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CMS! > Gastroenterology > Flashcards

Gastroenterology Flashcards

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Introductory Sommelier Exam (CMS) flashcards
1
Q

what are the 8 components of the GI tract?

A
  • esophagus
  • stomach
  • gall bladder
  • liver
  • pancreas
  • small intestine
  • large intestine
  • rectum
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2
Q

what are the 2 main functions of the gut?

A
  • digestion and absorption of nutrients
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3
Q

what is absorbed in the stomach?

A
  • water and alcohol
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4
Q

what is absorbed in the duodenum?

A

iron and vit B12

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5
Q

where is folate absorbed?

A

jejunum

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6
Q

what are the 2 divisions of the pancreas?

A

exocrine and endocrine

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7
Q

what is the hormone made by the endocrine division of the pancreas?

A

insulin

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8
Q

what is the function of the gall bladder?

A

concentration and storage of bile

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9
Q

what is the 3 functions of the liver?

A
  • metabolise nutrients and toxins
  • protein synthesis
  • production of bile
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10
Q

what are 9 GI symptoms?

A
  • pain
  • dysphagia
  • dyspepsia
  • nausea and vomiting
  • diarrhoea
  • constipation
  • weight loss
  • bleeding
  • steatorrhoea
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11
Q

define dysphagia

A

difficulty swallowing

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12
Q

define dyspepsia

A

discomfort in upper GI tract (eg heartburn)

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13
Q

what is steatorrhoea?

A

pale bulky stools

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14
Q

what are the main investigations of the GI tract?

A
  • endoscopy
  • colonoscopy
  • sigmoidoscopy
  • radiographs
  • ultrasound (esp liver and billary tract)
  • MRI
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15
Q

what 2 types of medication can be given to suppress acid?

A
  1. antacids

2. gastric acid reduction

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16
Q

name 3 types of antacid

A
  • calcium carbonate (rennies)
  • aluminium hydroxide
  • alginate based (gaviscon)
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17
Q

what are the 2 types of gastric acid reducers?

A
  1. proton pump inhibitors

2. histamine receptor antagonists

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18
Q

name two histamine receptor antagonists?

A
  • ranitidine

- cimetidine

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19
Q

name 2 types of PPIs

A
  • lanzoprazole

- omeprazole

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20
Q

what does GORD stand for?

A

gastro oesophageal reflux disease

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21
Q

define GORD as a condition

A

excess acid at the lower oesophageal spincter

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22
Q

name 4 things associated with GORD

A
  • smoking
  • lying flat
  • obesity
  • fatty foods
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23
Q

what is the main symptoms of GORD?

A

heartburn

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24
Q

how can a diagnosis of GORD be made?

A

endoscopy

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25
Q

how is GORD treated? 3 things

A
  • lifestyle changes
  • drugs (PPIs and antacids)
  • rarely surgery
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26
Q

name the 2 types of peptic ulcers

A
  1. gastric ulcer

2. duodenal ulcer

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27
Q

what is the main worry with a gastric ulcer?

A

they have the tendency to become malignant

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28
Q

what is the aetiology of peptic ulcers?

A
  • NSAIDs (esp for gastric)

- helibacter pylori

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29
Q

what are the 4 main symptoms of a gastric ulcer?

A
  • anorexia
  • vomiting
  • dyspepsia
  • epigastric pain
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30
Q

what complications can come from a peptic ulcer?

A

bleeding and perforation

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31
Q

what is the treatment of an acute peptic ulcer?

A

endoscopically stop bleeding (sometimes surgery)

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32
Q

what is the treatment for non-acute peptic ulcer disease? 2 things

A
  • acid suppression (PPI)

- treat H. pylori (PPI and antibiotics)

33
Q

what are the symptoms of a hiatus hernia?

A

heartburn

34
Q

what are the 2 treatment options for a hiatus hernia?

A
  • medication

- surgery (fundoplication)

35
Q

what is a hiatus hernia?

A

a structural abnormality of the stomach leaving a segment above diaphragm

36
Q

With patients who have a GI disorder you should be cautious with what during dental treatment… 3 things

A
  • NSAIDs
  • may have oral ulceration due to anaemia due to chronic blood loss
  • NCTSL mat occur due to acid reflux
37
Q

define coeliac disease

A

multi-system auto-immune disease that is caused by a sensitivity to gluten in the diet.

38
Q

what happens to the villous of the small intestine in those with coeliac disease?

A

villous atrophy

39
Q

what are 5 symptoms of coeliac disease?

A
  • malaise
  • diarrhoea
  • weight loss
  • iron and folate deficiency
  • protein deficiency
40
Q

how is coeliac disease diagnosed? 2 things

A
  • blood test showing TTGA antibodies

- endoscopy with biopsy

41
Q

what does TTGA stand for?

A

tissue transglutaminase antibody

42
Q

what is the treatment for those with coeliac disease? 2 things

A
  • gluten free diet

- osteoporosis prophylaxis

43
Q

what are the 2 main types of Inflammatory disease?

A
  • Crohn’s disease

- Ulcerative colitis

44
Q

where in the body is affected by chron’s disease?

