Gastro Flashcards
What percentage of cancers occur in the GI tract?
20%
What is stomatitis?
inflammation in the mouth from any cause
What is angular stomatitis?
inflammation of the corners of the mouth
Define dyspepsia
collection of symptoms including: Abdo discomfort Bloating Siaty Nausea Vomiting Loss of appetite Regurgitation
What are the alarm symptoms when accompanying dyspepsia?
Dysphagia Weight loss Vomiting Anorexia Haematemesis Melaena
What is the vomiting reflex?
Involves central neural control centres located in the lateral reticular formation of the medulla which are stimulated by the chemoreceptor trigger zones (CTZs) in the floor of the fourth ventricle, and also by vagal afferents from the gut.
The central zones are directly stimulated by toxins, drugs, motion sickness and metabolic disturbances.
What is nausea?
Feeling of wanting to vomit, often associated with autonomic effects including salivation, pallor, sweating
What is Reidel’s lobe?
Anatomical variant consisting of a palpable enlargement of the lateral portion of the right lobe of the liver
Causes of oral neoplasia?
tobacco,
heavy alcohol consumption
areca nut
HPV 16
What are the premalignant lesions in oral cancers?
leucoplakia
lichen planus
submucous fibrosis
erythroplakia
What is the common type of oral cancer?
squamous cell carcinoma
What are the risk factors for oral candidiasis?
post abx therapy
inhaled steroids
diabetes
immunocompromise
What would a biopsy of leucoplakia show?
alteration in keratinization and dysplasia of epithelium
Causes of dry mouth
Sjögren’s syndrome
Drugs (e.g. antimuscarinic, antiparkinsonian, antihistamines, lithium, monoamine oxidase inhibitors, tricyclic and related antidepressants, and clonidine)
Radiotherapy
Psychogenic
Dehydration, shock and chronic kidney disease.
What is dysphagia?
a sensation of obstruction during the passage of liquid or solid through the pharynx or oesophagus
Causes of dysphagia
Disease of mouth and tongue - tonsilitis
neuromuscular disorders - bulbar palsy, myasthenia gravis
oesophageal motility disorders - achlasia, scleroderma, diffuse oesophageal spasm
intrinsic lesion - foreign body, stricture, oesophogeal web
What features suggest a diagnosis of IBS?
The diagnosis of IBS should be considered if the patient has had the following for at least 6 months:
abdominal pain, and/or
bloating, and/or
change in bowel habit
What is the criteria for diagnosing IBS?
A positive diagnosis of IBS should be made if the patient has abdominal pain relieved by defecation or associated with altered bowel frequency stool form, in addition to 2 of the following 4 symptoms: altered stool passage (straining, urgency, incomplete evacuation) abdominal bloating (more common in women than men), distension, tension or hardness symptoms made worse by eating passage of mucus
What blood tests should be taken if IBS is suspected?
full blood count
ESR/CRP
coeliac disease screen (tissue transglutaminase antibodies)
