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Summer 2017-Oral Medicine Final > Gastroenterology and Pancreatic Disorders > Flashcards

Gastroenterology and Pancreatic Disorders Flashcards

1
Q

Peptic Ulcer

A
  1. gastric vs.duodenal
  2. affects 14% of mid-adult population
  3. M > F
  4. related to H pylori: increased acid secretion and loss of protective mucin layer
  5. relieved by antacids
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2
Q

General Management of Coeliac Disease

A
  1. confirm diagnosis (short stature–>early onset disease)

2. gluten-free diet

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3
Q

Dental Aspects of Coeliac Disease

A
  1. diarrhea
  2. dental defects
  3. anemia (glossitis, stomatropyrosis, angular chelitis, oral aphthae)
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4
Q

Ulcerative colitis

A
  1. colorectum
  2. superficial inflammation
  3. painful, bloody diarrhea
  4. high GI cancer risk (30X)
  5. no oral lesions
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5
Q

Crohn Disease

A
  1. ilium
  2. genetic component
  3. GRANULOMAS
  4. persistent diarrhea
  5. malabsorption
  6. increased GI risk
  7. Tx w/ corticosteroids
  8. ORAL LESIONS (COBBLESTONE)
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6
Q

Dental Aspects of Crohn’s Disease

A
  1. malabsorption complications
  2. corticosteroid complications
  3. NO NSAIDs
  4. NO antibiotics that cause diarrhea
  5. large, linear, ragged mucosal ulcers
  6. COBBLESTONE mucosa
  7. facial/lip swelling
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7
Q

Orofacial Granulomatosis

A
  1. incomplete manifestation of Crohn dz or hypersensitivity to food/medicine??
  2. large, linear, ragged mucosal ulcers
  3. COBBLESTONE appearance of mucosa
  4. facial and labial swelling
  5. MELKERSSON-ROSENTHAL syndrome
    * *facial and labial swelling
    * *facial palsy
    * *fissured tongue
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8
Q

Familial Polyposis

A
  1. autosomal dominant
  2. adenomatous colorectal polyps–>adenocarcinoma
  3. Gardner’s syndrome
    * *GI polyps
    * *jaw exostoses
    * *jaw osteomas
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9
Q

Carcinoma of the Colon Risk Factors

A
  1. cholecytectomy
  2. diet
  3. heredity
  4. IBD
  5. tobacco
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10
Q

Symptoms of Colon Cancer

A
  1. abdominal pain
  2. chain in bowel habits
  3. anemia
  4. melena
  5. weight loss
  6. obstruction
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11
Q

Management of Colon Cancer

A
  1. surgery
  2. radiation
  3. chemotherapy
  4. LIVER metastasis common
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12
Q

Dental Aspects of Colon Cancer

A
  1. general anesthesia=HOSPITAL ONLY

2. ANEMIA may complicate care

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13
Q

Acute Pancreatitis

A
  1. multiple etiologies: gallstones, ALCOHOLISM, trauma, ERCP, drugs
  2. activate enzymes: fat necrosis
  3. abscess, renal failure, DIC
  4. severe disease–>15-25% mortality
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14
Q

Dental Aspects of Pancreatitis

A
  1. bleeding due to Vitamin K mal-absorption
  2. alcoholism
  3. diabetes
  4. hyperthyroidism
  5. cystic fibrosis
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15
Q

Risk Factors for Pancreatic Cancer

A
  1. alcohol abuse
  2. tobacco use (30%)
  3. betel chewing
  4. exposure to petroleum products
  5. chronic pancreatitis
  6. diet
  7. heredity
  8. obesity
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16
Q

Pancreatic Cancer

A
  1. originate in exocrine duct
  2. 95% are adenocarinomas of pancreas head
  3. binary obstruction, pancreatitis, diabetes
  4. peripheral venous thrombosis, pruritic, nausea, vomiting
  5. treating surgically with adjuvant chemo
  6. WORST SURVIVAL RATE OF ANY CANCER
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17
Q

Dental Aspects of Pancreatic Cancer

A
  1. binary obstruction/liver metastasis–>bleeding
  2. diabetes
  3. conscious sedation to relieve anxiety
  4. NO general anesthesia
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18
Q

Gastro-Esophageal Reflux (GERD) Disease

A
  1. common form of dyspepsia (“heartburn”)
  2. multiple etiologies (hiatal hernia)
  3. tx’s: weight loss, frequent/small meals, elevate head of bed, proton pump inhibitors, H2 blockers
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19
Q

Dental Aspect of GERD

A

Dental Erosion

  1. palatal of maxillary anteriors and premolars
  2. rule out bulimia
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20
Q