A

the whole GI tract from the mouth to anus

45
Q

where in the body is affected by ulcerative colitis

A

the large intestine

46
Q

what type of conditions are inflammatory bowel diseases?

A

auto-immune with unknown aetiology

47
Q

what type of inflammation occurs in chron’s disease?

A

transmural - at walls or organs and blood vessels

48
Q

what type of inflammation occurs in ulcerative colitis?

A

mucosal - of mucous membranes in the intestine

49
Q

true or false - the symptoms for inflammatory bowel conditions can relapse and remit?

A

true

50
Q

what are the 5 symptoms of Chron’s disease

A
  • malabsorption
  • abdominal pain
  • bleeding
  • abscess formation
  • oral features
51
Q

what are the main two symptoms of ulcerative colitis?

A
  • bloody stools

- abdominal pain (less than with chrons)

52
Q

what is the extra-intestinal symptoms of IBD? 5 things

A
  • autoimmune arthritis (rarerly in TMJ)
  • skin lesions
  • autoimmune hepatitis
  • DVT and PE
  • ocular (eye) inflammation
53
Q

which IBD are you more likely to have long term complications that can lead to cancer?

A

Ulcerative colitis

54
Q

how is IBD diagnosed in the lower GI tract? 4 things

A
  • clinical
  • radiology
  • colonoscopy
  • stool sample
55
Q

what are the 2 uses of taking a stool sample?

A
  • rule out an infective cause

- faecal calprotectin

56
Q

what is the drug treatment of IBD? 4 things

A
  1. 5-aminosalicylic acid preperations
  2. corticosteroids (oral/enema)
  3. immunosuppressants
  4. biologics (anti-TNF agents)
57
Q

what kind of surgery can be done on those with IBD?

A
  • remove diseased bowel

- abscess drainage

58
Q

is is curative to remove diseased sections of the bowel in IBD?

A

yes, for ulcerative colitis

no, for Chron’s disease

59
Q

True or false : patients with IBD should NOT undergo “bowel resting” during acute episodes?

A

False, they should have parenteral nutrition/elemental diet

60
Q

how common is diverticula in over 50s?

A

50%

61
Q

what are the symptoms of diverticula?

A
  • usually none
  • bleeding
  • pain (abscess formation and obstruction)
62
Q

what % of GI patients have symptoms but no demonstrable disease?

A

80%

63
Q

what are 5 symptoms of Irritable bowel syndrome?

A
  • cramps
  • wind
  • diarrhoea
  • constipation
  • bloating
64
Q

what is the treatment of a patient with functional bowel disease (ie IBS)?

A
  1. reassurance
  2. dietary changes (increases fibre)
  3. anti-spasmodics
  4. amitriptyline or SSRIs
65
Q

what is acute liver disease described as?

A

hepatitis

66
Q

what is chronic liver disease described as?

A

cirrhosis

67
Q

what are 7 causes of liver disease?

A
  1. alcohol
  2. viruses (hepatitis a-e)
  3. iron overload (heamachromatosis)
  4. drugs (formulary and herbal)
  5. auto-immune
  6. diabetes
  7. cryptogenic (unknown)
68
Q

what are the 7 clinical features of liver or biliary tract disease?

A
  • jaundice
  • ascites (abdominal fluid accumulation)
  • telangiectasia (dilation of capillaries that leads to spider like purple appearance)
  • encephalopathy (impaired consciousness/confusion)
  • variceal haemorrhage (life treatening bleed)
  • coagulopathy (impaired clotting)
  • prone to infections
69
Q

treatment of liver disease is… 3 things

A

remove underlying cause
supportive (possibility of regeneration)
transplant

70
Q

when treating patients with liver disease you must consider which 3 things..

A
  1. their reduced platelets (less clotting)
  2. their susceptibility to infections
  3. immunosuppressants following transplant
71
Q

what are the symptoms and treatment for gall stones?

A
  • pain
  • jaundice
  • pancreatitis
    all can be alleviated by
    1. endoscopic surgery
    2. open cholecystectomy (removal of the gall bladder)
72
Q

how would you diagnose someone who had pancreaitits?

A

blood test - if shows high amylase in blood then pancreatitis

73
Q

what is the 2 common causes for pancreaitis?

A
  1. gall stones

2. alcohol/drugs

74
Q

what type of patients are at highest risk of getting mouth cancer?

A

patients who already have cancer of the GI tract.

75
Q

what are 4 non-specific signs that could indicate mouth cancer?

A
  • angular cheilitis
  • burning mouth syndrome
  • candidal infections
  • recurrent oral ulceration
76
Q

what is burning mouth syndrome usually cause by?

A 
deficiency in 
-iron 
-folate
-vitB12 
having anaemia
77
Q

in 20% of cases recurrent oral ulceration indicates..

A

underlying anaemia

78
Q

can you get primary oral side effects in patients with ulcerative colitis?

A

no as it only affects the large intestine

79
Q

can you get primary oral side effects in patients with Crohn’s disease?

A

yes.

CMS! (23 decks)

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