Digestive System Pathologies Flashcards
1
Q
What is oral thrush?
A
A fungal infection of the mouth
Sign of low immunity
Not contagious
2
Q
What is Candida albicans?
A
Fungus that causes oral thrush
3
Q
List three signs/symptoms of oral thrush…
A
- White patches on the oral mucosa (that can be wiped off)
- Red/raw appearance to underlying tissue
- Loss of taste or an unpleasant taste
4
Q
Allopathic treatment for oral thrush?
A
Antifungals
5
Q
Natural treatment for oral thrush…name 2 anti fungal dietary treatments
A
- Oregano oil
- Garlic
- Apple cider vinegar
- Grapefruit seed extract
- probiotics and eliminate refined and simple sugars
6
Q
Name three possible causes of mouth ulcers…
A
- Physical trauma and hot food/liquids
- Nutritional deficiencies (iron, zinc, folate and vitamin b12)
- Stress (fight or flight)
- GIT pathologies such as Crohn’s disease
7
Q
What are cold sores?
A
A viral infection that lies dormant and activates when immunity is low.
The virus migrates along the nerve to the skin or mucosa around the mouth causing tingling/ burning sensation
8
Q
Name the cause / risk factor of cold sores…
A
Herpes simplex virus (normally type 1) > triggers include stress, steroid use, trauma, local infections, sunlight exposure.
9
Q
What is an abscess?
A
A localised pocket of pus surrounded by inflammation. A defensive reaction of the tissue to prevent spread of infection elsewhere
10
Q
Name 3 signs and symptoms of an abscess…
A
- Pain and redness
- Local swelling
- Fever, malaise
11
Q
What is gingivitis
A
Is a bacterial infection of the gums
12
Q
What might gingivitis progress to if left untreated?
A
Periodontal disease (pathology of the bone around teeth)
13
Q
Symptoms of gingivitis include bleeding and receding gums. Name 5 causes…
A
- Plaque build up, poor dental hygiene, dental amalgams.
- Long-term steroid use
- Diabetes mellitus
- Smokers
- Poor nutrition
14
Q
Describe angular stomatitis
A
Fissuring and dry scaling of the surface of the lips and angles of the mouth.
15
Q
Name 3 causes of angular stomatitis
A
- Vitamin B deficiencies: Riboflavin (B2) and folic acid (B9)
- Iron deficiency
- Candida albicans (opportunistic) and staphylococcus
16
Q
What is the term to describe a dry mouth due to reduced or absent flow of saliva.
A
Xerostomia
17
Q
What is Sjogrens syndrome?
A
Auto immune attack on the exocrine glands
18
Q
List 4 complications of Xerostomia
A
- Candidiasis
- Gingivitis
- Tonsillitis
- Halitosis
19
Q
What does teratogen mean?
A
Something causing embryo malformation
Chemo, radiation, alcohol, excess vitamin A, anti convulsant medications, smoking, substance abuse
20
Q
What is a cleft lip?
A
Malformation of the lip in the embryonic development
Can be unilateral or bilateral, complete or incomplete
21
Q
What is a cleft palate?
A
Malformation of the hard palate in embryonic development.
Causing difficulty in speech, feeding and hearing
22
Q
List 3 causes of Cleft lip/palate…
A
- Genetic defects
- Environmental (maternal disease, dietary)
- Teratogens (chemo, radiation etc…)
23
Q
Oral cancer is carcinoma of the oral mucosa, lip or tongue. Name 3 causes
A
- Smoking
- Alcohol
- HPV infection
24
Q
Name two signs and symptoms of oral cancer…
A
- Red or white patches on oral mucosa or tongue
2. Difficulty eating and breathing
25
Describe salivary calculi…
Metabolic imbalance affecting mineral concentration resulting in stone formation in one of the salivary glands.
26
Salivary Calculi can abrade the gland wall causing inflammation, fibrosis and blockage. Name 3 causes of salivary calculi…
1. Dehydration
2. Abnormal calcium metabolism
3. Sjogrens syndrome
27
Signs and symptoms of salivary calculi
Intermittent pain and swelling of the affected gland, particularly when eating - ‘mealtime syndrome’. There may also be a palpable mass
28
What is tonsillitis ?
