Digestive Flashcards
causes of missing teeth
dental decay periodontal disease, dental injury, congenitally missing
aka third molars
wisdom teeth
infection resulting in erosion of tooth surface
dental caries
cause of dental caries
bacteria in mouth breaks down sugars into acid plaque which erodes calcium in enamel; GERD/purging
tx dental caries
- removal of diseased portion of tooth enamel and pulp & fill cavity with dental amalgam composite material
- root canal procedure
- tooth extraction
- dental implant
cause of discolored teeth
aging, dead tooth, smoking, drinks, foods, antibacterial mouth wash, severe pertussis, measles, naturally occuring fluoride
tx discolored teeth
polishing w/rotary polisher, bleaching procedures, bond teeth w/synthetic veneer to tooth, whitening gel
inflammation and swelling of gums
gingivitis
cause of gingivitis
plaque, vitamin deficiencies, glandular disorders, blood diseases, viral infections, certain medications
destructive bone and gum disease around one or more teeth
periodontitis
aka periodontal disease
periodontitis
cause of periodontitis
plaque biofilm, unchecked gingivitis, poor oral hygiene
list contributing factors of periodontitis
smoking, certain meds, chemotherapy, diabetes, HIV infection, stress, poor nutrition, hormonal medications, pregnancy
how is periodontitis diagnosed
measure depth of pockets and xrays
tx periodontitis
scaling and root planing and curettage, brush and floss multiple times per day, oral/local sub-antimicrobial dose of antibiotic, periodontal surgery, bone/gum graft
tx oral tumors
observe periodically, excise if necessary
cause of malocclusion
genetics, oral habits, deviated septae, enlarged tonsils, allergies
tx malocclusion
braces, tooth extraction, surgical removal of part of jaw, combining crowns/bridges
cause of temporomandibular joint disorder
unbalanced activity of jaw muscles, bruxism, malocclusion, poorly fitting dentures, rheumatoid/degenerative/traumatic arthritis, neoplastic disease, clenching and grinding of teeth, habitual gum chewing
how is temporomandibular joint disorders diagnosed
oral exam, pt history, radiographic studies
tx temporomandibular joint disorders
immobilization of mandible, NSAIDs, wear special appliances, plastic bite plate (splint), intraarticular injections of hydrocortisone, physical therapy, stress counseling, muscle relaxants, TMJ arthroscopy, joint restructuring, joint replacement
pus filled sac developed in tissue surrounding base of root
tooth abscess
cause of tooth abscess
- decayed/dying tooth
- exposed dental nerve to bacteria
tx tooth abscess
antibiotics, root canal therapy, apicectomy, tooth extraction
lesion on mucous membrane exposing underlying sensitive tissue in mouth
mouth ulcers
cause of mouth ulcers
mechanical trauma, viral and bacterial infection, stress, illness, medications, tumor in mouth, anemia, leukemia
tx mouth ulcers
antiseptic mouthwash rinsing w/warm salt water, avoid spicy or acidic food, topical analgesics, soothing agents, steroid mouthwash, topical/oral antiviral agents
cause of cold sores
herpes simplex virus 1, exposure to sunshine or wind, another infection
tx cold sores
antiviral ointment or capsule (acyclovir [Zovirax] or penciclovir), rest, aspirin, anesthetic mouthwash, topical cream (docosanol [Abreva] Novitra)
candidiasis of oral mucosa
thrush
the cause of oral thrush is candidiasis albicans, other predisposing factors are
chemotherapy, diabetes, glucocorticoid therapy, removal dental prostheses
how is oral thrush diagnosed
oral exam, lab analysis of lesion
tx oral thrush
antifungal (nystatin), fluconazole [Diflucan])
aka acute necrotizing ulcerative gingivitis or trench mouth
necrotizing periodontal disease
cause of necrotizing periodontal disease
poor oral hygiene, bacterial infection, gingivitis, HIV/AIDS, stress, poor nutrition, throat infections, smoking, serious illness, oral contraceptives
tx necrotizing periodontal disease
