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path 2 test 3 > ch 14 > Flashcards

ch 14 Flashcards

0
Q

what are aphthous ulcers

A

thin exudate (white), red rim
idiopathic self-limiting
cause stress, fever, certain foods

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1
Q

what is another name for aphthous ulcer

A

canker sore

recurrent aphthous stomatitis

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2
Q

what are the signs of Herpes simplex virus

A

1-3 vesicles (blister like)
itching, burning, tingling and pyrexia (fever)
self limiting

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3
Q

what is primary HSV

A

in young children
80% asymptomatic
10-20% acute herpetic gingivostomatitis (this is when there is a breakout all over the face)

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4
Q

what is HSV in adults

A

if it gets reactivation then it is called recurrent herpetic stomatitis
(dormant in trigeminl ganglion)

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5
Q

what is HSV-1 and HSV-2

A

HSV-1 orofacial

HSV-2 genital

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6
Q

what are some of the things that could trigger HSV

A 
uv light 
pyrexia 
cold 
trauma 
URTI 
pregnancy
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7
Q

what is it called if HSV spreads to the nervous system (brain and spinal cord)

A

encephalitis

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8
Q

what is another name for oral candidiasis and what will cause this

A

thrush

Candida albicans

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9
Q

what does oral candidiasis look like

A

gray-to-white shit in the mouth

may be scraped off

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10
Q

what % of newborns have oral candidiasis

A

37%

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11
Q

what is fibroma

A

submucosal fibrotic mass near the bite line

caused by chronic irritation

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12
Q

what is pyogenic granuloma

A 
caused by hormonal factors, irritation 
vascular mass (red-to-purple), gingival
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13
Q

what is leukoplakia

A

raised, white patch
DX of exclusion
caused by inflammation
biopsy to rule out CA (SCC)

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14
Q

what is Erythroplakia

A

looks like leukoplakia
50% pre-cancerous
red, velvety area

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15
Q

what is hairy leukoplakia

A

associated with EBV and people with AIDS

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16
Q

what is verrucous leukoplakia

A

associated with HPV
warty appearance
commonly transformation into SCC

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17
Q

when is oral cancer normally DX

A

in advanced stages

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18
Q

if you have oral cancer what is it most likely to be

A

Squamous cell carcinoma (95%)
painful
multiple primary tumors

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19
Q

what are the risk factors for oral cancer

A

alcohol
tobacco
>30 years old
HPV-16

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20
Q

what does SCC look like

A

whitish-gray or red

mimics leukoplakia or erythoplakia

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21
Q

if you have SCC where is it most likely to metastasis to

A

the cervical lymph nodes

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22
Q

what could give you a better prognosis if you have SCC

A

HPV-16

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23
Q

what is the most common gland that gets salivary gland disease

A

parotid gland

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24
Q

what are some of the signs of salivary gland disease

A

xerostomia (dry mouth)

dysphagia, dysarthria (difficulty swallowing and speaking)

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25
Q

what is sialadenitis

A

inflammation and enlargement of the salivary glands

MC cause is mumps (MC viral cause of parotids)

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26
Q

what is a mucocele

A

blockage/rupture of salivary gland

this will cause inflammation

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27
Q

what % of salivary gland neoplasms happen in the parotid gland and what % of those are malignant

A

65-80% and
15-30% malignant
the bigger the gland the higher % of incidents and lower % of malignant

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28
Q

what % of salivary gland neoplasms happen in the submndibular gland and what % of those are malignant

A

10% and

40% malignant

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29
Q

what % of salivary gland neoplasms happen in the sublingual and minor salivary gland and what % of those are malignant

A

10-25%

50-90% malignancy

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30
Q

what is a pleomorphic adenoma

A

it is a benign tumor in the parotid gland
it accounts for 60% of the parotid gland
risk for malignant development

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31
Q

what is achalasia

A 
this is located at the inferior part of the esophagus
has the triad 
1 incomplete LES relaxation 
2 increased LES tone 
3 esophageal aperistalsis
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32
Q

what are the signs of when you have achalasia

A

Dysphagia (difficult swallowing)

regurgitation

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33
Q

what are primary and secondary Achalasia cause by

A

Primary: is idiopathic (MC),
secondary: is inflammation near auerbach’s plexus

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34
Q

what is Esophageal varices

A

it is when you have PORTAL HTN that will cause the blood to shunt blood to ESOPHAGEAL VENOUS PLEXUS
90% of the time this is caused by liver cirrhosis
could rupture and bleed out

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35
Q

what is esophagitis

A

this is a common and all it is is esophageal inflammation

symptoms do not correlate degree of inflammation

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36
Q

what is GERD

A

idiopathic inflammation of the lower esophagus

heartburn “SOUR BRASH “

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37
Q

what will cause chemical esophagitis and what is it

A

acute inflammation that is caused by tobacco, alcohol, pill-induced

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38
Q

what will cause infectious esophagitis

A

severely debilitated or immunosuppressed (AIDS)

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39
Q

what is mallory-weiss tear

A

longitudinal tears at the gastroesophageal junction caused by forceful vomiting
risks: alcoholics, bulimia, acute illness

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40
Q

what is a hiatal hernia

A

this is when some part or the stomach protrudes through the esophageal hiatus.