Inflammation of the tonsils
29
names 3 signs and symptoms of tonsillitis ...
1. Red, sore and painful tonsils
2. Fever over 38 degrees
3. Coughing
4. Headache
5. Pus
30
Tonsillitis can cause otitis media, what is otitis media?
Middle ear infection
31
What does GORD stand for?
Gastro-Oesophageal Reflux Disease
32
Explain what GORD (acid reflux) is ...(what happens)
The lower oesophageal sphincter relaxes and acid regurgitates from the stomach into the oesophageal.
33
Give the medical term for heartburn...
retrosternal pain
34
List 3 possible trigger foods (or drink) for GORD...
1. Spicy foods
2. fatty foods
3. alcohol
4. Caffeine
5. carbonated beverages
6. onions
7. chocolate.
35
List 3 triggers (not foods) that may cause GORD...
1. Obesity
2. Hiatus Hernia
3. Pregnancy
4. Stress
36
List three possible complications of GORD....
1. Ulcers
2. Barretts oesophagus
3. cancer
37
What is Barretts oesophagus?
Barrett's oesophagus is a medical condition where some of the cells in your oesophagus grow abnormally.
Acid reflux damage causes the lining of the oesophagus to thicken and become red.
38
Name two natural treatments for GORD...
1. Avoiding trigger foods
2. Aloe vera
3. Slippery elm
4. Weight loss (if overweight)
5. Eating smaller meals
39
What is an Hiatus Hernia?
Part of the stomach protrudes (herniates) into the thoracic cavity through an opening in the diaphragm
40
List 3 possible causes of Hiatus hernia...
Increased abdominal pressure:
1. Heavy lifting
2. Hard coughing / sneezing
3. Violent vomiting
4. Pregnancy
5. Straining with constipation
6. Obesity
7. Smoking, drug abuse, stress.
41
What does dysphagia mean?
Difficulty swallowing
42
Oesophageal cancer is a common aggressive tumour with a poor prognosis. List a possible cause and a possible risk factor...
Cause: Chronic irritation, alcohol, smoking
| Risk factor: GORD, Barretts Oesophagus
43
What is acute gastritis?
Acute (sudden) inflammation of the stomach mucosa causing breakdown of the stomach lining.
44
What are prostaglandins
Prostaglandins are lipid autacoids derived from arachidonic acid. They both sustain homeostatic functions and mediate pathogenic mechanisms, including the inflammatory response.
45
One of the causes of acute gastritis is Helicobacter pylori, what is this?
Helicobacter pylori is a bacteria that can live in the digestive tract (these can infiltrate when acid pH levels are low)
46
Another possible cause of acute gastritis is NSAID's (non-steroid anti-inflammatory drugs) what compound in the GI tract does this lower the levels of...
Lowers prostaglandin
47
Another common cause of acute gastritis is alcohol, food poisoning and stress. Name two signs / symptoms of acute gastritis...
1. Epigastric pain
| 2. Nausea / vomiting
48
Chronic Gastritis?
Chronic stomach mucosal inflammation for more than 4-6 weeks.
49
# Fill in the missing words in regards to chronic gastritis...
Prolonged low-grade 1______ resulting in 2______ and hence loss of elasticity and 3______.
1. Inflammation
2. Fibrosis
3. Peristalsis
50
What are the 3 causes of chronic gastritis (ABC)?
A - Autoimmune
B - Bacterial - H pylori
C - Chronic irritation eg long term NSAIDS.
51
Peptic ulcers are ulcers of the GI mucosa. Commonly affects which two areas ...
1. proximal duodenum
| 2. lesser curvature of the stomach
52
Whats the difference in signs and symptoms between peptic ulcers in the gastric area compared to the duodenum...
Gastric - epigastric pain, 30-60 mins after eating, less often at night.