antibiotics, hydrogen peroxide mouthwash, teeth and gums professionally cleaned, gingivectomy
hyperkeratosis/epidermal thickening of buccal mucosa/palate/lower lip
oral leukoplakia
causes of oral leukoplakia
chronic irritation or heat
tx oral leukplakia
eliminate/smooth source of irritation
cause of oral cancer
smoking, alcohol, sun exposure, Betel nut chewing, HPV infection, poor oral hygiene, periodontal disease, oral leukoplakia
how is oral cancer diagnosed
fine needle aspiration biopsy, contrast enhanced imaging
what are common sites for metastasis of oral cancer
lungs, liver, bone
tx oral cancer
surgery, radiotherapy, laser therapy, neck dissection, therapeutic irradiation, speech and swallowing rehabilitation
regurgitation of stomach and duodenal contents into esophagus generally at night
gastroesophageal reflux disease (GERD)
cause of GERD
overeating, pregnancy, weight gain, hiatal hernia, medications, some foods
how is GERD diagnosed
barium swallow, esophagoscopy, esophagogastroduodenoscopy, esophageal pH monitoring
tx GERD
elevate head of bed, ingest light evening meal no less than 4 hours before bed time, antacids, weight loss, elimination/restriction of alcohol ingestion and smoking, medications, antireflux surgery
dilated submucosal veins developing in pts w/underlying portal hypertension and can cause serious upper GI bleeds
esophageal varices
cause of esophageal varices
increased pressure in veins, venous return to liver impeded, cirrhosis of liver
how is esophageal varices diagnosed
pt history, imaging, endoscopy
tx esophageal varices
restore blood volume, maintain fluid & electrolyte balance, endoscopic sclerotherapy, ligation of bleeding varices, emergency portal decompression
inflammation and tissue injury of esophagus
esophagitis
cause of esophagitis
acid reflux, certain oral antibiotics w/o enough water, chemical injury, HIV
how is esophagitis diagnosed
pt history, esophagoscopy
tx esophagitis
cimetidine (Tagament), Omeprazole (prilosec), sucralfate (carafate) suspension, small and frequent meals, avoid alcohol, dilate esophageal stricture, tx based on cause
esophageal squamous cell carcinoma is most often found in
Asia, Africa, Iran
list risk factors for esophageal squamous cell carcinoma
- cigarette smoking
- alcohol
- betel nut chewing
- drinking very hot beverages
- foods w/N-nitroso compounds
- diet low in fruit and veggies
- head and neck cancer history
- underlying esophageal disease
adenocarcinoma of the esophagus primarily affects
males and caucasians
list major risk factors for adenocarcinoma of the esophagus
- barrett esophagus
- chronic GERD
- smoking
- obese
how is esophageal cancer diagnosed
barium study, endoscopic biopsy
replacement of normal squamous epithelium with abnormal columnar epithelium
Barrett esophagus
how is Barrett esophagus developed
chronic GERD
cause of gastric and duodenal peptic ulcers
helicobacter pylori infection, NSAIDs, chronic gastritis, ingestion of gastric irritants, smoking, alcohol consumption, increase of acid and pepsin
tx peptic ulcers
rest, meds, change in diet, stress reduction, elimination of cause, small frequent meals of soft and bland food
inflammation of lining of stomach
gastritis
cause of gastritis
H pylori, medication (aspirin/antinflammatory), poison, alcohol, smoking, infection, stress, mechanical injury from swallowing of foreign object, lack of gastric acid production, peptic ulcer disease
how is gastritis diagnosed
gastroscopy, imaging, biopsy, blood count, serum test, fecal occult test potentially positive
tx gastiritis
antibiotics if H pylori infection, antacids, meds that restrict blood vessels, antiemetics, bland diet, mineral and vitamin supplements
cause of gastric cancer
H pylori, Barret esophagus, diet high in salt, smoking, previous gastric surgery, abdominal radiation, genetic predisposition
how is gastric cancer diagnosed
upper GI endoscopy w/biopsy
tx gastric cancer
antibiotics for H pylori, gastric resection, chemoradiotherapy, total gastrectomy, palliation
