Human disease L30: dobson lower gi Flashcards
oral manifestations of GIT disease such as
recurrent oral ulceration
angular cheilitis
candidal infections
glossitis
burning mouth syndrome
are these manifestations a direct involvement of the oral and peri-oral tissues mucosa by the disease process
or
secondary to disease elsewhere in the gastro-intestinal tract as a result of malabsorption or blood loss
secondary to disease elsewhere in the gastro-intestinal tract as a result of malabsorption or blood loss
coeliac disease affects which intestinal tract
small intestines
an autoimmune condition in which dietary proteins, known as glutens, activate an abnormal mucosal response with chronic inflammation and damage to the lining of the small intestines, what is the name of this condition
coeliac disease
what is villous atrophy
Villous atrophy occurs when your intestinal villi —the microscopic, finger-like tentacles that line the wall of your small intestine—erode away, leaving a virtually flat surface.
which three known glutens active at abnormal mucosal response with chronic inflammation and damage
wheat, barley and rye
what are crypt hyperplasia
Crypt hyperplasia is when the grooves are elongated compared to a normal intestinal lining which has short crypts. Blunted or atrophic villi. This is a shrinking and flattening of the villi due to repeated gluten exposure.
are males more likely to develop coeliac disease
no, females are twice as likely to develop it compared to men
what are the three pre-disposing factors that could increase you chances of developing coeliac disease
genetic
autoimmune thyroid gland disease
type 1 diabetes
would you expect to find intra-epithelial lymphocytes in a normal villi or in a villi with someone suffering from coeliac disease.
you would find intra-epithelial lymphocytes in the villi of someone suffering coeliac disease
symptoms of coeliac disease include the following;
malabsorption
malaise
diarrhoea, steatorrhoea
weight loss
iron and folate deficiency
protein deficiency
explain why these symptoms will be present
the micro villis purpose is for the absorption of nutrients and water.
due to villus atrophy absorption of nutrients will be minimal, which will be presented with with such symptoms.
with less uptake of water in the small intestines and the inflammation present, the stool will contain more water compared to normal.
if a patient come in to a dental practice, complaining of severe or persistent mouth ulcers, what test would you offer to the patients
offer serological testing for coeliac disease.
which antibodies are we looking for when we do a serology test
IgA to tissue transglutaminase antibody (tTGA)
if a patient has tested positive showing IgA to tTGA antibody for a serology test for coeliac disease, what would be the next step to confirm diagnosis
perform an endoscopy with biopsy
before doing a IgA to tTGA test what must the patient do
patients must have consumed gluten containing food at least twice , to avoid a false negative.
once someone has been diagnosed with coeliac disease what three management plans are put in place for them?
- gluten free diet
- correct deficiencies
- assess osteoporosis risk
name this condition
dermatitis herpetiformis
lower GI tract - coeliac disease, dental aspects
oral features of malabsorption of iron and folate deficiency results in what which oral condition
oral ulceration
there are two forms of inflammatory bowel disease, what are they
- chron’s disease - entire GI tract “mouth to anus”
- ulcerative colitis - large intestines
what is meant by skips lesions in chron’s disease
in chron’s disease the affected gut is not continous, meaning that there are areas of the gut that are unaffected and areas of the gut that are affected.
what is transmural inflammation in chron’s disease
transmural inflammation is the inflmmation of all the lining of the gut wall
in ulcerative colitis the inflammation is continous, which area of the gut does it affect
it only affects the superficial layer of the gut, the mucosal layer.
what does relapsing-remitting mean
Relapsing–remitting is a medical term referring to a presentation of disease symptoms that become worse over time (relapsing), followed by periods of less severe symptoms that do not completely cease (remitting)
what are the relapsing and remitting symptoms of crohn’s disease
malabsorption
abdominal pain
bleeding
abscess, fistula, sinus formation
oral features
are the abdominal pains experienced through ulcerative colitis less or more than crohn;s disease
less
is bloody diarrhoea a symptom of crohn’s disease or ulcerative colitis
ulcerative colitis
what is the mainstay treatment for IBD
supress inflammation
DMARDs
Corticosteroids (oral, enema)
biologics
if undergoing acute flareups, what would you do to give your bowels a rest
parenteral nutrition / elemental diet - this is when nutrition is administered intra venously and does not require digesting through the gut.
this condition is a direct response of crohns disease, what is the name of the condition
stag horning of tissues
oral ulceration
mucosal tags
cobblestone mucosa
lip and / or facial swelling
angular cheilitis
stag horning of tissues
full width gingival inflammation
the symptoms above are a direct response from which lower GI disease
crohn’s disease
oral ulceration and other oral conditions related to anaemia / iron deficiency in ulcerative colitis is what?
secondary to blood loss
