Exam 1: GI Flashcards

1
Q

Aphthous Ulcer

A

Painful ulceration of oral mucosa and pharynx

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2
Q

Aphthous ulcers are self limiting, ____ but commonly recur

A

Noncontagious

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3
Q

Physical characteristics of aphthous ulcer

A

White exudate

Red rim

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4
Q

Aphthous ulcer present in ____, and risk factors include

A

40% population

Females, < 20 yo
Genetics
Celiac / IBD
Smoking 
Stress 
Trauma 
Fever
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5
Q

Supplementation with ___ can reduce aphthous ulcers

A

Vitamin B12

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6
Q

Behcet disease

A

Aphthous ulcers that travel down into esophagus

More intense

In women can effect vaginal region

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7
Q

Oral herpes caused by

A

Herpes simplex virus

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8
Q

60% of adults are carriers for

A

Oral herpes

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9
Q

HSV is latent in what ganglion

A

Trigeminal

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10
Q

HSV 1

A

Orofacial

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11
Q

HSV 2

A

Genital

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12
Q

Herpesviral encephalitis

A

Life threatening
Acute inflammation

MC HSV1

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13
Q

Intense initial reaction to HSV in childhood

A

Acute hermetic gingivostomatitis

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14
Q

Oral candidiasis aka

A

Thrush

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15
Q

Causative fungus of thrush

A

Candida albicans

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16
Q

Characteristics of thrush

A

Gray/white pseudomembranes

Underlying erythema

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17
Q

Thrush is ____

A

Opportunistic

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18
Q

2 oral proliferative lesions

A

Fibroma

Pyogenic granuloma

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19
Q

Fibroma

A

Modular mass following chronic irritation

Usually along bite line

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20
Q

Pyogenic granuloma aka

A

Pregnancy tumor

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21
Q

Pyogenic granuloma

A

Hemangioma of gingiva
Red/purple
Grows rapidly

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22
Q

Pyogenic granuloma can be on ____ or ____

A

Skin

Oral cavity

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23
Q

Leukoplakia

A

Raised, white patch that can’t be scraped off

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24
Q

Leukoplakia present in ___

A

3% population

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25
Q

Risks for leukoplakia

A

Inflammation (tobacco, alcohol, candidiasis)

Males

Age 40-70

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26
Q

25% of leukoplakia are pre-cancerous and can progress to

A

Squamous cell carcinoma

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27
Q

Erythroplakia

A

Red, velvety organ lesion with irregular borders

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28
Q

Risks fro erythroplakia

A

Males
Age 40-70
Tobacco

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29
Q

> 50% of erythroplakia transition into

A

Squamous cell carcinoma

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30
Q

Oral cancer is _____ MC in ___

A

2X MC in males

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31
Q

Thrush present in ___

A

40% kids

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32
Q

Thrush is characteristic of

A

AIDS
Diabetes
Antibiotics

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33
Q

Mutation common in oral cancer

A

TP53

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34
Q

95% of cases of oral cancer are what type?

A

Squamous cell carcinoma

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35
Q

Leukoplakia is considered a

A

Preneoplasic lesion

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36
Q

Erythroplakia is more __ and ___ than leukoplakia

A

Rare

Aggressive

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37
Q

SCC has ___ prognosis

A

Poor

<50 % long term survival

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38
Q

Risks for SCC in oral cavity

A

Alcohol
Tobacco
> 30 yo
HPV 16

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39
Q

Oropharyngeal pain and dysfunction are observed in

A

SCC (oral cancer)

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40
Q

Multiple primary tumors are common in

A

SCC (oral cancer)

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41
Q

MC locations for oral SCC

A
Ventral tongue 
Floor of mouth
Lower lip
Soft palate
Gingiva
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42
Q