cause of appendicitis
obstruction of narrow appendiceal lumen (lymphoid hyperplasia, fecaliths, parasites, foreign bodies, Crohn disease, primary/metastatic cancer)
how is appendicitis diagnosed
maximal tenderness of abdomen at McBurney point, Rebound tenderness on opposite side, elevated WBC
defect in diaphragm causing segment of stomach to slide into thoracic cavity
hiatal hernia
cause of hiatal hernia
congenital defect/weakness in diaphragm (obesity, old age, trauma, intraabdominal pressure, unknown)
how are hiatal hernia diagnosed
chest xray, barium radiographic studies, endoscopy, measure reflux pH, examine reflux contents
tx hiatal hernia
dietary modifications, minimize activities that increase intraabdominal pressure, lose weight, antacids, medications that control acid secretions, stop smoking, avoid lying down after eating
condition which organ protrudes through abnormal opening of abdominal wall
abdominal hernia
cause of abdominal hernia
weak area/congenital malformation of abdominal wall, trauma, increased intraabdominal pressure (heavy lifting/pregnancy), surgery
how is abdominal hernia diagnosed
palpation, physical exam, Valsalva maneuver (inguinal hernia), imaging of abdomen, WBC count
tx abdominal hernia
truss, herniorrhapy
chronic inflammatory disorder of GI tract
Crohn Disease
aka Crohn Disease
regional enteritis
cause of Crohn’s disease
unknown
how is Crohn’s disease diagnosed
sx, radiographic studies of both intestines, colonoscopy, enteroscopy, skip lesions, biopsy, characteristic lesions, electrolyte abnormalities, CT, blood test
tx Crohn’s disease
nutritional support, dietary supplements, IV nutrition, medication therapy (antibiotics, steroids, anticholinergics, narcotic agents, corticosteroids, immunosuppressive drugs, surgical resection
chronic inflammatory bowel disease affecting mucosa and submucosa of rectum and colon
ulcerative colitis
cause of ulcerative colitis is unknown but it is thought to be associated as an
autoimmune
how is ulcerative colitis diagnosed
clinical sx, examine stool for blood, reduced Hgb level and leukocytosis, electrolyte abnormalities, barium enema, colonoscopy,, biopsy
tx ulcerative colitis
well balanced diet, avoid foods irritating to stomach, diet low in fat and bulk and high in protein/vitamins/calories, anticholinergic drugs, antidiarrheal agents, corticosteroid therapy, proctocolectomy, ileostomy, ileoanal anastomosis
acute inflammation of lining of stomach and intestines
gastroenteritis
cause of gastroenteritis
ingestion of bacteria from contaminated food/water, ingestion of poison/chemicals, chronic ingestion of spicy/irritating food, alcohol, caffeine, aspirin, antinflammatory agents, acute illness
how is gastroenteritis diagnosed
lab analysis, culture of stool, blood studies, endoscopy
tx gastroenteritis
antiemetics, antibiotics, antacid, oral/IV rehydration solutions, rest, eat as tolerated, antidiarrheal
cause of intestinal obstruction
neoplasm, foreign bodies, fecal impaction, strictures, from Crohn disease, compression of bowel, volvulus, strangulated hernia, adhesion, ileus, certain medications, peritonitis
paralytic condition of small bowel that may occur after abdominal surgery
ileus
how are intestinal obstructions diagnosed
radiographic studies w/barium or gastrografin contrast, elevated WBC count, acid-base disturbances, electrolyte imbalances
tx intestinal obstructions
resection of diseased bowel, ostomy, surgical removal of blockage, enemas, manual disimpaction, nasogastric tube
progressive condition characterized by defects in muscular wall of large bowel
diverticulosis
cause of diverticulosis
inadequate roughage in diets, excessive amounts of highly refined food
tx diverticulosis
adequate fluids and roughage, fiber supplements, stool softener
how is diverticulosis diagnosed
clinical picture, air-contrast barium enema radiographic study, colonoscopy
tx diverticulosis
