Digestive System #1

Question 1

Missing teeth

Answer 1

loss of permanent teeth after the loss of primary teeth
can cause joint disease, or bolting (inadequate chewing) which leads to digestive disturbances
causes = dental decay, age, dental injury, may be a sign for other diseases
treatment = permanent or removable false tooth

Question 2

Impacted third molars

Answer 2

third molar (wisdom teeth) is malpositioned prevent normal eruption
generally erupts around 17 and 21 years of age
impacted when they do not have enough room to erupt due to bone structure or other teeth
treatment = antibiotic for infections, extraction

Question 3

Dental caries

Answer 3

also known as tooth decay, can lead to pain, abscess may form
infection arises from erosion of tooth surface, first appears at white spots
caused by bacteria that forms acid plaques from sugars, which erodes the enamel, causing a cavity
treatment = diseased portion is removed then filled with dental amalgam, composite material, root canal procedure, tooth extraction

Question 4

Discoloured teeth

Answer 4

colour may range from slight yellow to brown and grey
can be caused by age, smoking, red wine, coffee, tea, drugs, antibacterial mouthwash
treatment = if superficial, then polishing, otherwise use bleaching procedure or cap and crown

Question 5

Gingivitis

Answer 5

inflammation and swelling of the gums
gums become red, soft and shiny, bleed easily, can lead to bone disease
almost 50% of american adults have some gingivitis
causes = plaque, vitamin deficiencies, pregnant women, diabetics
treatment = removal of plaque from cleaning, mouthwash, root planing

Question 6

Periodontitis

Answer 6

destructive gum and bone disease around teeth
end result of gingivitis, teeth become sensitive to temperature extremes in food, painful during chewing
generally due to lack of oral hygiene, smoking, HIV, diabetes
treatment = SCP scaling, root planing, curettage, surgery

Question 7

Oral tumors

Answer 7

can develop anywhere in/on surface of mouth, gums, cheeks or palate, not teeth
benign are not life threatening, malignant are not painful until advanced stages
tobacco seems to affect tumor development into malignancy
treatment = benign are excised

Question 8

Malocclusion

Answer 8

angles of malposition and contact of maxillary and mandibular teeth
faulty bite = malocclusion, protrusion or recession of faw
occurs due to heredity, finger sucking, airway problems
treatment = braces, extraction of teeth, removing portion of jaw

Question 9

Temporomandibular joint syndrome

Answer 9

inflammation/disease/dysfunction of temporomandibular joint
jaw movement is limited, clicking sounds, pain is usually bilateral with one side more painful, sinus pain
due to unbalanced activity of jaw from teeth grinding, malocclusion, poor dentures, arthritis
treatment = appliances to prevent teeth grinding, splint, physical relaxants

Question 10

Tooth abscesses

Answer 10

pus-filled sac that develops in tissue around base of root
toothache, throbbing, glands may become swollen, fever
due to tooth decay or tooth structure loss
antibiotic therapy, root canal therapy, apicoectomy

Question 11

Mouth ulcers

Answer 11

lesion on mucous membrane (canker sores), pale yellow spots
aphthous ulcers = occur during stress or illness
traumatic ulcers = result from injury
treatment = antiseptic mouthwashes, warm salt water, creams

Question 12

Herpes simplex

Answer 12

contagious recurrent viral infection (cold sores), due to Herpes type 1
produces painful ulcers, tingling and numbness precede appearance
exposure to sun, wind, stress affect onset
treatment = no cure, antiviral ointment to shorten duration

Question 13

Thrush

Answer 13

fungal infection from candida albicans
sore, slight raised yellow patches in mouth, burning sensation
most common in young children, immunodeficient, elderly
occur as result of prolonged treatment with antibiotics, cancer, diabetes, glucocorticoids
treatment = antifungal medication for 14 days

Question 14

Necrotizing periodontal disease

Answer 14

ulceration of disease of the gums, gums bleed and can appear greyish
due to anaerobic bacteria resulting from poor oral hygiene, second to gingivitis
most common in HIV/Aids
treatment = antibiotics, mouthwash, minor surgery

Question 15

Oral leukoplakia

Answer 15

epidermal thickening of buccal mucosa, palate or lower lip
mucous membrane becomes rough/hard/whitish gray
most common in the elderly, reaction to tobacco
treatment = eliminating source of irritation

Question 16

Oral cancer

Answer 16

SCC in the oral cavity, some are adenocarcinomas
white patchy lesion or ulcer that fails to heal
use of alcohol, tobacco are large factors
treatment = surgery, laser therapy

Question 17

Gastroesophageal reflux disease

Answer 17

clinical manifestations of regurgitation of stomach contents, mostly at night
may be described as heartburn, vomitus occurs, tooth enamel becomes eroded
can result from overeating, pregnancy, medications
treatment = elevating the head, taking a light meal before bed, antacids

Question 18

Esophageal varices

Answer 18

dilated submucosal veins that develop in patients with hypertension
results in upper GI bleeding
may produce no symptoms until the rupture, causing hemorrhages
occurs in many patients with cirrhosis of the liver
treatment = endoscopic sclerotherapy

