gastrointestinal_week_3_20190518174140 Flashcards
what causes oral cancer
tobacco and alcohol, HPV, candida
what diet factors cause cancer
low in vitamin A, C and iron - causes atrophy of oral mucosa which makes it more susceptible to local carcinogens
how is oral sex tied to cancer
HPV 16 and 18associated with oropharyngeal cancer
what is high risk sites for oral cancer
soft sites eg ventral tongue/floor of mouth and lateral tongue
what are potentially malignant lesions which can occur in mouth
erythroplaskia, arythroleukoplakia, leukoplakia, erosive lichen planus, submucous fibrosis, dyskeratonsis congenita
what is the warning signs for oral cancer
red and white lesion, ulcer, numb feeling, unexplained pain in mouth or neck, change in voice, dysphagia
what are other orofacial manifestations of cancer
drooping eye lid or facial palsy, fracture of mandible, double vision, blocked or bleeding from nose, facial swelling
what is DMF index
sum of decayed, missing or filled teeth of surfaces
what is def
a count of all primary teeth that are decayed, extracted due to caries or filled
what is DMFS
a count of all decayed or missing or filled tooth surfaces
what diseases can be characterised by inflammation of peridontal tissues
gangivitis, peridonitis, necrotising ulcerative gingivitis, peridontal abscess, perio-endo lesion, gingival enlargement
what can endoscopes visually diagnose
oesophagitis, gastritis, ulceration, coeliac disease, crohns disease, ulcerative colitis, sclerosing cholangitis
which vascular abnormalities can it detect
varices, ectatic blood vessels (GAVE, dieulafoy) and angiopsyplasia (small vessels)
which miscellaneous conditions can it detect
mallory-weiss tears, diverticulae, foreign bodies, stones, worms
what is able to be treated down endoscope
GI bleeding, nerve blocks, resection of early cancer
how is variecal bleeding treated
ABCinjection sclerotherapy (ethanolamine)banding histocryl glue
what is component of ingested lipids
fats/oils, phospholipids, cholesterol and cholesterol esters and fatty acids
what is the solubility properties of lipids
either insoluble (cholesterol esters) or poorly soluble (causing special problems for digestion and absorption - triacylglycerols and cholesterol)
lipids must be converted from solid fat an oil masses into an emulsion of small oil droplets suspended in water. How does emulsification occur
mouth - chewing stomach - gastric churning and squirting through the narrow pylorus - content mixed with digestive enzymes from mouth to stomach SI - segmentation and peristalsis mix luminal content with pancreatic and biliary secretions
how are emulsion droplets stabilised
addition of coat of amphiphilic molecules that form surface layer on droplets that include:product of lipid digestion (fatty acids, monoacylglycerols)biliary phospholipids cholesterolbile salts (when droplets have progressively been reduced to unilamellar and mixed micelles)
how does lipid digestion of TAG by enzymes (triacylglycerols - fat)
mouth - lingual phasestomach - gastric phase - by gastric lipase - resistant to digestion by pepsin (and lingual lipase in salvia)duodenum - intestinal phase - by pancreatic TAG lipase (produces 2-monoacylgylcerol and free fatty acids
how are bile salts released into duodenum
released in bile from the gall bladder in response to CCKThey act as detergents to help emulsify large lipid droplets to small droplets
what does failure to secrete bile salts result in
lipid malabsorption - steatorrhoea (fat in faeces)secondary vitamin deficiency due to failure to absorb fat soluble vitamins (A, D, E and K)
what is the downside to bile salts
they increase SA for attack by pancreatic lipasethis problem solved by colipase