antibiotics, liquid diet, stool softeners, removal of diseased colon IV antibiotics, nutritional support, percutaneous drainage
cause of colorectal cancer
age, history of large adenomatous polyps, diabetes mellitus, ulcerative colitis, Crohn disease, first-degree relative of colorectal cancer, cigarette smoking, obesity
how is colorectal cancer diagnosed
colonoscopy, fecal occult blood test, double contrast barium enema
tx colorectal cancer
surgical resection, colostomy, chemotherapy, radiation
acute inflammation with plaque like necrotic debris and mucus adhered to damaged superficial mucosa of small and large intestines
pseudomembranous enterocolitis
cause of pseudomembranous enterocolitis
broad-spectrum antibiotics, C diff infection
how is pseudomembranous enterocolitis diagnosed
C diff found in stool, rectal biopsy, elevated WBC count, serum albumin reduced, abnormal serum electrolyte, distended colon on abdominal radiograph
tx pseudomembranous enterocolitis
discontinue broad-spectrum antibtioics and substitute w/metronidazole or vancomycin, cholesytramine (Questran), monitor fluid and electrolyte balance, proper hand washing, isolation, decontamination
small bowel fails to absorb nutrients bc of inadequate absorptive surface (small intestine shortened by disease or surgery)
short bowel syndrome
cause of short bowel syndrome
crohn disease, inetstinal infarction, radiation enteritis, volvulus, tumor resection, trauma
how is short bowel syndrome diagnosed
pt history, abnormal electrolyte levels, pH disturbances, anemia, increased amount of fat in stool
tx short bowel syndrome
medication for infection, antidiarrheals, vitamin and mineral supplements, analgesics, food supplements, surgery
functional bowel disorder characterized by chronic abdominal pain or discomfort, bloating, and erratic dysfunction of bowel habits
irritable bowel syndrome
how is IBS diagnosed
pt history, physical exam, rule out other conditions
tx IBS
soluble fiber supplements, stool softeners, laxatives, antidiarrheal, ondansetron, antispasmodic drugs, tricyclic antidepressants, nonabsorbed antibiotics, mental/relaxation therapy
inflammation of peritoneum
peritonitis
cause of peritonitis
blood borne organisms/organisms from GI or genital tract, appendicitis, diverticulitis, perforated petic ulcer, perforated gallbladder, penetrating wound to abdomen, lupus, noninfective secretions
how is peritonitis diagnosed
elevated WBC, abnormal serum electrolyte levels, gaseous distention of bowel on radiographs, CT, aspiration of peritoneal fluid
tx peritonitis
broad-spectrum antibiotics, analgesics, antiemetics, fluid and electrolyte replaced parenterally, surgery,
varicose dilations of vein in anal canal or anorectal area
hemorrhoids
cause of hemorrhoids
constipation, straining, pregnancy
how are hemorrhoids diagnosed
physical exam, proctoscopy, Hgb level and RBC below normal
tx hemorrhoids
stool softeners, diet high in fruits/veggies/whole grain cereals, warm sitz baths, topical anesthetic ointment, witch hazel compresses, hydrocortisone acetate/pramoxine hydrochloride, sclerotherapy injections, band ligation, cryosurgery, photocoagulation, electrocoagulation, thermocoagulation, stapled hemorrhoidectomy
chronic degnerative disease of liver resulting in replacement of normal liver cells w/hard fibrous scar tissue
cirrhosis of liver
aka hobnail liver
cirrhosis of liver
cause of cirrhosis of liver
chronic alcoholism, malnutrition, hepatitis B and C, parasites, toxic chemicals, CHF, idiopathic
how is cirrhosis diagnosed
enlarged firm and hard liver with palpable blunt edge, elevated liver enzyme and bilirubin levels, CT, ultrasound, needle biopsy of liver
tx of cirrhosis
prohibit alcohol intake, adequate rest, vitamin and mineral supplements, antacids, diuretics, paracentesis, liver transplant
what hepatitis is the only one to cause spiking fevers
hepatitis A
how is hepA diagnosed