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41
Q

what is a axial(sliding) hiatal hernia

A

MC 95%

bell shaped dilation

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42
Q

what is a non-axial (rolling) hiatal hernia

A

this is when a separate portion of the stomach protrudes

look at the pick on page 7 of the paper copy

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43
Q

how common is a hiatal hernia

A

20% of all adults
70% of those >70 years old
90% are asymptomatic
GERD like symptoms

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44
Q

what is Barrett esophagus

A

intestinal metaplasia of the esophagus (the stomach cells have started to grow out through the esophagus)
pre-cancerous lesion

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45
Q

what are you at risk for if you have Barrett esophagus

A

esophageal adenocarcinoma (30-100x)

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46
Q

what does a Barrett Esophagus look like

A

red, velvety mucosa

bands (tongues) that extend superiorly

47
Q

what is a adenocarcinoma and what are the risk factors

A

it is esophageal tumors,

risks: US, Barrett esophagus, GERD, Caucasians, Males (7X)

48
Q

what is squamous cell carcinoma in the esophageal tumors

A

it is the most common esophageal cancer in the world about 90%

49
Q

what are some of the features of adenocarcinoma

A

inverse relationship with fruits vegetable intake
has a early invasion of the lymphatics (DX late)
DX in the late stage

50
Q

where in the esophagus is esophageal adenocarcinoma

A

the distal 1/3

51
Q

who is at risk to getting squamous cell carcinoma in the esophagus

A

> 45 year olds, males(4X) and african americans

52
Q

what is the prognosis of squamous cell carcinoma in the esophagus

A

poor <10% 5 year survival rate

53
Q

where is the squamous cell carcinoma in the esophagus located

A

in the middle 1/3

this will also cause strictures (narrowing)

54
Q

what are some of the signs of acute gastritis

A 
TRANSIENT mucosal inflammation (pain) 
epigastric pain 
nausea 
vomiting 
anorexia
55
Q

what can cause Acute gastritis

A

NSAIDs (aspirin) the more you take the worse the inflammation gets

56
Q

what are acute peptic ulceration associated with

A

severe physiological stress and NSAIDs

57
Q

what is cushing ulcers

A

it is a acute peptic ulceration

caused by intracranial disease

58
Q

what are some of the signs of acute peptic ulcerations (cushing ulcers)

A

vomiting up of “coffee-ground” hematemesis

59
Q

how does chronic gastritis compared to acute gastritis

A

less severe, more prolonged

60
Q

what are the causes of chronic gastritis

A 
helicobacter pylori (MC)
additional factors upset mucosal balance
61
Q

what do you have a great risk of getting if you have chronic gastritis

A

stomach cancer

(MC) gastric adenocarcinoma

62
Q

who is at the greatest risk of having a H. pylori infection

A

poor childhood sanitation/hygiene

63
Q

what is the effects does a chronic gastritis have with a H pylori infection

A

increase in acid production

64
Q

where are you most likely to get a peptic ulcer disease (PUD)

A 
proximal duodenum (MC (4X))
gastric antrum
65
Q

what is the lifetime risk of getting a PUD

A

10% males

4% females

66
Q

what are the causes of PUD

A

NSAIDs

H. pylori (MC) (70-90%)

67
Q

what is a gastric polyps

A

mass projecting above surrounding mucosa (into the lumen)

68
Q

what is the only way to determine the type of gastric polyps

A

with a biopsy

69
Q

what gastric polyps are the most concerning and why

A

gastric adenomas because 30% transition into adenocarcinomas

70
Q

what is the most common type of gastric carcinomas

A

gastric adenocarcinomas (90%)

71
Q

what do gastric carcinomas (adenocarcinomas) resemble

A

chronic gastritis

72
Q

when it comes to gastric carcinomas (adenocarcinomas) when are the symptoms developed and what is the outcome

A

MC Dx. late and <20% 5 year survival rate

73
Q

what are the 4 intestinal obstructions

A

herniation
adhesions
intussusception
volvulus

74
Q

what is a herniation

A

abdominal wall defect allows intestinal protrusion (inguinal/umbilical), edema, strangulation

75
Q

what is an adhesions

A

inflammatory fibrosis, adherent intestinalsegments, may create closed loops

76
Q

what is a Intussusception:

A

telescoping of the proximalbowel into the distal segment

77
Q

what is a Volvulus:

A

twisting a loop of bowel, possible infarction

78
Q

what is Meckel diverticulum

A

Congenital, blind-ended outpouching of the small intestine

has the rule of two (this means if he is asking a question about this just pick anything with a 2 in it)

