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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
Caused by gallstones and alcoholism
chronic pancreatitis and acute pancreatitis
26
Acinar atrophy
chronic pancreatitis
27
Decreased exocrine and endocrine function: decreased enzyme secretions, decreased insulin secretion
chronic pancreatitis
28
Affects 14% of mid-adult population, M > F
peptic ulcer
29
Related to H. pylori: increased loss of protective mucin layer
peptic ulcer
30
Causes anemia (glossitis, stomatopyrosis, angular chelitis, oral aphthae)
Coeliac Disease
31
Colorectum
Ulcerative colitis
32
Superficial inflammation
Ulcerative colitis
33
Painful, bloody diarrhea
Ulcerative colitis
34
High GI cancer risk
Ulcerative colitis
35
NO oral lesions
Ulcerative colitis
36
Ilium
Crohn Disease
37
Granulomas
Crohn Disease
38
Persistent diarrhea, mal-absorption, increased GI risk
Crohn Disease
39
Tx w/ corticosteroids
Crohn Disease
40
Cobblestone oral lesions
Crohn Disease (orofacial granulomatosis)
41
NO NSAIDs or antibiotics
Crohn Disease
42
Large linear/ragged mucosal ulcers
Crohn Disease (orofacial granulomatosis)
43
Facial/lip swelling
Crohn Disease (orofacial granulomatosis)
44
Incomplete manifestation of Crohn disease/hypersensitivity to food/medicine
Orofacial granulomatosis
45
Facial palsy
Melkersson-Rosenthal syndrome
46
Fissured tongue
Melkersson Rosenthal syndrome
47
Autosomal dominant
Familial polyposis
48
Adenomatous colorectal polyps
Familial polyposis
49
GI polyps
Gardner's Syndrome
50
Jaw exostoses
Gardner's Syndrome
51
Jaw osteomas
Gardner's Syndrome
52
Activate enzymes: fat necrosis
Acute pancreatitis
53
Abscess, renal failure, DIC
Acute pancreatitis
54
Bleeding due to Vitamin K mal-absorption
Pancreatitis
55
Originates in exocrine duct
Pancreatic Cancer
56
Binary obstruction, pancreatitis, diabetes
Pancreatic Cancer
57
Peripheral venous thrombosis, pruritic, nausea, vomiting
Pancreatic Cancer
58
Post-cricoid dysplasia
Plummer-Vinson Syndrome
59
Upper esophageal web
Plummer-Vinson Syndrome
60
Iron deficiency anemia
Plummer-Vinson Syndrome
61
Increased risk for oral cancer
Plummer-Vinson Syndrome
62
Gluten-sensitive enteropathy
Coeliac
63
Most common genetic disease in Europe
Coeliac
64
SI mucosa hypersensitive to gliadian component of gluten
Coeliac
65
Destruction of jejunal villa and mal-absorption
Coeliac

Summer 2017-Oral Medicine Final (17 decks)

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