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HD 4 - dental relevance > Gastroenterology + nutrition > Flashcards

Gastroenterology + nutrition Flashcards

1
Q

what is the difference between Crohn’s and ulcerative colitis?

A

crohns = any part of GI - ORAL MANIFESTATIONS

ulcerative colitis = just colon - large bowel

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2
Q

2 types of IBD

A

crohns + ulcerative colitis

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3
Q

how do you diagnose IBS

A

diagnosis of exclusion - not IBD

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4
Q

oral complication of IBD related to inflammatory activity

A

aphthous stomatitis - repeated formation of benign + non-contagious ulcers

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5
Q

3 common causes of aphthous ulcers

A

menstruation, gut problems, medications

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6
Q

how do you test for sarcoidosis

A

serum ACE levels raised

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7
Q

rectal bleeding in IDB may cause mouth ulcers because..

A

patient anaemic

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8
Q

what is protocolitis

A

inflammation of anus + rectum lining

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9
Q

what is Barretts oesophagus?

A

complication of GORD - disease in which ep cells in oesophagus undergo dysplastic change

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10
Q

3 components of the anti-reflux barrier

A
  1. Lower oesophageal sphincter - LOS
  2. diaphragm - external sphincter
  3. small part of stomach rolled up
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11
Q

In GORD what damages the oesophageal mucosa

A

hydrochloric acid + pepsin

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12
Q

2 components of oesophageal clearance

A

gravity + peristalsis

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13
Q

what does saliva contain to neutralise acid?

A

bicarbonate - therefore xerostomia = erosion/caries

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14
Q

3 protective components of GI mucosa - against GORD + peptic ulcers

A

mucosa, bicarbonate, prostaglandins

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15
Q

how can hiatus hernia affect GORD

A

impairs oesophageal clearance

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16
Q

6 risk factors for GORD

A

genetic
smoker
diet - late at night, high fat content, caffeine, xs alcohol
pregnancy
hiatus hernia
drugs - TCAs, anticholinergics, nitrates, Ca2+ blockers

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17
Q

typical symptoms of GORD

A 
heartburn 
retrosternal discomfort
acid brash
water brash
odynophagia
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18
Q

atypical symptoms of GORD

A

non cardiac chest pain
dental eroding
resp symptoms

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19
Q

what is Russell sign

A

callous at back of fingers where vomiting induced

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20
Q

what would you do if patient complained of acute gastro-intestinal bleeding

A

sign post to GP, for them to refer immediatly

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21
Q 
what would you do if a patient presented with indigestion and any of the following:
gastrointestinal bleeding
weight loss unintentional
progressive difficulty swallowing
persistent vomiting
iron deficiency anaemia 
epigastric mass
A

refer immediately for endoscopy

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22
Q

what is the drug treatment for GORD

A

proton pump inhibitors - omeprazole/lansoprazole

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23
Q

what is haematemesis

A

vomiting blood

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24
Q

what is melaena

A

pooing blood

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25
Q

signs + symptoms of upper GI bleeding

A 
abdominal discomfort
haematemesis
melaena
signs of shock
change in orthostatic vital signs
26
Q

3 main causes of oesophageal varices

A
  1. portal hypertension
  2. chronic alcohol abuse + liver cirrhosis
  3. ingestion of caustic substance
27
Q

how are peptic ulcers formed

A

erosion caused by gastric acid

28
Q

3 mains causes of peptic ulcers

A

NSAID use
alcohol/tobacco
h. pylori

29
Q

2 types of drugs used to treat peptic ulcers

A

histamine blockers (H2 receptor antagonists) (less acid made) + long term antacids (neutralises acid)

30
Q

inflammation of gingiva/mucosa may be caused by 3 conditions

A
  1. gingivitis
  2. crohns
  3. sarcoidosis - granulomatous
31
Q

2 common drugs causing aphthous ulcers

A

nicorandil + methotrexate

32
Q

most common oral manifestations of GI disorder

A

ulcer + sore throat

33
Q

what common medications must patients not take if they suffer from peptic ulcers?

A

NDAIDs

34
Q

2 types of peptic ulcer

A

gastric + duodenal

35
Q

infection by which bacteria causes peptic ulcers

A

h. pylori

36
Q

how do H2 receptor agonists treat peptic ulcers

A

reduce acid secretion - block histamine H2 receptor

-idine

37
Q

how do prostaglandin analogues treat peptic ulcers

A

inhibit acid secretion + increase mucus + bicarbonate

38
Q

how do proton pump inhibitors treat peptic ulcers

A

stop final step in acid production - action of H+/K+ atlases pump

39
Q

how do antacids treat peptic ulcers

A

weak base that interact with acid to produce salts + neutralise - this inactivates pepsin

40
Q

how to chelates treat peptic ulcers

A

coat mucosa - physical barrier, stimulate bicarb + mucous, inhibit pepsin

e.g. sulfracate - xerostomia + metallic taste

41
Q

3 components of triple therapy against h. pylori

A

proton pump inhibitors, clarithroymicin (do not give in history of UC), metronidazole/amoxicillin

42
Q

dental side effect of omeprazole

A

xerostomia

43
Q

what antibiotics does antacids reduce absorption of?

A

tetracyclines - dentists can prescribe doxycycline

44
Q

how does omeprazole effect dental IV sedation?

A

inhibits metabolism of diazepam - may overstate

45
Q

if a patient with a peptic ulcer needs prednisolone or NSAIDs what might you have to co-prescribe?

A

Proton pump inhibitor

46
Q

3 ways individuals become malnourished

A
  1. inadequate intake
  2. excessive loss
  3. increased metabolic requirements
47
Q

nutritional screening vs nutritional assessment

A 
screening = any health care workers
assessment = nutritional expert
48
Q

parenteral vs enteral delivery of nutrition

A 
parenteral = IV
enteral = tube to gut

enteral > parenteral (except when non functioning GI tract)

49
Q

what is MUST?

A

malnutrition university screening tool

50
Q

2 solid GI organs

A

pancreas + liver

51
Q

what autoimmune disease may cause dysphagia ? - autoantibodies against ACH receptors at neuromuscular junctions

A

myasthenia gravis

52
Q

what is pernicious anaemia?

A

autoimmune disease - ab against intrinsic factor

53
Q

3 complications of peptic ulcers

A

perforation, bleeding, stricture

54
Q

-oscopys also offer opportunity for what?

A

biopsies

55
Q

what is diverticulitis?

A

mucosa out-patches through wholes in walls - popular in 65+yrs = diverticular disease

if become inflamed = diverticulitis

56
Q

which parts of GI system can you not get direct vision?

A

jejunum + ileum

57
Q

which medications cause indigestion? and how can this be combated?

A

aspirin + NSAIDs

give PPI

58
Q

why is hiatus hernia important if patient having GA?

A

causes acid reflux - pt can spill over

59
Q

what can you view with an OGD?

A

oesophagus to upper jejunum

60
Q

3 signs of jaundice

A
  1. yellow skin
  2. dark urine/pale stool
  3. itch
61
Q

3 components of charcot’s triangle

A

fever, pain, jaundice

sign of ascending cholangitis

62
Q

3 main categories of benign hepatic-pancreato-biliary disease

A
  1. biliary obstruction - stones (choledocholithiasis) + strictures
  2. pancreatitis - acute vs chronic
  3. gallbladder disease - symptomatic gallstones

HD 4 - dental relevance (12 decks)

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