Digestive Diseases and Disorders Flashcards
Gingivitis
ETIOLOGY:
1) bacteria, sugars, and mucus accumulate at base of tooth -> “plaque” -> gum inflammation
2) certain drugs, vitamin deficiencies, anemia -> gum inflammation
S/S:
1) erythema, swelling, easy bleeding
TREATMENT:
1) chlorhexidine (antibiotic mouthwash), subgingival curettage
Periodontitis
ETIOLOGY:
1) Predisposing Factors: certain drugs, endocrine diseases, vitamin deficiencies, stress
1) untreated or undertreated plaque -> involvement of bone around teeth
S/S:
1) pain, hypersensitivity, halitosis, foul taste, loose teeth
TREATMENT:
1) scaling and root planing (SRP) and curettage with antibiotics
2) respective periodontal surgery (RPS) with graft
Necrotizing Periodontal Disease
ETIOLOGY:
1) HIV/AIDS, stress, tobacco, untreated gingivitis -> anaerobic bacterial infection around base of teeth
S/S:
1) inflamed and necrotic gums, ulceration, halitosis, fever, lymphadenopathy
TREATMENT:
1) antibiotics and gingivectomy
Tooth Abscess
ETIOLOGY:
1) dental nerve exposed -> bacterial invasion -> pus-filled sacs in surrounding tissue
S/S:
1) throbbing pain, lymphadenopathy, fever, malaise
TREATMENT:
1) root canal procedure with antibiotics, apicectomy, or tooth extraction
Dental Caries
ETIOLOGY:
1) bacteria break down sugars (glucose, fructose, lactose) -> acid plaque -> enamel demineralization
S/S:
1) pain, hypersensitivity, foul taste, halitosis, gum inflammation
TREATMENT:
1) surgical resection and amalgam filling
2) root canal procedure with penicillin course
3) complete teeth extraction with prosthetic
BONUS FACTS:
1) risk of systemic bacterial infection through bloodstream
Thrush (Oral Candidiasis)
ETIOLOGY:
1) immunodeficiency OR cancer chemotherapy, chronic antibiotic treatment, glucocorticoids -> impaired immunity -> Candida albicans fungus (normal flora) infection
S/S:
1) painful yellow-white patches, slight bleeding, yeast breath
TREATMENT:
1) nystatin (antifungal drug)
Herpes Simplex (Cold Sores)
ETIOLOGY:
1) Herpes simplex virus type 1 (HSV-1) infection lies dormant -> relapses with wind, sun, stress, or infection
S/S:
1) prodrome (tingling around lips) -> vesicles around mouth and oral mucosal membrane -> ulcers
TREATMENT:
1) antiviral drugs, analgesics
BONUS FACTS:
1) risk of whitlow finger and corneal ulcers
Mouth Ulcer
ETIOLOGY:
1) (Traumatic) chronic mechanical, chemical, or thermal irritation
2) (Aphthous) infection, stress, certain drugs
S/S:
1) painful yellow spots with red borders
TREATMENT:
1) antiseptic mouthwash, benzocaine
Discolored Teeth
ETIOLOGY:
1) aging, certain foods, necrosis, smoking, certain chemicals -> discolored teeth
S/S:
1) yellow, white, gray, or brown patches on teeth
TREATMENT:
1) rotary polisher if superficial
2) bleaching procedures or veneer if deep
Impacted Third Molars
ETIOLOGY:
1) third molar eruption (17-21yrs) blocked by second molar or bone -> entrapment of food -> pericoronitis
S/S:
1) pain, halitosis, inflamed gums
TREATMENT:
1) penicillin and analgesics -> surgical extraction
Missing Teeth
ETIOLOGY:
1) age or disease related decay, congenital factors, trauma -> loss of teeth -> malocclusion
S/S:
1) bolting, jaw pain
TREATMENT:
1) prosthetic teeth
Malocclusion
ETIOLOGY:
1) congenital factors, tooth loss, chronic thumb sucking -> misalignment of maxillary and mandibular teeth
S/S:
1) difficulty with mastication
TREATMENT:
