoms of xerostomia
Dry mouth
Halitosis
Burning sensation
Speech and swallowing interference
List three causes of xerostomia other than autoimmune disease
Stress
Radiotherapy
Menopause
Describe two key differences between cleft palate and cleft lip
Cleft palate is malformation of the palate in embryonic development, while cleft lip is in the lip. Cleft palate causes difficulty in speech, feeding and hearing. Cleft lip can be complete or partial, unilateral or bilateral.
Name one cause for both cleft lip and palate under the following titles:
a. environmental
b. teratogens
a. Maternal disease
b. Radiation, Vitamin A (excess of)
Name two causes of oral cancer
smoking
HPV infection
alcohol
Define salivary calculi
stones forming in the salivary glands due to a metabolic imbalance affecting mineral concentration
Why is salivary calculi often referred to as the ‘mealtime syndrome’?
Pain usually presents at mealtimes since the saliva that is attemting to be released comes up against the blockage in the salivary ducts.
List one cause of salivary calculi
Sjögren’s syndrome
Dehydration
Using definitions, compare GORD with hiatus hernia
GORD is the regurgitation of stomach acid into the oesophagus due to a relaxed lower oesophageal sphincter which presents as heartburn. Hiatus hernia is the physical protrusion of the top part of the stomach through the opening in the diaphragm, which could present as GORD
Name two causes of GORD that is not food related
Hiatus hernia
Pregnancy
Stress
Obesity
Explain why GORD might be mistaken for a cardiac pathology
It presents with the same intense retrosternal pain
What are he signs and symptoms of oral cancer
Red or white patches on oral mucosa/tongue
Difficulty eating and breathing
Name one way in which the symptoms of GORD are aggravated
Lying down
Name one complication of GORD
Barrett’s Oesophagus (pre-cancerous cell changes)
Cancer
List two causes of hiatus hernia
Increased abdominal pressure due to:
Heavy lifting; hard coughing/sneezing; pregnancy; childbirth; violent vomiting; straining with constipation; obesity; smoking; drug abuse; stress; hereditary
List two dietary/lifestyle causes of oesophageal cancer
Smoking
Low fruit and veg diet
Alcohol
GORD -> Barrett’s Oesophagus
Using definitions, compare acute gastritis with chronic gastritis
Acute gastritis is the sudden onset of inflammation of the stomach mucosa causing breakdown of the stomach lining.
Chronic gastritis is the inflammation of the stomach mucosa for more than 4-6 weeks.
Outline the pathophysiology of:
a) Acute gastritis
b) Chronic gastritis
a) Acute gastritis develops due to insufficient mucus production in the stomach (due to reduction of prostaglandin synthesis) leaving the stomach mucosa vulnerable to erosion. The acute inflammation is also characterised by neutrophil infiltrate.
b) Acute gastritis develops when there is prolonged low-grade inflammation resulting in fibrosis and hence loss of elasticity and peristalsis. Lymphocytes and macrophages are characteristically found in the lamina propria.
Name one bacterial cause of acute gastritis
Helicobacter Pylori
How do NSAIDS contribute to acute gastritis?
NSAIDS inhibit prostaglandin production which reduces the gastric mucosal barrier, leaving it vulnerable to infection, damage and inflammation.
How do the signs and symptoms differ between acute and chronic gastritis?
The symptoms of acute gastritis is much more noticeable, with epigastric pain that is worse with food intake, nausea, vomiting and loss of appetite. Chronic gastritis presents with few symptoms, but there is discomfort with heavy meals.