Human disease L30: dobson lower gi

Question 1

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

Answer 1

secondary to disease elsewhere in the gastro-intestinal tract as a result of malabsorption or blood loss

Question 2

coeliac disease affects which intestinal tract

Answer 2

small intestines

Question 3

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

Answer 3

coeliac disease

Question 4

what is villous atrophy

Answer 4

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.

Question 5

which three known glutens active at abnormal mucosal response with chronic inflammation and damage

Answer 5

wheat, barley and rye

Question 6

what are crypt hyperplasia

Answer 6

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.

Question 7

are males more likely to develop coeliac disease

Answer 7

no, females are twice as likely to develop it compared to men

Question 8

what are the three pre-disposing factors that could increase you chances of developing coeliac disease

Answer 8

genetic

autoimmune thyroid gland disease

type 1 diabetes

Question 9

would you expect to find intra-epithelial lymphocytes in a normal villi or in a villi with someone suffering from coeliac disease.

Answer 9

you would find intra-epithelial lymphocytes in the villi of someone suffering coeliac disease

Question 10

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

Answer 10

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.

Question 11

if a patient come in to a dental practice, complaining of severe or persistent mouth ulcers, what test would you offer to the patients

Answer 11

offer serological testing for coeliac disease.

Question 12

which antibodies are we looking for when we do a serology test

Answer 12

IgA to tissue transglutaminase antibody (tTGA)

Question 13

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

Answer 13

perform an endoscopy with biopsy

Question 14

before doing a IgA to tTGA test what must the patient do

Answer 14

patients must have consumed gluten containing food at least twice , to avoid a false negative.

Question 15

once someone has been diagnosed with coeliac disease what three management plans are put in place for them?

Answer 15

1. gluten free diet
2. correct deficiencies
3. assess osteoporosis risk

Question 16

name this condition

Answer 16

dermatitis herpetiformis

Question 17

lower GI tract - coeliac disease, dental aspects

oral features of malabsorption of iron and folate deficiency results in what which oral condition

Answer 17

oral ulceration

Question 18

there are two forms of inflammatory bowel disease, what are they

Answer 18

1. chron’s disease - entire GI tract “mouth to anus”
2. ulcerative colitis - large intestines

Question 19

what is meant by skips lesions in chron’s disease

Answer 19

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.

Question 20

what is transmural inflammation in chron’s disease

Answer 20

transmural inflammation is the inflmmation of all the lining of the gut wall

Question 21

in ulcerative colitis the inflammation is continous, which area of the gut does it affect

Answer 21

it only affects the superficial layer of the gut, the mucosal layer.

Question 22

what does relapsing-remitting mean

Answer 22

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)

Question 23

what are the relapsing and remitting symptoms of crohn’s disease

Answer 23

malabsorption

abdominal pain

bleeding

abscess, fistula, sinus formation

oral features

Question 24

are the abdominal pains experienced through ulcerative colitis less or more than crohn;s disease

Answer 24

less

Question 25

is bloody diarrhoea a symptom of crohn’s disease or ulcerative colitis

Answer 25

ulcerative colitis

Question 26

what is the mainstay treatment for IBD

Answer 26

supress inflammation

DMARDs

Corticosteroids (oral, enema)

biologics

Question 27

if undergoing acute flareups, what would you do to give your bowels a rest

Answer 27

parenteral nutrition / elemental diet - this is when nutrition is administered intra venously and does not require digesting through the gut.

Question 28

this condition is a direct response of crohns disease, what is the name of the condition

Answer 28

stag horning of tissues

Question 29

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

Answer 29

crohn’s disease

Question 30

oral ulceration and other oral conditions related to anaemia / iron deficiency in ulcerative colitis is what?

Answer 30

secondary to blood loss