1) braces, tooth extraction, or jaw surgery
Temporomandibular Joint Disorder (TMD)
ETIOLOGY:
1) bruxism, malocclusion, rheumatoid or osteoarthritis, neoplasms -> inflammation of TM synovial joint
S/S:
1) pain, limited ROM, clicking noises, tinnitus, dizziness
TREATMENT:
1) immobilize joint, NSAIDs, hydrocortisone, splint, or surgical reconstruction
Oral Leukoplakia
ETIOLOGY:
1) chronic irritation or tobacco use -> hyperkeratosis of buccal mucosa, palate, or lower lips
S/S:
1) white hardening of mucosal
TREATMENT:
1) avoid causative factors
BONUS FACTS:
1) considered precancerous
Oral Cancer
ETIOLOGY:
1) chronic tobacco use, chronic irritation, HPV, oral leukoplakia -> SCC of oral mucosa
S/S:
1) white tumor, possible pain, dysphagia or odynophagia, weight loss
TREATMENT:
1) CEASE SMOKING, surgical resection with or without radiation therapy
Gastroesophageal Reflux Disease (GERD)
ETIOLOGY:
1) hiatal hernia, weight gain, pregnancy, and/or certain medications -> weakened cardiac sphincter and/or increased abdominal pressure -> reflux of gastric and duodenal contents
S/S:
1) burning sensation, belching, dental caries, erosive esophagitis
TREATMENT:
1) lifestyle changes, histamine-2 receptor antagonists
BONUS FACTS:
1) possible sequela of Barret’s esophagus
Esophagitis
ETIOLOGY:
1) acid reflux, chemical ingestion (corrosive) -> inflammation of esophagus
S/S:
1) heartburn, hematemesis, dysphagia, dysphonia
TREATMENT:
1) antacids
2) histamine-2 antagonists, endoscopic repair
Esophageal Varices
ETIOLOGY:
1) liver cirrhosis -> impeded portal vein -> increased venous pressure
S/S:
1) asymptomatic, tortuous and swollen veins
2) (if ruptures) hematemesis, melena, hypovolemic shock
TREATMENT:
1) endoscopic sclerotherapy or ligation, replenish blood and electrolytes
Esophageal Cancer
ETIOLOGY:
1) (Squamous Cell Carcinoma) poor diet, tobacco use, frequent hot beverages -> malignant squamous epithelial cells
2) (Adenocarcinoma) chronic GERD and subsequent Barret esophagus -> malignant columnar epithelial cells
S/S:
1) dysphagia, dysphonia, weight loss, heartburn, tracheoesophageal fistula
TREATMENT:
1) surgery with chemotherapy
2) (palliative) radiation therapy and endoscopic stent
BONUS FACTS:
1) poor prognosis (20% 5-year survival rate)
Gastritis
ETIOLOGY:
1) (acute) H. pylori, irritating agents (tobacco, alcohol), stress, NSAIDs -> gastric lining inflammation
2) (chronic) idiopathic or pernicious anemia (reduced vitamin B12) -> prolonged gastric lining inflammation
S/S:
1) epigastric pain, nausea, possible bloody stools
TREATMENT:
1) antibiotics if bacterial
2) H2 receptor antagonists, antacids, PPIs, antiemetics
Peptic Ulcers
ETIOLOGY:
1) (Gastric Ulcers) NSAIDs, Helicobacter pylori, chronic gastritis -
2) (Duodenal Ulcers) increase in gastric pepsin and acidic juices
S/S:
1) (gastric ulcers) asymptomatic, possible heartburn or epigastric pain
2) (duodenal) mild to severe epigastric pain, occult or frank stool bleeding
TREATMENT:
1) avoid NSAIDS, avoid irritating agents
2) antibiotics if bacterial, H-2 receptor antagonists, antacids, proton pump inhibitors (PPIs)
Hitial Hernia
ETIOLOGY:
1) congenital defects, weakened diaphragm (age, trauma, increased intraabdominal pressure) -> stomach pushes through diaphragm -> possible acid reflux
S/S:
1) heartburn, possible chest pain
TREATMENT:
1) cholinergic drugs (supports cardiac sphincter), antacids, H2 receptor antagonists, PPIs