Appearance of oral SCC can be ___ or ___

A

Whitish-gray or erythematous

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43
Q

HPV associated Oral SCC location

A

Base of tongue

Tonsillar crypts

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44
Q

HPV associated oral cancer due to what pathogen

A

HPV 16

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45
Q

MC lymph node affected by oral SCC

A

Cervical nodes

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46
Q

Composition of saliva

A

99% water
IgA
Enzymes

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47
Q

Primary salivary gland pathologies are ___

A

Rare

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48
Q

MC primary salivary gland affected in pathologies

A

Parotid

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49
Q

Xerostomia

A

Dry mouth due to low saliva production

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50
Q

Characteristics of xerostomia

A
Age related (20% > age 70)
Tongue may fissure/ ulcerate 
Risk for dental caries and candidiasis 
Dysphagia
Dysarthria
51
Q

Autoimmune attack on salivary and lacrimal glands

A

Sjogren syndrome

52
Q

Sialadenitis

A

Inflammation and enlargement of salivary glands

Due to trauma, autoimmunity, infections

53
Q

Viral sialadenitis MC due to

A

Mumps

54
Q

Bacterial sialadenitis MC due to

A

Staph aureus

55
Q

Mumps in adults can cause ___ and ___

A

Pancreatitis

Orchitis

56
Q

Mumps in kids is ___

A

Self-limited

57
Q

Mumps affects what gland?

A

Parotid

58
Q

Mucocele

A

Mucous cyst due to ductal obstruction

Saliva collects within tissue

59
Q

Mucocele common location

A

Lower lip

Postprandial

60
Q

Smaller salivary gland neoplasms are less common but ______

A

Greater cancer risk

61
Q

Salivary gland neoplasms are ___ and make up what percentage of tumor diagnosis

A

Rare

<2%

62
Q

Salivary gland ca MC what age and sex

A

60-80

Females

63
Q

3 MC salivary gland ca and percentage

A
  1. Parotid - 75%
  2. Submandibular - 10%
  3. Sublingual and minor glands - 15%
64
Q

Sublingual and minor salivary gland ca are ___ malignant

A

75%

65
Q

Parotid gland neoplasms are characterized by ___, ___ growth

A

Large,rapid

66
Q

MC benign tumor

> half of parotid gland tumors

A

Pleomorphic adenoma

67
Q

Up to 10% of pleomorphic adenomas progress to ___

A

Cancer

68
Q

Pleomorphic adenomas are mixed tissues and are usually ___ and ____

A

Painless

Encapsulated

69
Q

Aggressive parotid gland neoplasm that has a 30-50% 5 year survival

A

Carcinoma ex pleomorphic adenoma

70
Q

Zenker’s diverticulum aka

A

Phargyngoesophageal diverticulum

71
Q

Zenker’s diverticulum

A

Lower pharyngeal outpouching superior to UES

72
Q

Zenker’s diverticulum is usually from increases pressure in pharynx, which can be due to ___ or ___

A

Uncoordinated swallowing

Cricopharyngeus muscle spasm

73
Q

In zenker’s diverticulum, bolus accumulates, which can cause

A

Halitosis

74
Q

Beginning of GI tract

A

Esophagus

75
Q

Ectopic gastric mucosa

A

Inlet patch of stomach tissue
Upper 1/3 of esophagus

MC asymptomatic or cancer

76
Q

Triad of achalasia

A

Incomplete LES relaxation
Increased LES tone
Esophageal aperistalsis

77
Q

Achalasia

A

Failure to relax

78
Q

Radiologic sign of achalasia

A

Bird beak sign

79
Q

Primary achalasia

A

MC
Loss of inhibitory innervation to LES
Idiopathic

80
Q

Secondary achalasia

A

Co-morbidity impairs LES function

81
Q

Secondary achalasia can be due to

A
Chagas’ disease
Irradiation 
Polio
Diabetes 
Inflammation near Auerbach’s plexus
82
Q

Achalasia cause dysphagia and ____ esophagus

A

Dilated

83
Q

Esophageal Varices develop from

A

Portal HTN

84
Q

90% of esophageal varices come from

A

Cirrhosis (alcoholic liver disease)