79
Q

what is Hirschsprung disease

A

Lack of ganglia in distal intestines causing Failure to pass meconium (the first poop when you are a new born)

80
Q

what is Ischemic bowel disease

A

cutting of the blood to the intestine causing infarction

81
Q

what will cause a Thrombosis Ischemic bowel disease

A

atherosclerosis, vasculitis, dissecting aneurysm, inflammation (CA),hypercoagulability, cirrhosis

82
Q

what will cause a Arterial embolism Ischemic bowel disease

A

myocardial infarction (muralthrombus), angioplasty, endarterectomy

83
Q

what will cause a Non-occlusive ischemia Ischemic bowel disease

A

heart failure, shock, dehydration, vasoconstrictive meds

84
Q

what are the signs of acute Ischemic bowel disease

A

sudden/severe abdominal pain (rigidity), nausea, vomiting, bloody diarrhea (melanotic)
• Hours: shock/vascular collapse

85
Q

what are the signs of chronic Ischemic bowel disease

A

abdominal distention & G.I. bleeding

86
Q

who is at the greatest risk for Ischemic bowel disease

A

elderly

87
Q

what is Angiodysplasia

A

Tortuous/abnormal dilations

• Submucosal & mucosal blood vessels

88
Q

where is the most common place to get Angiodysplasia

A

Cecum or ascending colon

89
Q

what is the cause of Angiodysplasia

A

Idiopathic

90
Q

who usually gets hemorrhoids and what are some of the risk factors for them

A 
>50 years old 
↑ intra-abdominal pressure (Valsalva's)
 Liver cirrhosis (portal HTN)
91
Q

where are the internal and external hemorrhoids

A

internal ↑ anorectal line (columnar cells)

External: below anorectal line (squamous cells)

92
Q

what are some of the signs of hemorrhoids

A

may bleed with bowel movement
irritates surrounding tissues
perianal pruritus (itching)

93
Q

what is the cause of diarrheal diseases

A

intestinal inflammation that cause diarrhea that might cause malabsorption

94
Q

what Steatorrhea poop

A

bulky, frothy, greasy, yellow/gray

95
Q

what is dysentery

A

painful, bloody, small volume diarrhea

96
Q

what are the features of malabsorption

A
  • Weight loss, muscle wasting (cachexia)
  • Abdominal distension
  • Borborygmus
  • Flatulence
97
Q

what are the the consequences of malabsorption

A 
Anemia (iron, B12, folate), vitamin deficiencies, osteopenia, tetany (↓ Ca++), amenorrhea, 
impotence, infertility, hyperkeratosis, edema, 
peripheral neuropathies (Vit. B12)
98
Q

what is Celiac disease

A

Immune-mediated reaction to gluten (gliadin)

Non-infectious malabsorption

99
Q

what will Celiac disease do to the small intestine

A

Loss of mucosal & brush border surface area called Villous atrophy

100
Q

in the US what % have celiac disease and who is most likely to get it

A

1% of US
Caucasians
30-60

101
Q

what are some of the signs of celiac disease

A

steatorrhea

bloating/destention

102
Q

what can celiac disease cause on the skin

A

dermatitis herpetiformis

103
Q

what do you need to know about Environmental enteropathy

A

Recurring, acute: diarrhea, fever, malaise
responds to antibiotics
villus flattening
MC age 2-3 years

104
Q

what is infectious enterocolitis

A

microbial infections that will cause inflammation and diarrhea
major global heath problem

105
Q

cholera

A

cause vibrio cholerae
massive chloride ion secretion
“rice water stool
hypotension/shock

106
Q

campylobacter enterocolitis

A 
AKA traveler's diarrhea (E.coli) 
cause campylobacter jejuni 
MC bacterial enteric pathogen in the US 
enterotoxins 
self-limited colitis
107
Q

pseudomembranous colitis

A

AKA antibiotic-associated colitis
cause clostridium difficile
risk hospitalization

108
Q

Viral gastroenteritis

A

50% of all gastroenteritis

children: rotavirus
adult: norovirus

109
Q

parasitic disease

A

Cause Giardia lamblia
resists cold and chlorine
“beaver fever”
alters SI enzymes

110
Q

what is Irritable bowel syndrome

A

altered bowel habits
no cellular abnormalities
MC 20-40 females
NO INFLAMMATION

111
Q

what is inflammatory bowel disease

A

idiopathic
crohn disease
ulcerative colitis

112
Q

what is crohn disease

A

skip lesions
MC in ileum
transmural (throughout the wall)

113
Q

what is ulcerative colitis

A 
starts in the rectum 
effects the mucosa and submucosa 
20-25 year olds 
smoking inhibitory 
stringy and bloody
114
Q

what is a adenomas polyps

A

onset >40 years of age
50% of all US adults >50 years old
could turn into adenocarcinomas

115
Q

what is familial adenomatous polyposis

A

numerous adenomas

100% chance of CA by age 30

path 2 test 3 (2 decks)

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