Duodenal - epigastric pain 2 - 3 hours after eating and at night. (pain generally occurs on an empty stomach)
53
80% of the time Peptic ulcers are due to H.Pylori bacterial infection, list 3 other possible causes
1. NSAIDS; Disrupt mucous barrier, lowers stomach bicarbonate, disrupts blood flow.
2. Stess - Sympathetic nervous system dominance - can often cause ischaemia (inadequate blood supply) resulting in defective tissue.
3. Chronic gastritis
54
What is dumping syndrome
Loss of control of gastric emptying.
55
What surgical procedure can often cause dumping syndrome...
```
Bariatric surgery
(cholecystectomy, gastric bypass, gastrectomy)
```
55
What surgical procedure can often cause dumping syndrome...
```
Bariatric surgery
(cholecystectomy, gastric bypass, gastrectomy)
```
56
Whats the name for the exit region of the stomach?
Pyloris
57
Gastric cancer is the 2nd highest cause of cancer related deaths in the world - where is it most prevalent and why?
highest prevalence in Korea and Japan, due to diet high in salted, pickled and smoked foods.
58
Name 3 causes / risk factors for Gastric cancer...
1. Male , smoking, age (55+)
2. H.Pylori infection
3. Diet rich in salted, smoked, pickled foods (N-nitroso compounds)
4. Low fruit and veg in diet
59
List 3 signs and symptoms of advanced stage gastric cancer....
1. Black blood in stool
2. Loss of appetite
3. Weight loss
4. Tiredness
5. , Anaemia
6. Jaundice
60
Where is the appendix?
The appendix is a narrow, finger-shaped pouch that projects out from the colon (large intestine).
61
Appendicitis is inflammation of the appendix, often causes by an obstruction, usually faecal matter.
List three signs / symptoms, include area of the body...
1. Initially umbilical pain
2. Pain travels to the right iliac fossa, becoming constant and severe.
3. Rebound tenderness at McBurneys point
4. Pallor, sweating and fever, nausea, vomiting and diarrhoea.
62
Appendicitis is the most common surgical emergency.
| List two complications of Appendicitis
1. Rupture (if pain subsides it usually indicates a rupture)
2. Peritonitis (release in faecal matter can result in infection which spreads to peritoneum)
63
What might show up in a blood test to diagnose appendicitis ...
High ESR - erythrocyte sedimentation rate
| This suggests inflammation in the body.
64
Why is dysentery a notifiable disease? And what does notifiable disease mean.
A notifiable disease means it is required by law to be reported to government authorities
Dysentery is a highly infectious bacterial infection
65
What does dysentery cause..include complications
Infection of the intestines that causes diarrhoea containing blood and/or mucus.
Dehydration is a complication of dysentery which is dangerous especially in small children, pregnancy and elderly.
66
What does SIBO stand for...
Small Intestinal Bacterial Overgrowth
67
What is SIBO...
SIBO describes the overpopulation of microflora in the small intestines.
68
What can the excessive bacterial growth in SIBO lead to ... (gases) and list 3 symptoms of this excess gas...
Lead to the production of hydrogen and methane gases as a result of carbohydrate use.
Symptoms include 1. Bloating 2. Flatulence 3. Diarrhoea or constipation.
69
What could SIBO ultimately result in... name 3 issues.
1. Malabsorption
2. Anaemia
3. Inflammation
4. Increased small intestine permeability
70
IBD describes two chronic inflammatory bowel diseases, name them.
1. Ulcerative colitis
| 2. Crohns disease
71
Ulcerative colitis list the following...
1. Region affected
2. Layers affected
3. Key symptoms
4. Complications
1. Colon and rectum
2. Mucosa layer (ulcers)
3. Abdominal pain - (left), bloody diarrhoea
4. Haemorrhage
71
Ulcerative colitis list the following...
1. Region affected
2. Layers affected
3. Key symptoms
4. Complications
1. Colon and rectum
2. Mucosa layer (ulcers)
3. Abdominal pain - (left), bloody diarrhoea
4. Haemorrhage
72
Crohns Disease list the following...
1. Region affected
2. Layers affected
3. Key symptoms
4. Complications
1. Any part of the GIT, mostly the terminal ilium
2. All layers - transmural
3. Crampy abdominal pain (right), Loose semi solid stools
4. Fistules, abcess, obstruction, malabsorption (B12, B9 def)
73
What is calprotectin?
