GI Tract- diseases Flashcards by lara monaghan

What medication can be used to eliminate acid formed in the GI tract?

Antacid

How well did you know this?

Not at all

Perfectly

What medications can be used to reduce acid secretion in the GI tract?

Proton pump inhibitors e.g. omeprazole

H₂ receptor blockers which prevent the activation of acid production of histamine

e.g. Ranitidine

How well did you know this?

Not at all

Perfectly

How can we improve the mucosal barrier in the GI tract?

Eradicate the helicobacter plylori-

Inhibit prostoglandin removal.

How well did you know this?

Not at all

Perfectly

What is an aphthae?

An ulcer

How well did you know this?

Not at all

Perfectly

Compare the types of aphthae.

Minor- surrounded by a red and inflamed border

Major- larger than a cm

Herpetiform- many small ulcers only found on keratinised mucosa (e.g. floor of the tounge)

How well did you know this?

Not at all

Perfectly

A patient exhibits these symptoms. Name the symptoms and diagnose the patient.

Cobblestoning

Angular Chelitis

Swollen lips

The patient has orofacial granulomatosis OR oral chrons (dependent on if there is GI tract involvement)

How well did you know this?

Not at all

Perfectly

what is orofacial granulomatosis?

When granuloma cells cause a blockage in the lymphatic channels. The lymph fluid still coming from the capillaries causes the swelling.

How well did you know this?

Not at all

Perfectly

Name the inflamatory disease that can be caused by amalgam fillings?

Lichen planus

How well did you know this?

Not at all

Perfectly

What is dysphagia?

Difficulty swallowing

How well did you know this?

Not at all

Perfectly

What are the symptoms of Gastro-oesophageal reflux disease?

epigastric burning

dysphagia

GI bleeding

pain due to osephageal muscle spasm

How well did you know this?

Not at all

Perfectly

Discuss the causes of GORD

defective lower oesophageal sphincter
impared lower clearing
impaired gastric emptying

What you are putting in is not being cleared out leaving the patient’s stomach fuller than it should be.

How well did you know this?

Not at all

Perfectly

How is GORD treated?

Antacids

H₂ blockers and PPIs

Stop smoking

lose weight and avoid triggering activity.

Increase GI motility and gastric emptying.

How well did you know this?

Not at all

Perfectly

What does Gastro-Osophageal reflux disease cause?

Ulceration
Inflammation
Metaplasia (Barretts’ oesophagus)

The stomach acid has changed columnar epithelium into sqaumous epithelium. (pre-cancerous)

How well did you know this?

Not at all

Perfectly

Compare the two types of hiatus hernia.

Sliding- stomach is wider at the bottom of the oesophagus

Rolling- Fundus extends at a seperate site to the oesophagus

How well did you know this?

Not at all

Perfectly

What is peptic ulcer disease?

Acid associated ulceration

How well did you know this?

Not at all

Perfectly

What causes peptic ulcer disease?

Helicobactor pylori

Drugs- NSAIDs and Steroids can cause ulcers.

Too much acid produced in the duodenum (Thinner wall so easier to perforate)

normal acid secretion in the stomach but reduced resistance of the stomach to the acid.

How well did you know this?

Not at all

Perfectly

Discuss the symptoms of Peptic ulcer disease?

Epigastric burning pain- worse before or after meals.

Relieved by eating or vomiting.

How well did you know this?

Not at all

Perfectly

How can we investigate peptic ulcer disease?

endoscopy

barium swallow

Has the bleeding from the ulcer caused anaemia.

How well did you know this?

Not at all

Perfectly

Discuss the local and systemic complications of peptic ulcer disease?

local-

perforation (hole)

stricture (scarring)

Haemorrhage

malignancy.

systemic- anaemia.

How can we treat Peptic ulcer disease?

medical -

eliminate the helibactor pylori

Ulcer healing drugs

Lifestyle- eat regular meals &stop smoking

Surgical

Gastrectomy (remove part of stomach)

Vagotomy (sever the vagus nerve to reduce acetyl choline so less acid is secreted )

Compare a bilroth 1 and bilroth 2 surgical procedure.