85
Q

Hepatic schistosomiasis

A

Flat worm cause of cirrhosis

86
Q

Esophageal varices can cause lethal ___

A

Hemorrhage

50% bleeds lethal

87
Q

Hepatic encephalopathy

A

Seen in advanced cirrhosis

Toxins into CNS

Severe swelling of brain (hepatic coma)

88
Q

Odynophagia

A

Pain when swallowing

89
Q

MC cause of esophagitis

A

GERD

90
Q

Rate of GERD in US adults

A

25-40%

91
Q

MC GI complaint

A

GERD

92
Q

GERD due to

A

Idiopathic LES dysfunction

93
Q

Signs of GERD

A

Dysphagia
Heartburn
“Sour brash”

94
Q

Risks for GERD

A
Obesity 
Alcohol 
Smoking 
Increase gastric volume 
Hiatal hernia 
Pregnancy 
>40yo
95
Q

Managing GERD

A
Avoid trigger foods
Maintain healthy weight
Eat smaller portions
Avoid swallowing air
Reduce stress
Avoid lying down after eating 
Probiotics
96
Q

Chemical esophagitis due to

A
Tobacco 
Alcohol 
Pill-induced 
Hot liquids 
Acidic foods 
Chemo
97
Q

Infectious esophagitis MC develops following ___

A

Ulcer

98
Q

Causative organisms for infectious esophagitis

A

Fungal - candida esophagitis

Viral - HSV, CMV

99
Q

Esophageal lacerations due to _____

A

Intense coughing/ vomiting

100
Q

2 types of esophageal lacerations

A

Mallory-Weiss syndrome

Boerhaave’s syndrome

101
Q

Mallory Weiss Tear

A

Longitudinal tear at G-E Junction

Forceful vomiting

102
Q

Signs of Mallory- Weiss tear

A

Hematemesis

Upper GI bleeds

103
Q

Hiatal hernia

A

Stomach protrudes into thorax

Congenital, acquired, or idiopathic

104
Q

Axial hiatal hernia (sliding)

A

MC

Bell shaped dilation

105
Q

Non-axial hiatal hernia (rolling)

A

Separate portion of stomach protrudes

Prone to strangulation or obstruction

106
Q

20% of all adults affected by ___, with 70% of those over 70 yo

A

Hiatal hernia

107
Q

Most hiatal hernias are ___

A

Asymptomatic

108
Q

Symptoms with hiatal hernia

A

Mimics GERD

MC with non-axial type

109
Q

Esophageal metaplasia; squamous cells —> columnar with goblet cells in distal esophagus

A

Barrett esophagus

110
Q

10% of symptomatic GERD patients will develop

A

Barrett esophagus

111
Q

Risks for Barrett esophagus

A
Caucasians 
Males 
Obesity 
History 
40-60 yo
112
Q

Characteristics of Barrett esophagus

A

Red, velvety mucosa

Bands or “tongues”

113
Q

2 common complications of Barrett esophagus

A

Esophageal adenocarcinoma

Ulcerations and strictures

114
Q

3 esophageal tumors

A

Leiomyoma
Adenocarcinoma
Squamous cell carcinoma

115
Q

MC esophageal tumor in US

A

Adenocarcinoma

116
Q

MC esophageal tumor worldwide

A

SCC

117
Q

Specific area SCC common to

A

Rural/ underdeveloped areas

118
Q

Bulimia can characteristically lead to ___

A

Mallory - Weiss tear

119
Q

Boerhaave’s syndrome is rare but very __

A

Serious (life-threatening)

120
Q

Prognosis of adenocarcinoma

A

Poor

<25% at 5 years

121
Q

Fruits and veggies can decrease which esophageal tumor

A

Adenocarcinoma

122
Q

Risks for SCC

A
>45 yo
Males 
African Americans 
Rural/underdeveloped 
Nitrosamines 
Irritants
123
Q

Prognosis for SCC

A

Poor

<10% 5 year survival