Calprotectin is a protein biomarker that is present in the faeces when intestinal inflammation occurs
74
Symptoms of ulcerative colitis and crohns disease are similar, what age range do they mostly occur...
15 - 35 years.
75
Name three causes of IBD - Irritable bowel disease.
1. Autoimmune
2. Dietary links
3. Genetic predisposition
4. Environmental triggers (antibiotics, infection) with defective immune system.
76
IBS - Irritable bowel syndrome is a functional GI disorder characterised by lower abdominal discomfort and altered bowel habits. Name 4 signs and symptoms...
1. Abdominal pain and cramping relieved by passing a stool
2. Diarrhoea, constipation or alternating between both
3. Bloating, painful flatulence, post-prandial urgency
4. Incomplete emptying of bowels and mucus in stools
77
Name three causes/triggers for IBS...
1. Stress / emotional factors: Central nervous system alterations in GI secretions, motility and pain sensitivity
2. GIT infection
3. Food allergy or intolerance
4. Altered microbiome, excessive antibiotic use
78
Summarise a low FODMAP diet...
FODMAP stands for Fermentable Oligo-, Di-, Mono-saccharides and Polyols.
These are nondigestible short-chain carbs that are osmotically active, meaning they force water into your digestive tract.
Additionally, because they’re nondigestible, your gut bacteria ferment them, increasing gas and short-chain fatty acid production
Therefore, FODMAPs are notorious for triggering digestive symptoms such as bloating, gas, stomach pain, and altered bowel habits varying from constipation to diarrhea or a combination of both
79
What is Coeliacs disease?
An autoimmune condition where the bodies immune system attacks its own mucosa tissue in the small intestine in response to ingestion of gluten.
80
Which genetic surface markers link to coeliacs disease?
HLA - DQ2 and DQ8
81
Gluten is made up of two types of protein molecules, name them...
1. Gliadins
| 2. Glutenins
82
# Fill in the missing words...
Gliadin is modified by 1.______ _______ (tTG), an enzyme found in the mucosa of the 2.____ ________. This modification allows the protein to be presented to the 3._____ ______. In Coeliacs, the immune system mistakenly identifies the 4.______ as 5.______. The immune system produces 6.________ and an inflammatory immune reaction which strips the 7._______ and ____, causing atrophy.
1. tissue transglutaminase
2. small intestine
3. Immune system
4. Gliadin
5. Foreign
6. antibodies
7. Microvilli and villi
83
Coeliacs disease has a spectrum of symptoms - name 6 of 9 Classic GI signs and symptoms...
1. Chronic diarrhoea / constipation
2. Pale, foul smelling stools
3. Steotorrhoea (fatty stools)
4. Bloating
5. Flatulence
6. Abdominal pain
7. Loss of appetite
8. Weight loss
9. Lactose intolerance - due to the loss of brush border enzymes
84
Coeliacs disease has a spectrum of symptoms - name 5 of 8 extra-intestinal symptoms ...
1. Lethargy, fatigue (iron deficiency anaemia and irritability)
2. Delayed growth in childhood
3. Mouth ulcers
4. Neurological problems (anxiety, depression)
5. Dermatitis herpetiformis (DH) is a bumpy, itchy skin rash
6. Muscle / joint pain
7. Osteopenia (low bone density) / osteoporosis (weak and brittle bones)
8. Infertility
85
Name 3 easy we can diagnose Coeliacs disease...
1. Blood test - anti-tranglutaminase antibodies (IgA, tTG)
2. Stool test, endoscopy
3. Biopsy of small intestinal mucosa is required for a definite diagnosis
86
Treatment for Coeliacs disease
Gluten free diet
| Potentially also dairy free due to the loss of brush border enzymes
87
Name 3 possible complications of Coeliacs disease...
1. Osteoporosis
2. Anaemia
3. Bowel cancer
88
What is Diverticulosis?
The presence of pea-sized pouches caused by herniations of mucosa bulging through the colon wall.
89
Faeces and food trapped in pea-sized colon pouches become infected and inflamed - what is this called?
