chapter 13 Flashcards
1) Caused by irritants: __________,_______,______
2) Caused by infectious agents
________HSV-1): Vesicles involving oral mucosa that rupture & results in shallow, painful, red ____. Primary infection occurs in childhood; lesions heal, but virus remains dormant in ______ of the ______ nerve. Stress and hormonal changes cause reactivation of the virus, leading to vesicles on the ____ (cold sores).
__________ (thrush,) is a local white, membranous lesion caused by _________. It occurs most commonly in _____ and ______, ___________ and _______ patients.
stomatitis alcohol, tobacco, stress herpes virus ulcers ganglia trigeminal lips oral candidiasis Candida albicans infants and children immuno-compromised diabetes
• Classified as squamous cell carcinomas
• Often related to _________
• _____ of the mouth is common location
• Oral leukoplakia and erythroplakia are precursor lesions.
Morphologically present as the following:
• _______: White plaque which cannot be scraped away represents squamous cell dysplasia.
• ________: Red plaque (vascularized) represents squamous cell dysplasia.
oral cancer tobacco smoking floor leukoplakia erythroplakia
infectious or autoimmune Clinically presents as swelling of glands by ______
• Prevented by ____ vaccine
• Neoplasms (greatest in women 20-40 years old)
– Most common localization of the _____glands
– Most common tumor is ________ adenoma (benign)
Sialadenitis mumps MMR parotid pleomorphic
Upper end of the esophagus is intact but ends in a blind pouch.
• ___________ : Lower part of the esophagus is normal but it tappers at the ____ end which communicates with trachea.
• Clinical symptoms: Fetus can not swallow _______ and neonates appear to be healthy. But, when fluids are administered they come out via ____ and ____ causing ________
• Treatment: ________
esophageal atresia tracheo esophageal atresia with fistula proximal amniotic fluid nose, mouth respiratory distress surgery
Disorder with esophageal motility with inability to relax the lower esophageal sphincter (LES).
• The condition is caused by a loss of ______ cells in the __________, which leads to the progressive dilation of the _________. One important source (principally in South America) is _______(parasite) infection in Chagas disease. In other cases, ganglion cells are lost for reasons that are not known.
• Clinical characteristics include difficulty in ________
• Achalasia can lead to esophageal _______ cell carcinoma in about 5% of
achalasia ganglion myenteric plexus esophagus Trypanosoma cruzi swallowing squamous
____________: Protrusion of the abdominal contents through abdominal wall to thoracic cavity
__________: Above the diaphragm (90%) ____________: Below the diaphragm origin but rolls alongside the distal esophagus
hiatal hernia
sliding hernia
paraesophageal/rolling hernia
Hernia protrudes through the inguinal canal & extends into the _______is known as
scrotum
inguinal hernia
Hernia occurs through the Femoral canal in the ______ is also known as
groin
femoral hernia
- Reflux of gastric juice into esophagus.
- Characteristics usually include _____ pain relieved by ______. Manifestations often include substernal pain (_____).
- Most commonly,associated conditions include incompetent lower esophageal _____ & ______ hernia. GERD is also associated with excessive use of _____ and _____
- ______ and ______ are late complications.
gastroesophageal reflux disease (GERD) burning antacids heartburn sphincter hiatal alcohol tobacco ulceration, Barret esophagus
Lower portion of the esophagus is affected by this disorder. The _____ cell lining is replaced by ______ epithelium. Most aggressive form of _______
• Common cause is _____ where the glandular _______ happens due to the acid injury.
• Treatments for GERD or peptic ulcer: a) ______ are not permanent solution. b) H-2 blockers like Zantac blocks the _______ which in terms inhibit ______ secretion. c) __________ drugs like Nexium which decrease the acid production via acid pump.
Barret's esophagus squamous columnar epithelium adenocarcinoma GERD metaplasia antacids h-2, histamine, gastric acid acid pump reducer
diseases of stomach: clinical symptoms Pain—\_\_\_\_\_\_, upper abdomen • \_\_\_\_\_\_ • Bleeding • \_\_\_\_\_\_: upset stomach • Systemic consequences—e.g., \_\_\_\_\_\_\_\_\_ anemia caused by chronic blood \_\_\_, vitamin \_\_\_\_ malabsorption– related \_\_\_\_\_\_\_ anemia
midline vomiting dyspepsia iron deficiency loss b12 megaloblastic
diseases of stomach: developmental abnormality
Congenital hypertrophy of pyloric smooth muscle; more common in _____ Seen in two weeks of birth.
• Prevents _____ of the stomach& results in ______
•______ of the contracted muscle
congenital stenosis of pylorus males 2 emptying projectile vomiting surgical incision
Acidic damage to the stomach
• In most cases self-limited,of _____ duration
• May be associated with _____ , with bleeding
• Risk factors: ______: aspirin, ibuprofen, naproxen,
Heavy _____ consumption, severe ___ patients (____ ulcer: hypovolemia leads to decrease blood supply), Increased ______ pressure (_____ ulcer): Increased stimulation of ____ nerve resulting in acid production.
Treatment:___ blocker or _______ (proton pump inhibitor).
acute gastritis short mucosal ulceration NSAIDs alcohol burn curling intracranial cushing vagal h-2 acid pump reducer
characterized by chronic mucosal inflammation and _____ of the mucosal glands. Two types:
• _____:Autoimmune gastritis is associated with the presence of antibodies to _____ cells (and sometimes to ______), lack of gastric acid secretion, ______ anemia, and other autoimmune diseases, such as chronic _____ and ______ disease. It is also associated with ____, gastric ____, and gastric ______
- Type B: caused by _____ bacteria & common form of chronic gastritis. H. pylori is also strongly associated with ____ and _____ peptic ulcers and is thought to play a role in the development of ______ of the stomach and gastric ______ of the mucosa-associated lymphoid tissue (MALT) type.
- Treatment: _________ (antibiotic) to treat H. pylori. ________ test and lack of _____ antigen confirm H.pylori
chronic gastritis atrophy type A parietal intrinsic factor pernicious thyroiditis Addison's aging ulcer carcinoma type B H.pylori gastric duodenal adenocarcinoma lymphoma triple therapy negative urea breath stool
Most often, the stomach ulcer (punch out margins) occurs at or near the ____ curvature, in the _____ and ______ regions with hypertrophy of ____ glands. Caused by H. pylori (95 %)
• The ulcer is not a precursor lesion of _____ of the stomach.
• Unlike peptic ulcer that occurs elsewhere, peptic ulcer of the stomach is not dependent on increased gastric acid secretion; however, ____ and ____ are believed to play a role.
• Presents with _______ that improves with meals. Rupture causes the risk of _____ from gastric arteries.
_____ ulcer is mediated by H. pylori, in which bacterial ____ and _____ break down ______ in gastric mucus, thus interfering with ______ protection.
• Increased permeability of the gastric mucosa to _______ ion, resulting in back diffusion of hydrogen ion with injury to the gastric mucosa.
• ______ gastritis leading to gastric ulceration.
• Treatment: same as ______
• Note a precursor to _______ .
peptic ulcers: gastric & duodenal lesser antral pre-pyloric Brunner carcinoma acid, pepsin epigastric pain bleeding gastric ureases proteases glycoproteins epithelial hydrogen bile-induced GERD gastric carcinoma
