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xD3 Med Mgmt Ex2 > Liver and GI (DeLuke) > Flashcards

Liver and GI (DeLuke) Flashcards

1
Q

What Hepatitis is transmitted by the oral-fecal route?

A

Hepatitis A

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2
Q

What was the first Hepatitis discovered?

A

Hepatitis A

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3
Q

Which is associated with unsafe drinking water in deveoping countries?

A

Hepatitis E

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4
Q

Which Hepatitis is significant to dentists? Why?

A

B. It is transmitted by blood or saliva exposure.

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5
Q

Which Hepatitis has a vaccine?

A

Hepatitis B

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6
Q

Which Hepatitis coexists with B?

A

Hepatitis D

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7
Q

What is the most effective treatment for patients with a chronic viral hepatitis?

A

Interferon B

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8
Q

Which recently identified Hepatitis is similar to C?

A

Hepatitis G

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9
Q

What are the three main entities of alcoholic liver diseases?

A
  1. Fatt infiltrate (reversible)
  2. Alcoholic Hepatitis (reversible)
  3. Cirrhosis (irreversible)
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10
Q

Which Hepatitis has a vaccine?

A

Hepatitis B

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11
Q

Which Hepatitis viruses coexist?

A

Hepatitis B and D

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12
Q

The dentist should be concerned with what in a patient with hepatitis on interferon Alpha therapy?

A

Platelet count

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13
Q

What is an alcoholic liver disease that is reversible and seen in early chronic alcoholics (hepatocytes show increased fatty acid uptake, decreased fatty acid oxidation and lipoprotein secretion)?

A

Fatty infiltration

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14
Q

What is an alcoholic liver disease that is reversible and is characterized by inflammatory cells invading and killing hepatocytes?

A

Alcoholic hepatitis

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15
Q

What is an alcoholic liver disease that is irreversible and seen in long-term chronic alcoholics?

A

Cirrhosis

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16
Q

Alcoholic hepatitis has what interaction between the hepatocytes and ethanol and is it reversible?

A

Ethanol causes surface cell changes on hepatocytes making them appear as antigens and setting up an inflammatory immune response

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17
Q

In cirrhosis, liver cells are replaced by what?

A

Fibrous tissue

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18
Q

What causes splenomegaly in cirrhosis?

A

Hepatic flow slow, blood backs up in in the spleen, causing splenomegaly and increased platelet destruction

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19
Q

The symptoms of cirrhosis causing kidney abnormalities that lead to ascites and peripheral edema are due to what?

A

Portal hypertension

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20
Q

Jaundice in a patient with cirrhosis results from what?

A

Decreased processing of bilirubin in damaged or destroyed hepatocytes

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21
Q

Jaundice is first seen where?

A

Floor of the mouth

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22
Q

When considering liver disease, consider what 4 functions of the liver?

A
  1. Coagulation
  2. Metabolism
  3. Bile regulation
  4. Protein synthesis
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23
Q

What is jaundice of the eye?

A

Scleral icthyus

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24
Q

What may cause enlarged parotids?

A

Bulimia, malnutrition, alcohol abuse

25
Q

What are some oral manifestations of bulimia?

A
  1. Enlarged parotid glands
  2. Erosion of the palatal surfaces of maxillary teeth (especially anterior teeth)
  3. Esophagitis (not necessarily benign)
  4. (This is systemic) electrolyte imbalance
26
Q

If a patient has an enlarged liver due to cirrhosis, what pain will they present with?

A

Upper right quadrant

27
Q

What is the cause of alcoholic encephalopathy?

A

Patient cannot break down ammonia in the body

28
Q

An alcoholic may show what enlarged glands?

A

Enlarged parotid glands

29
Q

What is the cause of thrombocytopenia in a Cirrhosis patient?

A

Enlarged spleen eats up more platelets because of a backup

30
Q

What antibiotic should be prescribed to a patient with cirrhosis or impaired hepatic function?

A

Clindamycin

31
Q

What pain medication should be lowered or not used in an advanced liver disease case?

A

Acetaminophen and opioids

32
Q

All coagulation factors except which 2 are produced by liver parenchymal cells?

