GI SYSTEM

Question 0

Oral cavity inflammatory pathology

list 3 types

Answer 0

1- dental caries

2-Dental disease
consisting of periodontitis and Pyorrhea

3 - stomatitis consisting of

• viral, example herpes
• fungal, example thrush
• Aphthous, example canker source

Question 1

Oral cavity

Developmental pathology

Answer 1

cleft lip or cleft palette

can be repaired surgically

Question 2

Dental caries part of the inflammatory pathology

Answer 2

Dental caries can progress to periodontal disease causing Periodontitus and pyorrhea

Living microorganisms that exist naturally mouth can get into fissures and cause disease

Question 3

What micro organism causes tooth decay?

Answer 3

Streptococcus mutans

Question 4

Stomatitis

List 3 types of stomatitis

Answer 4

Stomatitis is inflammation of the mouth and unusual- would need immunocompromise

VIRAL- herpes
FUNGAL- thrush; Candida albicans
APHTHOUS- unknown etiology- canker sores. (A localized stomatitis, malfunction of the immune system)

Question 5

Most common oral cancer

Answer 5

Squamous cell cancinoma is the most common malignant tumor in the mouth

Question 6

Where can oral cancers occur?

Where is most common?

Answer 6

Anywhere in the mouth

Most common on sides of tongue, where drinking and smoking/chewing would deposit

Question 7

What are the risk factors of oral cancer?

List 2

Answer 7

Risk factors are additive-
Smoking (particularly pipe and chewing tobacco)
Chronic alcoholism

Question 8

Different oral cancer appearances

List 5

Answer 8

Leukoplakia - white, slightly elevated plaque
Erythroplakia- red plaque
Ulcer- shallow defect
Crater- deeper defect with raised margins
Nodule- area of induration

Erythroplakia and leukoplakia advance to an ulcer state

Oral cancers are extremely locally aggressive, but not often deadly

Question 9

Salivary gland diseases -inflammatory
Name for them
Describe 4 types

Answer 9

SIALADENITUS

1-acute-SIALORRHEA - bacterial
2-viral -MUMPS - epidemic parotitis
3-chronic-from obstruction- SIALOLITHIASIS
4-causes xerostomia-DRY MOUTH -can be from salivary glands- leads to dry mouth

Question 10

Neoplasms
40-60 yrs old peak
Name commonly affected gland
Name common tumor and describe

Answer 10

PAROTID GLAND (largest gland)
PLEOMORPHIC ADENOMA
Benign
Slow growing
Can reoccur can be excised

Question 11

Esophageal diseases

Name 2 congenital

Answer 11

Atresia- anatomic organ has formed and then disappeared -usually seen with tubular organs–A developmental abnormality that caused a segment of the esophagus to not form.

Esophagotracheal fistula-a tract between 2 existing channels

Question 12

esophageal diseases

Reflux
Name what causes reflux

Answer 12

Hiatal hernia, displacement of Cardia region of stomach into the thoracic cavity

Reflux allows the acid from the stomach to come up into the esophagus due to the hiatal hernia

Question 13

Esophageal diseases
Motility disorders
Name the disorder and describe

Answer 13

Achalasia-lack of relaxation of the esophagus

Causes dysphagia-difficulty in swallowing

Question 14

Esophageal diseases
Inflammatory
Describe types and causes
Esophagitis is the same as ______________

What are long term effects of inflammatory esophagitis?

Answer 14

Infectious -viral from Herpes

Fungal from Candida albicans THRUSH

Reflux from hiatal hernia

Irritants

Esophagitis this is the same as STOMATITIS

Long term effects it produces intestinal metaplasia a.k.a. Barrett’s esophagus

Question 15

Define metaplasia

Answer 15

Changing one type of tissue to another type of tissue; not becoming malignant but cells changing to protect itself example simple Squamous cell lining changing to columnar cell that has goblet cells that can produce mucus; this change in the esophagus is known as Barrett’s esophagus.

Question 16

Stomach diseases
Congenital diseases
Name one disease and explain

Answer 16

Pyloric stenosis

A major disorder : if severe enough produces projectile vomiting requires surgery

Question 17

Stomach diseases

inflammatory conditions. Name two categories

Answer 17

Gastritis acute or chronic

Question 18

Acute gastritis types

Answer 18

Acute gastritis results in erosions or ulcers and is caused by circulatory disturbances or irritants. Patients with severe burns or patients with Brain tumors. Curlings ulcers - patients with severe burns;
Cushing’s ulcers - patients with brain tumors.

