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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
what are some of the signs of salivary gland disease
xerostomia (dry mouth) | dysphagia, dysarthria (difficulty swallowing and speaking)
25
what is sialadenitis
inflammation and enlargement of the salivary glands | MC cause is mumps (MC viral cause of parotids)
26
what is a mucocele
blockage/rupture of salivary gland | this will cause inflammation
27
what % of salivary gland neoplasms happen in the parotid gland and what % of those are malignant
65-80% and 15-30% malignant the bigger the gland the higher % of incidents and lower % of malignant
28
what % of salivary gland neoplasms happen in the submndibular gland and what % of those are malignant
10% and | 40% malignant
29
what % of salivary gland neoplasms happen in the sublingual and minor salivary gland and what % of those are malignant
10-25% | 50-90% malignancy
30
what is a pleomorphic adenoma
it is a benign tumor in the parotid gland it accounts for 60% of the parotid gland risk for malignant development
31
what is achalasia
``` this is located at the inferior part of the esophagus has the triad 1 incomplete LES relaxation 2 increased LES tone 3 esophageal aperistalsis ```
32
what are the signs of when you have achalasia
Dysphagia (difficult swallowing) | regurgitation
33
what are primary and secondary Achalasia cause by
Primary: is idiopathic (MC), secondary: is inflammation near auerbach's plexus
34
what is Esophageal varices
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
35
what is esophagitis
this is a common and all it is is esophageal inflammation | symptoms do not correlate degree of inflammation
36
what is GERD
idiopathic inflammation of the lower esophagus | heartburn "SOUR BRASH "
37
what will cause chemical esophagitis and what is it
acute inflammation that is caused by tobacco, alcohol, pill-induced
38
what will cause infectious esophagitis
severely debilitated or immunosuppressed (AIDS)
39
what is mallory-weiss tear
longitudinal tears at the gastroesophageal junction caused by forceful vomiting risks: alcoholics, bulimia, acute illness
40
what is a hiatal hernia
this is when some part or the stomach protrudes through the esophageal hiatus.
41
what is a axial(sliding) hiatal hernia
MC 95% | bell shaped dilation
42
what is a non-axial (rolling) hiatal hernia
this is when a separate portion of the stomach protrudes | look at the pick on page 7 of the paper copy
43
how common is a hiatal hernia
20% of all adults 70% of those >70 years old 90% are asymptomatic GERD like symptoms
44
what is Barrett esophagus
intestinal metaplasia of the esophagus (the stomach cells have started to grow out through the esophagus) pre-cancerous lesion
45
what are you at risk for if you have Barrett esophagus
esophageal adenocarcinoma (30-100x)
46
what does a Barrett Esophagus look like
red, velvety mucosa | bands (tongues) that extend superiorly
47
what is a adenocarcinoma and what are the risk factors
it is esophageal tumors, | risks: US, Barrett esophagus, GERD, Caucasians, Males (7X)
48
what is squamous cell carcinoma in the esophageal tumors
it is the most common esophageal cancer in the world about 90%
49
what are some of the features of adenocarcinoma
inverse relationship with fruits vegetable intake has a early invasion of the lymphatics (DX late) DX in the late stage
50
where in the esophagus is esophageal adenocarcinoma
the distal 1/3
51
who is at risk to getting squamous cell carcinoma in the esophagus
>45 year olds, males(4X) and african americans
52
what is the prognosis of squamous cell carcinoma in the esophagus
poor <10% 5 year survival rate
53
where is the squamous cell carcinoma in the esophagus located
in the middle 1/3 | this will also cause strictures (narrowing)
54
what are some of the signs of acute gastritis
``` TRANSIENT mucosal inflammation (pain) epigastric pain nausea vomiting anorexia ```
55
what can cause Acute gastritis
NSAIDs (aspirin) the more you take the worse the inflammation gets
56
what are acute peptic ulceration associated with
severe physiological stress and NSAIDs
57
what is cushing ulcers
it is a acute peptic ulceration | caused by intracranial disease
58
what are some of the signs of acute peptic ulcerations (cushing ulcers)
vomiting up of "coffee-ground" hematemesis
59
how does chronic gastritis compared to acute gastritis
less severe, more prolonged
60
what are the causes of chronic gastritis
``` helicobacter pylori (MC) additional factors upset mucosal balance ```
61
what do you have a great risk of getting if you have chronic gastritis
stomach cancer | (MC) gastric adenocarcinoma
62
who is at the greatest risk of having a H. pylori infection
poor childhood sanitation/hygiene
63
what is the effects does a chronic gastritis have with a H pylori infection
increase in acid production
64
where are you most likely to get a peptic ulcer disease (PUD)
``` proximal duodenum (MC (4X)) gastric antrum ```
65
what is the lifetime risk of getting a PUD
10% males | 4% females
66
what are the causes of PUD
NSAIDs | H. pylori (MC) (70-90%)
67
what is a gastric polyps
mass projecting above surrounding mucosa (into the lumen)
68
what is the only way to determine the type of gastric polyps
with a biopsy