Diverticulitis
90
Name 3 signs /symptoms of diverticulitis...
1. Bloating
2. Abdominal pain
3. Diarrhoea
4. Fever / chills
91
name two possible causes of diverticulitis
1. Low fibre diet - slow GI transit > straining > high intra-abdominal pressure (constipation)
2. Weak connective tissue
92
What the difference between diverticulosis and diverticulitis ?
Diverticulosis are pea-sized pouches caused by herniations of the mucosa bulging out through the colon wall, Diverticulitis is when these pouches become infected and inflammed. These can bleed ./ rupture and leak into the peritoneum.
93
What is a hernia?
An internal part of the body pushes through a weakness in the muscle or surrounding tissue wall.
94
What is an Inguinal hernia?
Swelling or lump in the groin (inguinal canal), common, mostly affecting men, caused by straining - lifting, constipation, heavy coughing - which all increase th intra-abdominal pressure.
95
What is hiatus hernia?
Portion of the stomach protrudes into the thoracic cavity through an opening in the diaphragm
Rarely symptomatic but can cause GORD
96
Name two signs/symptoms of a hernia?
1. Swelling or lump in the groin or abdominal region
| 2. Pain when straining, disappears when lying down
97
What might cause necrosis in a hernia?
If strangulation occurs there might be loss of blood supply or bowel obstruction causing necrosis (death of the tissue)
98
What are colonic polyps?
Benign epithelial growths of the colonic mucosa. Usually asymptomatic, sometimes occult blood in stool (very small amount)
99
What may be a complication of colonic polyps?
May become malignant (cancerous)
100
List two signs and symptoms of Colorectal cancer...
1. Fluctuating bowel habits (constipation/diarrhoea)
| 2. Blood (and mucosa) in stools. Abdominal pain
101
Name 3 possible causes of colorectal cancer...
1. Diet high in meat and low in fibre
2. lack of vitamin D
3. Polyps
4. Family history
102
What investigations might they use to diagnose colorectal cancer, name 2
1. Colonoscopy and biopsy
2. Stool analysis (blood and M2PK)
3. Blood tests - CEA, inflammatory markers and low Hb
CEA = Carcinoembryonic antigen
103
Where might colorectal cancer spread before causing symptoms...name 2
1. Liver - portal vein
2. lungs
3. brain
4. bone
104
Why is acute pancreatic a medical emergency?
Because enzymes (proteases) are activated whilst still in the pancreas leading to self digestion of pancreatic tissue
105
Signs and symptoms of acute pancreatitis... name 3
1. Sudden extreme periumbilical pain
2. Nausea and vomiting
3. Diarrhoea, fever
106
name three possible causes for acute pancreatitis
1. Alcohol abuse
2. Gallstones
3. Cancer
107
Which pathology would you say a patient with the following has....
1. Repeated episodes of abdominal pain
2. Fatty, foul-smelling stools
3. Drinks a lot of alcohol
Chronic pancreatitis
108
What does metastatic mean...
Metastasis. In metastasis, cancer cells break away from where they first formed (primary cancer), travel through the blood or lymph system, and form new tumors (metastatic tumors) in other parts of the body.
109
Pancreatic cancer has a poor prognosis, what age range does this more commonly affect...
Older people, over 40 years of age.
110
Name 4 signs, symptoms of Pancreatic cancer...
1. Epigastric pain radiating to the back
2. Unexplained weight loss, anorexia and fatigue
3. Jaundice (caused by potential blockage of the common bile duct preventing the waste removal of bilirubin)
4. Post-prandial nausea
5. Glucose intolerance (neuroendocrine tumour)
111
What does the term palliative mean...
Relieving pain
| relieving pain without dealing with the cause of the condition
112
HLA stands for human leukocyte antigen, a family of genes found on chromosome 6 which provide the instructions to make a group of proteins known as the HLA complex. Name the two HLA genes associated with coeliacs disease...
HLA DQ2
| HLA DQ8
113
List two common causes of dysentery
1. Shigella
| 2. amoebic
114
What is liver cirrhosis?
irreversible scarring of there liver tissue due to long term damage
115
Conversion of normal hepatocytes to fibrotic non-functional tissue is known as what pathology?