A
  1. Factor 8

2. VWF

33
Q

What lab value is elevated in patients with liver disorders?

A

PT

34
Q

Alcohol causes what type of platelet defect?

A

Impaired aggregation because diminished thromboxane A2

35
Q

Does the dentist need a liver function test or a CBC (platelet count, PTT, PT, BT) for a liver patient?

A

CBC. We’re concerned with bleeding.

36
Q

A bulimic patient will show what during periods of starvation?

A

Parotid gland enlargement

37
Q

Electrolyte imbalance caused by frequent vomiting leads to loss of Cl and H causing an alkylosis, for which the body compensates by excreting K to absorb H, causing what?

A

Hypokalemic hypochloremic metabolic alkalosis

38
Q

What results when a portion of the stomach protrudes into the chest cavity through a weakened portion of the diaphragm giving GERD symptoms?

A

Hiatal hernia

39
Q

Pain with a hiatal hernia is relative to what?

A

The patient’s position

40
Q

What is a sharply defined break in the GI mucosa greater than 3mm that results from chronic acid-pepsin secretion and the disruptive effects of H. pylori?

A

Peptic Ulcer Disease (PUD)

41
Q

What are 4 things than can actively promote peptic ulcers?

A
  1. Gastrin
  2. Histamine
  3. Pepsin
  4. Increased vagal activity
42
Q

What is a differentiating symptom between a gastric ulcer and a duodenal ulcer?

A

Gastric ulcer will have pain with food ingestion

Duodenal ulcer will have relief with food ingestion

43
Q

What are 3 mechanisms by which H.pylori causes mucosal damage leading to peptic ulcer disease?

A
  1. Negative feedback for gastrin is halted causing increased acid release
  2. Local inflammatory response to the bacteria in the stomach
  3. Bacteria produce cytotoxins
44
Q

What is a side effect of anticholinergics given for the treatment of peptic ulcer disease?

A

Xerostomia

45
Q

What oral fungal infection is common for peptic ulcer disease?

A

Candida

46
Q

What side effect of peptic ulcer disease can manifest as gingival bleeding?

A

Thrombocytopenia

47
Q

What should a peptic ulcer patient be prescribed for pain management?

A

Acetaminophen (not NSAIDS or ASA)

48
Q

What is a differential between Crohn’s disease and Ulcerative colitis?

A

Crohn’s will have colon ulcers and oral manifestations . Ulcerative colitis confined to colon.

49
Q

What therapy might a patient with Ulcerative colitis or Crohn’s disease be on?

A

Long term steroids

50
Q

What will be the appearance of Crohn’s disease oral manifestations?

A

Wwill be like aphthous ulcer or diffuse granulomatous swellings

51
Q

Which disease is transmural (going through all layers) primarily involving ileum and right colon: Crohn’s or Ulcerative colitis?

A

Crohn’s disease

52
Q

Which disease manifests in mucosal ulcerations of lower colon and rectum: Crohn’s or Ulcerative colitis?

A

Ulcerative colitis

53
Q

What is the age range for Crohn’s?

A

20-30, 40-50

54
Q

Which disease has an unknown genetic etiology: Crohn’s or Ulcerative colitis?

A

Crohn’s

55
Q

Which disease has perianal involvement and fistulas commonly: Crohn’s or ulcerative colitis?

A

Crohn’s

56
Q

Which disease has rectal involvement in 100% of the cases: Crohn’s or Ulcerative colitis?

A

Ulcerative colitis

57
Q

What is caused by broad spectrum antibiotics (Clindamycin, ampicillin, amoxicillin, cephalosporin) eliminating normal flora of gut and allowing C.difficle to bloom and produce enterotoxin?

A

Pseudomembranous colitis in distal colon

58
Q

Should an anti-diarrheal be given to a patient experiencing pseudomembranous colitis?

A

No. The diarrhea is getting the toxin out

59
Q

What is the timeline for pseudomembranous colitis to appear with antibiotic administration?

A

Usually w/in 4-10 days. May develop 1-8 weeks after antibiotic administration

xD3 Med Mgmt Ex2 (6 decks)

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