Congenital Pyloric Stenosis
ETIOLOGY:
1) possible hereditary factors, 4x more common in males
S/S:
1) abdominal distension, bile-free emesis, hunger
TREATMENT:
1) pyloromyotomy
Infantile Colic
ETIOLOGY:
1) (unclear) cow’s milk, air swallowing, or overfeeding thought to contribute
S/S:
1) intermittent episodes of colic (crying, abdominal pain, flatulence)
TREATMENT:
1) remove contributing factors, add support people
Gastric Cancer
ETIOLOGY:
1) family history, H. pylori infection, smoking, poor diet -> gastric carcinoma
S/S:
1) weight loss, epigastric pain, dysphagia, melena, palpable mass
TREATMENT:
1) gastric resection with combined chemoradiation therapy
Crohn’s Disease (Regional Enteritis)
ETIOLOGY:
1) idiopathic but possible immunologic factors -> chronic inflammation of any layer of any section of alimentary canal
S/S:
1) chronic diarrhea, intermittent abdominal pain, weight loss, anorexia, fever and malaise -> perianal fistulas/fissures, ulcers
TREATMENT:
1) hyperalimentation and dietary changes
2) anticholinergics, corticosteroids, immunosuppressive drugs
Irritable Bowel Syndrome (IBS)
ETIOLOGY:
1) unknown, but possible neuroimmune factors
S/S:
1) chronic abdominal pain, episodes of diarrhea or constipation, tenesmus
TREATMENT:
1) if IBS-C: fiber supplements, laxatives
2) if IBS-D: anticholinergic drugs, antispasmodic drugs, probiotics
Intestinal Obstruction
ETIOLOGY:
1) strictures (Chron’s), strangulated hernia, adhesions, volvulus, intussusception, fecal impaction, neoplasms, foreign bodies -> mechanical blockage of intestines -> possible ischemia and sepsis
2) ileus (post-surgery) or drugs -> intestinal paralysis
S/S:
1) abdominal distension, severe pain, constipation, nausea or vomiting
TREATMENT:
1) temporary or permanent ostomy if mechanical, hyperalimentation if paralytic
Peritonitis
ETIOLOGY:
1) primary or secondary (i.e. appendicitis) bacterial infection OR enzymatic secretions -> peritoneal inflammation
S/S:
1) rebound pain, abdominal distention, nausea, fever, weakness
TREATMENT:
1) aggressive antibiotics, analgesics, hyperalimenation
BONUS FACTS:
1) high risk of septic shock
2) possible complications of adhesions and abscesses
Abdominal Hernia
ETIOLOGY:
1) congenital defects, trauma, increased abdominal pressure -> internal organ pushes through abdominal wall
S/S:
1) pain and palpable mass (ranges with organ, location, and size)
TREATMENT:
1) herniorrhaphy or truss
Gastroenteritis
ETIOLOGY:
1) bacterial or parasitic food poisoning (traveler’s diarrhea), viral food poisoning (stomach flu), chemical poisoning, allergic responses -> GI inflammation
S/S:
1) diarrhea, nausea, abdominal cramping, dehydration, fever
TREATMENT:
1) rehydration, antibiotics, antiemetics, antacids
Celiac Disease (Gluten Enteropathy)
ETIOLOGY:
1) genetic factors -> gluten hypersensitivity -> intestinal villi damage
S/S:
1) dermatitis herpetiformis, large and greasy stools, weight loss, diarrhea, gas
TREATMENT:
1) dietary restriction of gluten
Short Bowel Syndrome
ETIOLOGY:
1) dysfunctional small intestines from disease or resection -> malabsorption of macronutrients and/or micronutrients and fluids
S/S:
1) abnormal stools, weight loss, lethargy, weakness, dizziness, brittle hair and nails
TREATMENT:
1) nutrient supplementation, possible surgical reconstruction followed by temporary hyperalimentation
Pseudomembranous Colitis