69
what gastric polyps are the most concerning and why
gastric adenomas because 30% transition into adenocarcinomas
70
what is the most common type of gastric carcinomas
gastric adenocarcinomas (90%)
71
what do gastric carcinomas (adenocarcinomas) resemble
chronic gastritis
72
when it comes to gastric carcinomas (adenocarcinomas) when are the symptoms developed and what is the outcome
MC Dx. late and <20% 5 year survival rate
73
what are the 4 intestinal obstructions
herniation adhesions intussusception volvulus
74
what is a herniation
abdominal wall defect allows intestinal protrusion (inguinal/umbilical), edema, strangulation
75
what is an adhesions
inflammatory fibrosis, adherent intestinalsegments, may create closed loops
76
what is a Intussusception:
telescoping of the proximalbowel into the distal segment
77
what is a Volvulus:
twisting a loop of bowel, possible infarction
78
what is Meckel diverticulum
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
what is Hirschsprung disease
Lack of ganglia in distal intestines causing Failure to pass meconium (the first poop when you are a new born)
80
what is Ischemic bowel disease
cutting of the blood to the intestine causing infarction
81
what will cause a Thrombosis Ischemic bowel disease
atherosclerosis, vasculitis, dissecting aneurysm, inflammation (CA),hypercoagulability, cirrhosis
82
what will cause a Arterial embolism Ischemic bowel disease
myocardial infarction (muralthrombus), angioplasty, endarterectomy
83
what will cause a Non-occlusive ischemia Ischemic bowel disease
heart failure, shock, dehydration, vasoconstrictive meds
84
what are the signs of acute Ischemic bowel disease
sudden/severe abdominal pain (rigidity), nausea, vomiting, bloody diarrhea (melanotic) • Hours: shock/vascular collapse
85
what are the signs of chronic Ischemic bowel disease
abdominal distention & G.I. bleeding
86
who is at the greatest risk for Ischemic bowel disease
elderly
87
what is Angiodysplasia
Tortuous/abnormal dilations | • Submucosal & mucosal blood vessels
88
where is the most common place to get Angiodysplasia
Cecum or ascending colon
89
what is the cause of Angiodysplasia
Idiopathic
90
who usually gets hemorrhoids and what are some of the risk factors for them
``` >50 years old ↑ intra-abdominal pressure (Valsalva's) Liver cirrhosis (portal HTN) ```
91
where are the internal and external hemorrhoids
internal ↑ anorectal line (columnar cells) | External: below anorectal line (squamous cells)
92
what are some of the signs of hemorrhoids
may bleed with bowel movement irritates surrounding tissues perianal pruritus (itching)
93
what is the cause of diarrheal diseases
intestinal inflammation that cause diarrhea that might cause malabsorption
94
what Steatorrhea poop
bulky, frothy, greasy, yellow/gray
95
what is dysentery
painful, bloody, small volume diarrhea
96
what are the features of malabsorption
* Weight loss, muscle wasting (cachexia) * Abdominal distension * Borborygmus * Flatulence
97
what are the the consequences of malabsorption
``` Anemia (iron, B12, folate), vitamin deficiencies, osteopenia, tetany (↓ Ca++), amenorrhea, impotence, infertility, hyperkeratosis, edema, peripheral neuropathies (Vit. B12) ```
98
what is Celiac disease
Immune-mediated reaction to gluten (gliadin) | Non-infectious malabsorption
99
what will Celiac disease do to the small intestine
Loss of mucosal & brush border surface area called Villous atrophy
100
in the US what % have celiac disease and who is most likely to get it
1% of US Caucasians 30-60
101
what are some of the signs of celiac disease
steatorrhea | bloating/destention
102
what can celiac disease cause on the skin
dermatitis herpetiformis
103
what do you need to know about Environmental enteropathy
Recurring, acute: diarrhea, fever, malaise responds to antibiotics villus flattening MC age 2-3 years
104
what is infectious enterocolitis
microbial infections that will cause inflammation and diarrhea major global heath problem
105
cholera
cause vibrio cholerae massive chloride ion secretion "rice water stool hypotension/shock
106
campylobacter enterocolitis
``` AKA traveler's diarrhea (E.coli) cause campylobacter jejuni MC bacterial enteric pathogen in the US enterotoxins self-limited colitis ```
107
pseudomembranous colitis
AKA antibiotic-associated colitis cause clostridium difficile risk hospitalization
108
Viral gastroenteritis
50% of all gastroenteritis children: rotavirus adult: norovirus
109
parasitic disease
Cause Giardia lamblia resists cold and chlorine "beaver fever" alters SI enzymes
110
what is Irritable bowel syndrome
altered bowel habits no cellular abnormalities MC 20-40 females NO INFLAMMATION
111
what is inflammatory bowel disease
idiopathic crohn disease ulcerative colitis
112
what is crohn disease
skip lesions MC in ileum transmural (throughout the wall)
113
what is ulcerative colitis
``` starts in the rectum effects the mucosa and submucosa 20-25 year olds smoking inhibitory stringy and bloody ```
114
what is a adenomas polyps
onset >40 years of age 50% of all US adults >50 years old could turn into adenocarcinomas
115
what is familial adenomatous polyposis
numerous adenomas | 100% chance of CA by age 30

path 2 test 3 (2 decks)

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