hepatitis profile, liver function studies, elevated serum levels of alanine aminotransaminase and aspartate aminotransaminase, prothrombin time prolonged, serum bilirubin level elevated, bilirubinuria, HAV antibody
tx hep A
rest, IM immune globulin, pt isolation, antiemetics, analgesics, low fat high carb diet, restrict physical activity, avoid alcohol
tx hep B
oral antiviral therapy, interferon, rest, sx control
tx hep C
Sofosbuvir (Solvadi) w/ribavirin/peginterferon/ribavirin, other meds, gamma globulin, interferon and ribavirin, glucocorticoids, well balanced diet, rest, liver transplant
cause of hepatocellular carcinoma
HBV, hereditary hemochromatosis, cirrhosis, exposure to aflatoxins
how is Hepatocellular carcinoma diagnosed
increase in AFP level greater than 500 g/L in high risk pt, ultrasound/CT/MRI of liver, liver biopsy
tx hepatocellular carcinoma
surgical resection (partial hepatectomy), radiofrequency ablation, percutaneous ethanol injection, systemic therapy with sorafenib, chemotherapy
condition with too much fat in liver cells but drink little/no alcohol
nonalcoholic fatty liver disease
abnormal presence of calculi or gallstones that form in bile
cholelithiasis (gallstones)
aka cholelithiasis
gallstones
cause of cholelithiasis
age, high calorie high cholesterol diet, obesity, oral contraceptive use, ileal disease, alcoholic cirrhosis, biliary tract infection, diabetes mellitus
how is cholelithiasis diagnosed
clinical picture, ultrasound of gallbladder and biliary ducts, elevated serum bilirubin level
tx colelithiasis
limit fat intake, cholecystectomy, bile acids, extracorporeal shock wave lithotripsy
acute/chronic inflammation of gallbladder associated with cholelithiasis and infection often follows inflammation
cholecystitis
cause of cholecystitis
obstruction of gallbladder from gallstones, trauma, insult to gallbladder, infection
how is cholecystitis diagnosed
clinical picture, ultrasound of gallbladder and biliary ducts, radioiostope gallbladder study, elevated WBC, increased serum bilirubin level
tx cholecystitis
eliminate fatty foods, NG tube, IV solution to replace fluid and electrolytes, cholecystectomy, antibiotics, analgesics, antiemetics
cause of acute pancreatitis
escape of activated pancreatic enzymes into surrounding tissue (alcoholism, biliary tract disease, trauma, infection, structural anomalies, elevated Ca levels in blood, hemorrhage, hyperlipidemia, drugs), gallstones, metabolic/endocrine disorder, idiopathic
how is acute pancreatitis diagnosed
dramatically elevated serum amylase and lipase levels, WBC and Hct elevated, radiography and ultrasound may show stones in biliary tract/dilation of common bile duct, hyperglycemia, CT with contrast, elevated bilirubin
tx acute pancreatitis
IV fluid and electrolyte replacement, NPO and NG tube, narcotic, supportive care
cause of pancreatic cancer
cigarette smoking, obesity, chronic pancreatitis/diabetes, family history of pancreatic cancer, mutations in cancer susceptibility genes
how is pancreatic cancer diagnosed
abdominal ultrasound/CT, ERCP, elevated serum tumor marker for pancreatic cancer, fine needle aspiration biopsy
tx pancreatic cancer
surgical resection
cause of malabsorption syndrome
defective mucosal cells in small intestine, diseased pancreas, blocked pancreatic duct, reduced secretion of bile from hepatic disease/bile duct obstruction, metabolic or endocrine disorders, severe parasitic and worm infestations
cause of food poisoning
cheese, mushrooms, shellfish, food contaminated by poisonous insecticides, toxic substances, food undergone putrefaction or decomposition, food contaminated w/bacteria
eating disorder linked to psychological disturbance in which hunger is denied by self-imposed starvation resulting from distorted body image and compulsion to be thin
anorexia nervosa
how is anorexia nervosa diagnosed
clinical picture and history (lost at least 15% total body weight, appear emaciated, absent/irregular menses, hypotension, bradycardia, intense fear of gaining weight)