Question 19

Esophagitis

Answer 19

inflammation and tissue injury of esophagus
heartburn, vomiting of blood
corrosive esophagitis results from ingestion of alkali or acid
can also appear as GI manifestation of HIV
treatment = bland diet, medications

Question 20

Esophageal cancer

Answer 20

SCC on the squamous epithelium of esophagus
dysphagia, weight loss, burning sensation, hoarseness
risk factors = smoking, alcohol, very hot beverages, history
mostly affects caucasians and males
treatment = chemoradiotherapy, surgery

Question 21

Gastric and duodenal peptic ulcers

Answer 21

ulceration of the lining of upper intestinal tract or stomach
generally symptom free however can report heartburn, gnawing pain
factor of peptic ulcers is a bacterial infection or use of antiinflammatory agents
treatment = rest, medication, changes in diet, surgery

Question 22

Gastritis

Answer 22

inflammation of the lining of the stomach
epigastric pain, indigestion, fullness after meals,
chronic gastritis more common in the elderly
main cause is bacterial infection ingestion of irritating foods
treatment = antibiotics, antacids

Question 23

Gastric cancer

Answer 23

occurs in the stomach, frequently asymptomatic in early stages
weight loss, persistent abdominal pain, anorexia
japan has highest incidence in the world, smoking, heredity, diet containing nitroso compounds
treatment = gastric resection, chemoradiotherapy, palliation

Question 24

Acute appendicitis

Answer 24

inflammation of the appendix
vague discomfort around navel, localizes in a few hours, nausea, diarrhea
due to obstruction of appendiceal region
treatment = appendectomy

Question 25

Hiatal hernia

Answer 25

defect in diaphragm permitting segment of stomach to slide into thoracic cavity
results in esophageal reflux, causing heartburn, chest pain, respiratory complications
caused by congenital defect, age, obesity, trauma
treatment = dietary modification, drug therapy

Question 26

Abdominal hernia

Answer 26

an organ protrudes through an abnormal opening in the abdominal wall
symptoms are base on site/size of hernia, sharp pain
occurs due to trauma, pregnancy, previous surgical scar
treatment = truss to reduce hernia sac, surgery

Question 27

Crohn’s disease

Answer 27

chronic inflammatory disorder of GI tract
diarrhea, intermittent abdominal pain, weight loss, malaise, nausea, stomach is tender and distended
treatment = incurable, nutritional support to control symptoms, antibiotics

Question 28

Ulcerative colitis

Answer 28

chronic inflammatory bowel disease
abdominal cramping, urgency to defecate, watery stools
generally runs in families
treatment = well balanced diet low in fat and bulk, drug, surgical removal of colon and rectum

Question 29

Gastroenteritis

Answer 29

acute inflammation of lining of stomach and intestines
presence of mucus, pus, blood in stool, traveler’s diarrhea
caused by bacteria, parasites from contaminated food
treatment = rest and eat as tolerated, maintain fluids and electrolytes

Question 30

Intestinal obstruction

Answer 30

mechanical or functional blockage of intestines
due to partial/complete blockage of the bowel, electrolyte imbalance and high WBC count
causes = neoplasm, volvulus, crohn’s disease
treatment = surgery, fed intravenously until peristalsis returns

Question 31

Diverticulosis

Answer 31

caused by defects in the muscular wall of the large bowel, causes outpouches that vary in size
pain, flatulence, difficulty in defecation
diet that contains inadequate roughage and highly refined food
treatment = adequate fluids and roughage

Question 32

Diverticulitis

Answer 32

infection/inflammation of diverticula
abdominal pain, tenderness
lack of dietary bulk, inadequate fluid, constipation
treatment = antibiotics, surgical intervention

Question 33

Colorectal cancer

Answer 33

cancer in any part of the colon or rectum, third most common cancer
abdominal pain, change in bowel habits, bloody stools, abdominal distension, pallor
risk increases with age, history of diabetes, crohn’s disease, family history
treatment = surgical resection, colostomy

Question 34

Pseudomembranous enterocolitis

Answer 34

acute inflammation with plaque like adhesion of necrotic debris
bowel mucosa have membranous appearance, greenish water diarrhea, concentrated urine
generally due to use of broad-spectrum antibiotics, allows for C. difficile infection
treatment = discontinue antibiotic, substitute different medication

Question 35

Short-bowel system

Answer 35

small bowel fails to absorb nutrients due to inadequate absorptive surface
significant signs of malnutrition are noted, weight loss, rashes
crohn’s disease, tumor resection, trauma
treatment = drugs, food supplements, surgery

Question 36

Irritable bowel syndrome

Answer 36

cramp like/aching abdominal pain, change in bowel habits, bloating
immune/neuroimmune disorder
significant female predominance, 20-40 years of age
treatment = medications, stool softeners, soluble fiber supplements

Question 37

Peritonitis

Answer 37

inflammation of the peritoneum, becomes hyperemic
has the potential to cause abscesses and adhesions
abdominal pain, nausea, vomiting
caused by bacterial invasion, E.coli
treatment = broad-spectrum antibiotics, analgesics

Question 38

Hemorrhoids

Answer 38

varicose dilations of vein in the anal canal or anorectal area
often painless, or some rectal pain, itching, bleeding
can be due to constipation, straining, pregnancy
treatment = stool softeners, fruits/vegetables, warm baths, cryosurgery