Bilroth 1- top half of stomach is connected to the duodenum

bilroth 2- top half of stomach is connected to the small bowel

Discuss helibacter pylori

This is a bacteria that lives in the stomach and causes inflamation of the gastric muocsa.

It results in gastric ulcers and chronic gastric wall inflamation.

How do we eradicate helibactor pylori?

Triple therapy for 2 weeks

2 antibiotics:

Amoxicillin

metronidazole

1 Proton Pump inhibitor-

Omeprazole

What is coeliac disease?

This is a loss of surface area (and villi) in the jejunum due to a sensitivity of gluten

Compare the effects of coeliac disease on an adult and a child?

malabsorption causes malnourishment in a child means they will not grow at the same rate. Coeliac disease in an adult will not be as obvious as you don't need to grow

How does coeliac disease present in a patient's mouth?

There are mouth ulcers due to a folic acid malabsorption.

List symptoms of coeliac disease?

Weight loss lassitude (lack of energy) weakness Statorrhoea dysphagia Diahorrea Apthae Abdominal swelling.

How do we investigate coeliac disease?

jejunal biopsies look at faecal fat levels Autoantibodies (sensitive test but not specific)

How do we treat coeliac disease?

Gluten free diet to reverse jejunal atrophy.

What are the symptoms of a bowel carcinoma.

Rectal bleeding anaemia Can be asymptomatic

How do we screen for a bowel carcinoma?

We invite for screenings from age 50 every 5 years. FOB- looking for blood in bowel motions If there is blood in the stool sample we complete an endoscopy.

Describe the aetiology of a bowel carcinoma?

Most cancers arise in polyps. Polyps can be flat or pedunculated (on a stalk). Irritation and trauma will cause polyp bleeding.

What is shown in this patient image? and what does it tell us about the patient?

Peutz- Jehgers syndrome. The patient has a small intestine polyposis.

What is shown in this patient image? and what does it tell us about the patient?

This is cowden's syndrome. The patient has a polyp in the large intestine (high risk of carcinoma)

Compare Chron's disease to Ulcerative colitis in terms of: * site * inflamation progress * features * serosa involvement

Site: Chron's disease can occur **all down the GI tract**, Ulcerative colitis occurs in the **colon.** Inflamation progress: Chron's disease is **discontinuous**. Ulcerative colitis is **continuous**, it starts in the rectum and works its way up. Features: Chron's is **non vascular**/ Ulcerative colitis is **vascular** Chrons has a **cobbled mucosa and fissures** Ulcerative colitis has **granular mucosa and ulcers.** Serosa involvment- Chrons inflamation extends the **full thickness** of the bowel wall. Ulcerative colitis only the **top layer is inflamed** no serosa involvement.

Compare the symptoms of chrons and ulcerative colitis.

Ulcerative colitis- Blood from elsewhere that passes through the rectum. abdominal pain Diahorrea Intestinal chrons= ulcerative colitis symptoms. Oral chrons- Orofacial granulomatosis symptoms

Why do we check for faecal calprotectin when investigating chrons disease?

Calprotectin is released when there is inflamation. The level of calprotectin will tell us if the bowel is inflamed or not.

Discuss the medical treatment of inflamatory bowel diseases

If to do with the patient's immune system we want to supress it using: * systemic Steroids (prednisolone) * local steroids * NSAIDs (Pentasa/ Mesalazine/ Sulphasalazine) * Non steroidal immunosupressants (azathioprine/ methotrexate)

Compare the surgical treatment of chrons disease and ulcerative colitis?

In Chron's disease you remove the obstructed bowel segments in Ulcerative colitis it is a colectomy (where all or part of the colon is removed)

How do we stage a colonic carcinoma

Dukes classification.

What is dukes classification A?

Carcinoma in the submucosa

What is duke's classification B?

A colonic carcinoma that extends into the muscularis

What is duke's classification C?

A colonic carcioma that extends into the lymph nodes

What is duke's classification D?

A colonic carcinoma that has spread (metastases) most commonly to the liver.

Discuss the dental relevance of GORD?

Erosion of teeth.

How would we treat a patient with recurrent ulcers?

Benzthiazide- a steroid spray which getrs rid of ulcers quicker. The patient should not rinse their mouth out after use.