Plummer-Vinson Syndrome

A
  1. post-cricoid dysplasia
  2. upper esophageal web
  3. iron deficiency anemia
  4. increased risk for oral cancer
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21
Q

Management of peptic ulcers

A
  1. screen for H. pylori
  2. conservative therapy: dietary alterations, proton pump inhibitors, antibiotics
  3. if not caused by H. pylori, may be due to NSAID use; tx with H2 blockers
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22
Q

Peptic Ulcers-Dental Aspects

A
  1. dental erosion
  2. transmission of H. pylori?
  3. reservoir in plaque/dentures?
  4. contributor to halitosis?
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23
Q

Coeliac Disease

A
  1. AKA gluten-sensitive enteropathy
  2. most common genetic disease in Europe
  3. hypersensitivity of SI mucosa to gliadin component of gluten
  4. gluten found in all forms of wheat and related grain (oats?)
  5. ingestion causes destruction of jejunal villa and inflammation (malabsorption)
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24
Q

Chronic Pancreatitis

A
  1. primary etiologies (gallstones and alcoholism)
  2. acinar atrophy
  3. decreased exocrine and endocrine function
    * *decreased enzyme secretions
    * *decreased insulin secretion
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25
Q

Caused by gallstones and alcoholism

A

chronic pancreatitis and acute pancreatitis

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26
Q

Acinar atrophy

A

chronic pancreatitis

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27
Q

Decreased exocrine and endocrine function: decreased enzyme secretions, decreased insulin secretion

A

chronic pancreatitis

28
Q

Affects 14% of mid-adult population, M > F

A

peptic ulcer

29
Q

Related to H. pylori: increased loss of protective mucin layer

A

peptic ulcer

30
Q

Causes anemia (glossitis, stomatopyrosis, angular chelitis, oral aphthae)

A

Coeliac Disease

31
Q

Colorectum

A

Ulcerative colitis

32
Q

Superficial inflammation

A

Ulcerative colitis

33
Q

Painful, bloody diarrhea

A

Ulcerative colitis

34
Q

High GI cancer risk

A

Ulcerative colitis

35
Q

NO oral lesions

A

Ulcerative colitis

36
Q

Ilium

A

Crohn Disease

37
Q

Granulomas

A

Crohn Disease

38
Q

Persistent diarrhea, mal-absorption, increased GI risk

A

Crohn Disease

39
Q

Tx w/ corticosteroids

A

Crohn Disease

40
Q

Cobblestone oral lesions

A

Crohn Disease (orofacial granulomatosis)

41
Q

NO NSAIDs or antibiotics

A

Crohn Disease

42
Q

Large linear/ragged mucosal ulcers

A

Crohn Disease (orofacial granulomatosis)

43
Q

Facial/lip swelling

A

Crohn Disease (orofacial granulomatosis)

44
Q

Incomplete manifestation of Crohn disease/hypersensitivity to food/medicine

A

Orofacial granulomatosis

45
Q

Facial palsy

A

Melkersson-Rosenthal syndrome

46
Q

Fissured tongue

A

Melkersson Rosenthal syndrome

47
Q

Autosomal dominant

A

Familial polyposis

48
Q

Adenomatous colorectal polyps

A

Familial polyposis

49
Q

GI polyps

A

Gardner’s Syndrome

50
Q

Jaw exostoses

A

Gardner’s Syndrome

51
Q

Jaw osteomas

A

Gardner’s Syndrome

52
Q

Activate enzymes: fat necrosis

A

Acute pancreatitis

53
Q

Abscess, renal failure, DIC

A

Acute pancreatitis

54
Q

Bleeding due to Vitamin K mal-absorption

A

Pancreatitis

55
Q

Originates in exocrine duct

A

Pancreatic Cancer

56
Q

Binary obstruction, pancreatitis, diabetes

A

Pancreatic Cancer

57
Q

Peripheral venous thrombosis, pruritic, nausea, vomiting

A

Pancreatic Cancer

58
Q

Post-cricoid dysplasia

A

Plummer-Vinson Syndrome

59
Q

Upper esophageal web

A

Plummer-Vinson Syndrome

60
Q

Iron deficiency anemia

A

Plummer-Vinson Syndrome

61
Q

Increased risk for oral cancer

A

Plummer-Vinson Syndrome

62
Q

Gluten-sensitive enteropathy

63
Q

Most common genetic disease in Europe

64
Q

SI mucosa hypersensitive to gliadian component of gluten

65
Q

Destruction of jejunal villa and mal-absorption

Summer 2017-Oral Medicine Final (17 decks)

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