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GI > Diseases > Flashcards

Diseases Flashcards

1
Q

Most common type of oral cancer is?

A

oral squamous cell carcinoma

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2
Q

What can cause mouth ulcers?

A

systemic disease
idiopathic
trauma
neoplasia

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3
Q

Give some examples of systemic conditions which could cause mouth ulcers.

A 
Bechets
Anaemia
HIV
Primary heretiform gingiva stomatitis
Pemphigus
Pemphigoid
Lupus erythematosus
IBD
Peutz Jeghers
Gardener's syndrome
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4
Q

Persistant oral white patches which don’t rub off are likely to be?

A

leucoplakia (premalignant lesion)

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5
Q

What would a histological biopsy of leucoplakia show?

A

alteration in keratinization (hence looks white) AND dysplasia of epithelium

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6
Q

what is lichenoid inflammation?

A

chronic inflammation along the base of the epithelium causing damage to keratinocytes (seen in Lichen planus)

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7
Q

which is more concerning a red or white oral patch and why?

A

red, many are due to dysplasia or malignancy

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8
Q

Name 2 causative diseases of oral pigmentation.

A

Addison’s disease

Peutz-Jegher’s syndrome

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9
Q

What is Sjorgren’s syndrome?

A

a disorder of the immune system with common symptoms of dry mouth and eyes

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10
Q

What systemic disease can cause boggy gingivae and why?

A

leukaemia due to infiltration by malignant cells and immune-compromise

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11
Q

How can lymphoma affect the mouth?

A

palable lymph nodes causing

extra/intraoral diffuse swellings causing ulceration and tooth migration

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12
Q

What is recurrent aphthous ulceration (explain the types)?

A

multiple oral ulcers: 2 types minor (common, <10mm diameter with grey/white centre and thin halo, heals within 14 days with NO scar) and major (>10mm in diameter, persist for weeks/months, heal WITH scarring)

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13
Q

Recurrent aphthous ulceration is most common in who?

A

females and non-smokers

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14
Q

How would you treat recurrent aphthous ulceration?

A

Avoiding triggering food and drink

Corticosteroids may be used to lessen duration and severity

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15
Q

Where are the high risk sites for oral squamous cell carcinoma?

A

floor of mouth, lateral border and ventral surface of the tongue, soft palate and retromolar pad/tonsillar pillars

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16
Q

Where will oral squamous cell carcinoma rarely present?

A

on hard palate or dorsum of the tongue

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17
Q

which pre-malignant lesions could become oral squamous cell carcinoma?

A

leukoplakia (white patch)
lichen planus
submucous fibrosis
erythroplakia (red patch)

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18
Q

what are some risk factors for oral squamous cell carcinoma?

A 
Smoking
Alcohol
HPV
Chronic infection
Nutritional deficiencies 
UV exposure
19
Q

How might an oral squamous cell carcinoma present?

A 
Variably: white/red/speckled ulcer/lump
non-healing ulcer
unexplained pain in head or back of neck
numbness
dysphagia
odynophagia
20
Q

What is the prognosis for oral squamous cell carcinoma?

A

5 year survival in 40-50% of cases as is normally detected late

21
Q

What is more common in the oesophagus, a benign or malignant tumour?

A

malignant

22
Q

which types of malignancy affect the oesophagus?

A

squamous cell carcinoma

adenocarcinoma

23
Q

What can GORD be caused by?

A 
incompetent LOS
poor oesophageal clearance
barrier/visceral sensitivity
hiatus hernia
systemic sclerosis
24
Q

what are the risk factors for GORD?

A 
increased abdominal pressure (pregnancy or obesity)
high fat diet
caffeine
alcohol
smoking
25
Q

What are the main presentations for GORD?

A

heartburn (mainly)

regurgitation and odynophagia (due to oesophagitis)

26
Q

What does GORD cause?

A

Oesophagitis and if long standing can progress to Barrett’s oesophagus which predisposes to cancer

27
Q

what pharmacological treatment would you give a patient with GORD?

A

Antacids (symptom relief)
H2 antagonists (symptom relief)
PPI (symptom relief + healing) - best eg: omeprazole

28
Q

which drugs may cause reflux?

A 
antihistamines
steroids
CCBs
benzodiazepines
antidepressants
29
Q

what is Barrett’s oesophagus?

A

A complication of GORD where intestinal metaplasia has occured (change from squamous to columnar epithelium), hiatus hernia is almost always present

30
Q

what does Barrett’s oesophagus increase your risk of?

A

adenocarcinoma

31
Q

why does Barrett’s oesophagus occur?

A

a protective response aiming to change to have goblet cells (stomach mucosa) which will secrete mucin to neutralise the acid but instead results in unstable muscosa at risk of dysplasia

32
Q

How do you diagnose Barrett’s oesphagus?

A

endosopy and biopsy

33
Q

What is the treatment for Barrett’s oesophagus?

A

surveillance
PPI
removal of lesion endoscopically
radiofrequency ablation of lesion

34
Q

What is reflux oesophagitis?

A

inflammation of the oesophagus due to refluxed gastric contents causing hyperplasia

35
Q

What occurs pathologically in reflux oesophagitis?

A

basal zone hyperplasia and elongation of CT papillae (due to contant stress on the cells)

36
Q

Why could the LOS be defective?

A

CNS depressants (alcohol)
Pregnancy
Hypothyroidism
Systemmic sclerosis

37
Q

What is eosinophilic oesophagitis?

A

inflammation of the oesophagus due to increased eosinophils even though no reflux is occuring

38
Q

what does eosinophilic oesophagitis cause the oesophagus to look like?

A

corrugated or spotty

39
Q

how would someone with eosinophilic oesophagitis present?

A

long history of dysphagia
heartburn
oesophageal pain

40
Q

where is squamous cell carcinoma and adenocarcinoma of the oesophagus most likely to affect?

A

squamous cell carcinoma: middle and upper thirds

adenocarcinoma: lower 1/3 (normally due to reflux)

41
Q

what is squamous cell carcinoma of the oesophagus associated with?

A

smoking and alcohol

42
Q

what is adenocarcinoma associated with?

A

Barrett’s and GORD

43
Q

how do patient’s with oesophageal malignancy often present (is same for both types)?

A

initially asymptomatic then progressive dysphagia, wt loss, loss of appetite, anorexia and lymphadenopathy

GI (11 decks)

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