GI Tract Diseases Flashcards
Caries or cavity
bacterial infection that erodes + invades the tooth structure (common in children)
prevented by Fluoride !!
can lead to growth restrictions + slow development and predispose to other illnesses
peridontal disease
bacterial invasion of gingival pockets around tooth root from Porphyromonas gingivalis leading to tooth loss and halitosis
worsens with pneumonia, DM, CVD, CVA, pregnancy
oral and oropharyngeal cancer
RF: tobacco use, ETOH use, and age
oral cancer is 75% squamous cell carcinoma on hard palate or gums
oropharyngeal cancer is 70% human papilloma virus on soft palate, pharynx, tonsils
sialedenitis: what is it? how is it caused? symptoms?
inflammation of salivary glands from viral infection (mumps) or autoimmune disease (SLE or Sjorgrens)
Sjorgren’s syndrome: clicking + dry mouth
transient puffy cheeks
salivary tumors: most common location?
only 3% of all tumors; 75% are benign + usually affects parotid gland in older adults
causes of esophageal disease
reflux of gastric juices, infection, idiopathic, exogenous irritants, obstructing scar, tumor, neurologic disease
symptoms of esophageal disease
dysphagia + achalasia + hematemesis from mallory-weiss tear(more common and less severe) or varices (more concerning due to enlarged veins in esophagus)
GERD
gastroesophageal reflux disorder
transient gastric reflux back into esophagus (20% of adults) due to abnormal lower esophageal sphincter from smoking, pregnancy, caffeine, or hiatal hernia (stomach above duodenum)
what can hiatal hernia lead to
barrett’s esophagus (inflammation with glandular cells) + esophageal cancer or gastric strangulation (very rare + need sx)
gastritis: what is it? how do you dx? what is it caused by? symptoms? tx?
inflamed gastric mucosa (stomach) that is acute or chronic that is diagnosed with endoscopy
caused by infection, meds (NSAIDS, steroids), ETOH abuse
may be asymptomatic or decreased appetite + pain with N/V
Tx: lifestyle changes or meds
Gastric or duodenal ulcer
what is it? symptoms? associated with?
small lesions that extend into submucosa
asymptomatic OR N/V (Coffee grounds) + melena (dark feces)
Associated with H. pylori infection, alcohol and NSAID use, stress or brain injury
h pylori
more than 50% of US adults affected and 10-20% get ulcers
invades the gastric mucosa and initiates inflammation
causes 90% of chronic gastritis
Dx: blood, breath, biopsy and stool
Tx: antibiotics
Peptic Ulcer Disease
80% duodenum and 20% stomach
caused by h pylori or chronic aspirin/NSAIds, steroids and ETOH
chronic, recurrent deep and usually 1-2 and DO NOT resolve on its own
outcomes of bariatric surgeries
low vitamin deficiency, malnutrition, poor outcomes
indications for bariatric surgeries
BMI of 40 or higher OR 100 lbs overweight
BMI of 35 or higher + more than 2 comorbidities related to obesity (DM, high cholesterol, HTN, NAFLD, GI disorder)
Gastroenteritis: what is it? what is it caused by?
how is it transmitted?
inflammation of stomach, colon, and SI due to infection
Viral: norovirus (low mortality and epidemic diarrhea for 3 days) or rotavirus (vaccine available, more severe, usually affects children)
Bacterial: Salmonella or C jejuni (uncooked poultry or raw milk) or e coli
food-borne, water-borne or person to person
signs of gastroenteritis
abdominal pain, diarrhea, fever, dehydration
ileus: what is it? what can it lead to? how do you treat it?
what was it caused by?
What should you avoid?
peristaltic paralysis - no movement which can lead to constipation, bloating, distention, nausea, vomit, absent bowel sounds
Tx: IV fluids + NG suction (nasogastric)
Caused by abdominal surgery, gastroenteritis, chemical or electrolyte imbalance, mesenteric ischemia
AVOID OPIOIDS AND ANTI-ACH
celiac disease: what is it? what does it affect and lead to? what is tx?
gluten-sensitive enteropathy (type IV hypersensitivity)
affects the villi of the small intestine – atrophy, chronic diarrhea, unexplained anemia, chronic fatigue, weight loss
Tx: avoid wheat (gluten)
IBS
functional disorder with NO pathology (recurrent + onset around late teens)
abdominal pain, bloating and altered frequency/consistency of stool
Tx: increase fiber + decrease FODMAPS, exercise, decrease stress, probiotics ~ tailored to individual
inflammatory bowel disease caused by?
ocular manifestations?
onset?
Tx?
ulcerative colitis: nongranulamatous lesions in colon + continuous (SUPERFICIAL)
crohn disease: granulamatous lesions, discontinued, in GI tract (DEEP)
Ocular: conjunctivitis, uveitis, episcleritis
autoimmune etiology onset, family history, involvement of extra-intestinal tissue
Tx: immunosuppressants or sx (strictures or obstructions)
Diverticulosis
low fiber diet and 50% are over 60 years old
usually obese + low physical activity
diverticulum
blind pouch usually in sigmoid colon
diverticulitis: inflammation of the pouch ususally in sigmoid colon (lower left quadrant) with fever, pain, and tenderness
Tx: can be avoided with diet so initially lower fiber + fluids and long term increase fiber in diet
what can a diverticulitis lead to
fistula, abscess, scarring, fibrosis of walls
acute appendicitis: common in what age? symptoms? pathology?
common in teens and affects 10% of population
lower right tenderness, abdominal pain, fever, nausea, fever, anorexia
the initial obstruction will increase pressure and lower the blood flow and lead to edema, ischemia, necrosis, bacterial overgrowth, and rupture or peritonitis
CEA
carcinoembryonic antigen
monitoring tool for colon cancer treatment
not for screening bc rarely detected when it is treatable carcinoma
2nd leading cause of cancer deaths
colorectal cancer - prognosis depends on time of diagnosis
RF: genetics + diet + age
adenocarcinomas arise from colonic adenomas that are usually benign and transform over the years
colon polyps
common in lower colon and rectum (usually benign)
in-situ: 5 year prognosis
sessile polyp: broad and short base (more common)
pedunculate polyp: long and narrow stalk
familial adenomatous polyposis
genetics? pathology? symptoms?
autosomal dominant disease (APC gene) also called Gardner Disease
polyps develop in teen years + develop to colon cancer by 30s
Ocular: Bear Tracks + CHRPE (multiple in 65%) or bilateral in 87%
- if you see this, ask about colon cancer history