ETIOLOGY:
1) antibiotics reduce normal protective flora -> C. difficile infects and releases cytotoxins -> pseudomembrane forms from necrotic cells and inflammatory products
S/S:
1) greenish and watery diarrhea, dehydration, fever, weakness, abdominal pain
TREATMENT:
1) metronidazole, vancomycin (antibiotics), cholestyramine
Hirchsprung Disease (Congenital Aganglionic Megacolon)
ETIOLOGY:
1) (affects neonates) genetic factors -> parasympathetic ganglion cells absent in colon -> peristalsis failure
S/S;
1) abdominal distension, bile or fecal vomitus, failure to pass meconium
TREATMENT:
1) surgical exicsion of affected colon, temporary colostomy
Ulcerative Colonitis
ETIOLOGY:
1) unknown, but genetic and autoimmune factors -> chronic inflammation of mucosal and submucosal layers of colon/rectum
S/S:
1) cramping abdominal pain, bloody and slimy diarrhea, weight loss, fatigue and malaise (ranges from mild to fulminant)
TREATMENT:
1) lifestyle and dietary changes
2) anticholinergic agents, TNF antibodies
3) proctocolectomy followed by ileostomy or ileoanal anastomosis
Diverticulosis
ETIOLOGY:
1) low-fiber and smaller stools -> increased intraluminal pressure required for peristalsis -> mucosa herniates through colorectal muscular layer
S/S:
1) asymptomatic, possible nonspecific abdominal distress
TREATMENT:
1) eat more fiber, drink more fluids
Diverticulitis
ETIOLOGY:
1) fecal impaction of diverticula -> bacterial infection -> large bowel inflammation
S/S:
1) abdominal pain, constipation, palpable mass, possible fever
TREATMENT:
1) antibiotics, possible resection of affected large bowel
Acute Appendicitis
ETIOLOGY:
1) obstruction (fecaliths, tumors, foreign bodies, parasites) -> bacterial infection and subsequent inflammation
S/S:
1) McBurney point pain, nausea, vomiting, diarrhea
TREATMENT:
1) antibiotic therapy and appendectomy
Hemorrhoids
ETIOLOGY:
1) increased rectoanal pressure (constipation, pregnancy, straining)-> varicose veins within anal canal (internal) or outside canal (external) -> possible thrombus
S/S:
1) asymptomatic or pain, itching, bleeding
TREATMENT:
1) anaesthetic ointments, band ligation, or hemorrhoidectomy
Colorectal Cancer
ETIOLOGY:
1) age, adenomatous polyps -> colorectal carcinoma
S/S:
1) abdominal pain, diarrhea, constipation, weight loss -> ascites, cachexia, lymphadenopathy
TREATMENT:
1) surgical resection with possible colostomy, possible chemotherapy and/or radiation therapy
Cirrhosis
ETIOLOGY:
1) chronic alcoholism, viral hepatitis, hemochromatosis -> liver tissue replaced with scar tissue
S/S:
1) jaundice, weight loss, nausea, edema, ascites
2) testicular atrophy, gynecomastia
TREATMENT:
1) diuretics and paracentesis
2) liver transplant
Hepatitis A
ETIOLOGY:
1) Hepatitis A virus transmitted via fecal matter -> incubated from 2 weeks to 2 months
S/S:
1) spiking fever, fatigue, malaise, anorexia, myalgia, jaundice, clay-colored stools,
TREATMENT:
1) immune globulin, low-fat diet
Hepatitis B
ETIOLOGY:
1) Hepatitis B virus transmitted via blood, saliva, semen, vaginal secretions -> incubates from 2 to 6 months
S/S:
1) (fulminant or insidious) fever, fatigue, malaise, anorexia, myalgia, jaundice, clay-colored stools
TREATMENT:
1) immune-globulin, interferons, low-fat diet
Hepatitis C
ETIOLOGY:
1) Hepatitis C transmitted via blood and body fluids -> incubates from 2 weeks to 6 months
S/S:
1) (acute or chronic) fever, fatigue, malaise, anorexia, myalgia, jaundice, clay-colored stools
TREATMENT:
1) sofosbuvir
2) immune globulin, interferons, low-fat diet
BONUS FACTS:
1) vaccines currently not available for HCV
Liver Cancer (Hepatocellular Carcinoma or HCC)
ETIOLOGY:
1) HBV, hemochromatosis, cirrhosis -> uncontrolled proliferation of hepatic cells
S/S:
1) same as chronic liver disease (jaundice, weight loss, nausea, edema, ascites, testicular atrophy, gynecomastia)
2) palpable mass
TREATMENT:
1) surgical resection (partial hepatectomy) or radiofrequency ablation
Cholelithiasis
ETIOLOGY:
1) age, high-cholesterol diet -> cholesterol or bile salts form gallstones that block bile duct
S/S:
1) colic pain, nausea, jaundice
TREATMENT:
1) analgesics, extracorporeal shock wave lithotripsy (ESWL), cholecystectomy
Cholecystitis
ETIOLOGY:
1) cholelithiasis, trauma, or infection -> inflammation of gallbladder
S/S:
1) URQ pain, nausea and vomiting, fever, possible jaundice or clay-colored stools
TREATMENT:
1) hyperalimentation, analgesics, antibiotics, antiemetics -> cholecystectomy
Pancreatitis
ETIOLOGY:
1) chronic alcoholism, gallstones, infection -> acinar cells spill pancreatic enzymes -> local and auto- digestion
S/S:
1) (acute) epigastric pain and tenderness, diaphoresis, tachycardia, fast and shallow breaths
2) (chronic) mild back pain, weight loss, episdoes including acute symptoms
TREATMENT:
1) (if acute) hyperalimentation with analgesic
Pancreatic Cancer
ETIOLOGY:
1) risk factors include tobacco smoking, family history, diabetes mellitus -> pancreatic adenocarcinoma of exocrine cells
S/S:
1) abdominal pain, weight loss, glucose intolerance, fatty stools
TREATMENT:
1) surgical resection only viable treatment
BONUS FACTS:
1) poor prognosis
Malnutrition
ETIOLOGY:
1) (Kwashiorkor) inadequate protein intake, metabolic crisis from trauma -> protein deficiency
2) (Marasmus) inadequate protein and energy intake, cancer -> protein and energy deficiency
S/S:
1) loss of energy, significant weight changes, fragile hair and nails, muscle loss, hepatomegaly
TREATMENT:
1) oral or IV feedings, psychiatric intervention if related to mental disorder
Malabsorption Syndrome
ETIOLOGY:
1) impaired small intestine mucosal cells, defective enzymes, diseased pancreas or blocked pancreatic duct, diseased liver or blocked bile duct, or helminths -> nutrients not absorbed
S/S:
1) steatorrhea, weight loss, anemia (reduced vitamins)
TREATMENT:
1) treat causative factors, dietary changes
Anorexia Nervosa
ETIOLOGY:
1) family history, societal norms, and stressful events may be linked
S/S:
1) refuses food intake, mood disorders
2) brittle hair and nails, poor wound healing, cold intolerance, abdominal distress, bradycardia
TREATMENT:
1) team-based approach combining medical management, psychotherapy, and nutritional counseling
Bulimia Nervosa
ETIOLOGY:
1) family history, societal norms, stressful events, or OCD may be linked
S/S:
1) binge-purging cycles, weight fluctuations, dental caries, esophagitis
TREATMENT:
1) team-based approach combining medical management, psychotherapy, nutritional therapy, and possible SSRIs
Motion Sickness
ETIOLOGY:
1) physical motion of endolymph within semicircular canals and vestibular sac
S/S:
1) nausea, possible vomiting, air hunger, pallor, sweating, dizziness
TREATMENT:
1) avoid food and liquid before travel, sit in stable areas if possible