Liver cirrhosis
116
List three possible causes of liver cirrhosis
1. Alcoholic abuse
2. Hepatitis B / C
3. Bile obstruction, autoimmune liver disease, long term exposure to toxins.
117
Impaired liver function results in... name 3 of 6
1. Reduced ability to synthesis substances (ie clotting factors)
2. Decreased remove and conjugation of bilirubin
3. Impaired nutrient absorption
4. Impaired glucose metabolism
5. Decreased inactivation of hormones
6. Decreased remove of toxic substances
118
Liver cirrhosis symptoms and cause of symptoms ...name 4 of 8
1. JAUNDICE - impaired conjugation of bilirubin and reduced bile flow
2. FATIGUE - decreased gluconeogenesis, reduced bile for digestion of fats.
3. ITCHY SKIN - bile salts back up into blood / tissues
4. ANAEMIA - low iron storage (and vitamin B12 also)
5. OESOPHAGEAL VARICES AND SPLENOMEGALY - Portal hypertension
6. GYNAECOMASTIA - (enlarged breast in men) - impaired inactivation of sex hormone
7. ASCITES AND PERIPHERAL OEDEMA - portal hypertension causing shift of fluid, lymph obstruction
8. VOMITING BLOOD / DARKL TARRY STOOLS - Oesophageal varies, occult blood.
119
Name the three investigations to help diagnose liver cirrhosis...
1. Blood test - raised liver enzymes ie ALT and AST
2. Ultrasound
3. Biopsy
120
Liver cancer can be primary or secondary, what does this mean.
Primary means the cancer developed within the liver
| Secondary means the cancer has spread from another organ / tissue eg the stomach
121
List 5 signs and symptoms of Liver cancer.
1. Jaundice
2. Ascites
3. Hepatomegaly
4. Pruritus (itchy skin)
5. Bleeding oesophageal varisces
6. Weight loss
7. Vomiting, loss of appetite, feeling very full after eating, feeling sick, pain or swelling in the abdomen , fatigue and weakness.
122
List three possible causes for Liver cancer
1. Associated with Liver cirrhosis
2. Alcohol, toxins causing necrosis - chronic inflammation and cell proliferation (turnover)
3. Hepatitis B/C - viral integration into host genome affecting DNA
123
What is the allopathic treatment for Liver cancer
surgery / Liver transplant
124
What are gallstones made up of 80% of the time
Cholesterol
125
Gallstones are 70% asymptomatic at diagnosis however there are also signs and symptoms - name 2
1. Biliary colic - pain radiating under the right shoulder
2. Abdominal pain
3. Jaundice, fever, bloating, nausea
126
What are the 5 F's in regards to the risk factors of Gallstones...
1. Female
2. Fat
3. Fair
4. Forty
5. Fertile
127
Which excess hormone might contribute to the cause gallstones and why
Oestrogen - because oestrogen is responsible for pushing the cholesterol out into the gallbladder
128
What is Enterobiasis?
Pinworm - a parasitic 'helminth' infection with a lifespan of approximately 2 months
128
What is Enterobiasis?
Pinworm - a parasitic 'helminth' infection with a lifespan of approximately 2 months
129
Pinworm - eggs are ingested - face-oral route - and hatch in the duodenum within 6 hours. How ling does it take for the worms to mature and which part of the GIT do they commonly inhabit?
Mature in 2 weeks and commonly inhabiting the terminal ilium and large intestine
130
Who is most susceptible to get pinworm?
common amongst young children under 10 and institutionalised adults, but can affect all people.
131
Name the main symptom of pinworm...
Intense itching around the anus or vagina, particularly at night when female worms are laying their eggs.
132
Toxoplasmosis is an intracellular protozoan parasite. What is its main host and why?
Cats are the main host as toxoplasmosis can only reproduce within the intestines of cats
133
What are the main risks of toxoplasmosis - name 3
1. Health risk during pregnancy - can cause miscarriage
2. health risk in immunocompromised (HIV)
3. Can cause encephalitis and schizophrenia