Question 19

Chronic gastritis equals long term gastritis

explain

Answer 19

Scarring in stomach; atrophic gastritis is more scar tissue then
stomach tissue; common cause is pylori infection
Long-term chronic gastritis can cause ulcers such as peptic ulcer’s.

Question 20

Describe peptic ulcer’s

Answer 20

Peptic ulcer is caused by exposure to hydrochloric acid. Common in stomach or do I have none. Ulcers these extend through upper layer into the muscle. Can result in hemorrhage, penetration to the pancreas, perforations, scarring which is also called cocatrization.

Question 21

Name three neoplasms of the G.I.

Answer 21

-Polyps which are any kind of tumor that grows on a STALK.
-Adenomas glands in the stomach or adeno carcinoma, most common.
-Lymphoma- lymph tissue (MALT) gives rise to lymphomas. Fairly common.
GIST is a G.I. stromal tumor. Some tumors or benign some or malignant.

Question 22

Diseases of the small and large intestine.
Congenital
List three diseases

Answer 22

Atresia. Similar to in the esophagus. Parts of the tube not connecting.
Hirschsprung’s disease: lack of ganglion cells muscle cannot contract needs surgery.
Meckel’s diverticulum: A duct that connects the area of the ileum persists, looks like an appendix normal tissue in an abnormal location.

Question 23

Diverticulosis describe

Answer 23

Abnormal outpouching of the diverticula of the small intestine diverticulosis leads to diverticulitis can break down the wall of the large bowel perforation can happen Peritonitis can occur which makes you extremely ill. (Feces in peritoneal cavity)

Question 24

Intestinal vascular diseases a.k.a. diseases involving vessels and or circulation to the intestine

name two

Answer 24

Hemorrhoids rectum ( internal) anus (are external) they are varicose vein’s of the rectum and anus

Ischemic bowel disease caused by compromise of the circulation: clots can begin to form or heart failure can produce the necrosis; eventually entire wall become necrotic perforation possible can happen in the elderly.

Question 25

Inflammatory bowel disease

Explain

Answer 25

A.k.a. IBD -recurrent inflammations could be immune related but cause unknown one or two types
1-Crohn’s or regional enteritis: transmural inflammation which means inflammation through the entire wall of the intestine - fistulas can develop - abnormal connections can result - lots of scarring narrowing of the lumen last portion of the small intestine and colon, the ileum and colon.
2- ulcerative colitis - usually involves the large intestine. begins in rectum spreads proximally - inflammation is superficial - effects upper layers of the lining -continuous no skip -pseudo polyps means not real polyps -increases risk of developing carcinoma of the colon.

Question 26

Name three gastrointestinal infections

Answer 26

1-Pseudomembranous colitis - caused by C diff - the bacteria necroses the lining and produces pseudomembranes associated with prolonged antibiotic use.
2-viral gastroenteritis -is the most common form examples or rotavirus and norovirus.
3-protozoans - such as Giardiasis (campers parasite) and amobeias.

Question 27

Appendicitis

Answer 27

Usually caused by an obstruction most commonly fecalith. Native bacteria proliferate in a small space. Swelling produces ischemia may perforate.

Question 28

Peritonitis

Answer 28

Perforation of stomach or appendix or diverticulitis or Fallopian or gall bladder or pancreas - infection enters into peritoneum - can be sterile or infectious.

Question 29

List three kinds of obstructions (of the ileus)

Answer 29

1-Hernia - inguinal hernia, femoral hernia, incision hernia
2-intussusception, telescoping of the intestine usually caused by mass within lumen or scar tissue
3-volvulus - which is twisting of the intestines upon itself.

Question 30

Name three malabsorption syndromes

Answer 30

1-Celiac sprue also known as celiac disease,
2- tropical sprue - bacteria in the tropics,
3-Whipples disease - bacteria T whippelli. Effects middle-aged men.

Question 31

Types of intestinal neoplasms

list three

Answer 31

All non-neoplastic: Hyperplastic polyp’s or inflammatory and have no increased risk of cancer.
Hamartoma are normal components in an abnormal area -examples juvenile polyps peutz-jeghers.
Pseudopolyps are from ulcerative colitis.
Neoplastic polyps are benign

Question 32

Most common cancers of the colon :

Answer 32

adenocarcinoma (95% of cancers in the bowel)
fungating lesions tends to be silent longer undetected right colon
napkin ring lesions more likely to produce obstructions left colon

Question 33

Gastrointestinal carcinoids

Answer 33

Are Neuroendocrine tumors, typically low grade lesions, grow slower, better prognosis, can be found elsewhere in the gastrointestinal tract. Genetic abnormalities for some colon cancer’s.