Oral cavity and GI tract Flashcards
1
Q
An idiopathic, thin exudate sore with a red rim is called?
A
canker sore
2
Q
Whats another name for an aphthous ulcer?
A
canker sore
3
Q
Canker sores are idiopathic. T/F?
A
T
4
Q
What causes cancer sores?
A
stress, fever, or certain foods
5
Q
What percent of HSV are asymptomatic?
A
80%
6
Q
What organism causes HSV in children?
A
acute herpetic gingivostomatitis
7
Q
Where does HSV lay dormant?
A
Trigeminal ganglion
8
Q
What organism causes HSV in adults?
A
Recurrent Herpetic Stomatitis
9
Q
Which HSV is orofacial?
A
HSV-1
10
Q
Which HSV is genital?
A
HSV-2
11
Q
Are the 2 types of HSV exclusive to their respective spots on the body?
A
no
12
Q
What is it called when HSV spreads into the brain?
A
Herpesviral Encephalitis
13
Q
What are gray/white pseudomembranes that CAN be scraped off describing?
A
thrush
14
Q
What organism causes Thrush (Oral Candidiasis)?
A
Candida albicans
15
Q
What percent of newborns have thrush?
A
40%
16
Q
What nodular mass of the mouth is found following chronic irritation?
A
fibroma
17
Q
Where are fibromas MC in location?
A
the bite line
18
Q
What oral lesion is due to hormonal factors and irritation?
A
pyogenic granuloma
19
Q
What oral lesion is a raised, white patch ass. with cellular dysplasia?
A
Leukoplakia
20
Q
How do you diagnose Leukoplakia?
A
by exclusion
21
Q
What % of Leukoplakia is precancerous for squamous cell carcinoma?
A
25%
22
Q
What oral lesion is described as a red, velvety area?
A
Erythroplakia
23
Q
What % of Erythroplakia transitions into cancer?
A
> 50%
24
Q
Oral cancer is ass. with what gene mutation?
A
TP53
25
What's the MC type of oral cancer?
Squamous Cell Carcinoma (95%)
26
Describe the tumor pattern of Squamous Cell Carcinoma.
Commonly have multiple 1° tumors
27
What are the 2 MC locations of oral cancer?
ventral tongue and the floor of the mouth
28
Squamous Cell Carcinoma may develop atop a background of what two diseases?
leukoplakia or erythroplakia
29
What's the MC place for Squamous Cell Carcinoma for met.?
cervical lymph nodes
30
HPV-16 ass. Squamous Cell Carcinoma has a better or worse prognosis?
better
31
Although primary salivary gland diseases are rare, what is the MC location?
Parotid gland
32
Dysphagia(difficulty swallowing), dysarthria(difficulty speaking), and xerostomia are features ass. with what pathology?
salivary gland pathologies
33
What is the autoimmune disease that destroys salivary and lacrimal glands?
Sjögren Syndrome
34
Whats the MC viral infection of the salivary gland?
mumps
35
Whats the blockage/rupture of a salivary duct, where saliva collects within tissue leading to an inflamed cyst?
Mucocele
36
Whats the MC location of a Mucocele?
the lower lip
37
In respect to salivary gland neoplasms, the less common they are, the ____ the risk for cancer.
higher
| MC- parotid, submandibular, sublingual/ minor salivary -LC
38
Who do salivary gland neoplasms MC affect?
elderly
39
Pleomorphic Adenoma are MC benign or malignant?
benign
40
What percent of Pleomorphic Adenoma are parotid tumors? what % transition into cancer?
60%; 2-10% (Carcinoma Ex Pleomorphic Adenoma)
41
What are the 2 types of MECHANICAL obstructions of the esophagus?
Atresia and tracheal fistula
42
Whats the main FUNCTIONAL obstruction of the esophagus? and where does it most commonly happen?
Achalasia (absent peristalsis); Proximal esophageal dilation
43
Whats the 'triad' for Achalasia?
- Incomplete LES relaxation - Increased LES tone
| - Esophageal aperistalsis
44
Which type of Achalasia is idiopathic?
primary
45
Which type of Achalasia is ass. with inflammation near Auerbach's plexus??
secondary
46
Whats the pathology that has portal venous congestion leading to portal blood flow to the esophageal venous plexus?
Esophageal Varices
47
Where do Esophageal Varices normally develop?
distal esophagus
48
Esophageal Varices occur secondarily in patients with what?
Alcoholic liver disease( 90% of cirrhosis patients)
49
If an Esophageal Varices hemorrhages, what percentage of bleeds are lethal?
50% (hypovolemic shock)
50
In Esophagitis, symptoms do not correlate well with what?
the degree of inflammation
51
Whats the MC causes of Esophagitis?
GERD
52
'Sour brash' is ass. with what form of Esophagitis?
GERD
53
Which form of Esophagitis is acute and self-limiting?
chemical
54
Which form of Esophagitis does a fungal infection occur in the immunosuppressed?
infectious
55
What's a longitudinal esophageal tear from forceful vomiting at the GASTROESOPHAGEAL junction called?
Mallory-Weiss Tear
56
Which form of a hiatal hernia has a 'bell shaped' dilation?
axial (MC)
57
Which form of a hiatal hernia does a separate portion of the stomach herniate?
non-axial (symptomatic)
58
Hiatal hernias are common in whom?
adults
59
90% of hiatal hernias are asymptomatic, but when they do have symptoms it is from what?
GERD-like esophagitis (non-axial)
60
A non-neolplastic, intestinal/esophageal metaplasia at the distal esophagus is termed what?
Barrett Esophagus (obese, white, males)
61
10% of symptomatic GERD patients have what?
Barrett Esophagus
62
What are red, velvety mucosal bands (tongues) ass. with?
Barrett Esophagus
63
What is a major complication of Barrett Esophagus?
Esophageal adenocarcinoma
64
Whats the MC worldwide esophageal tumor? (90% of all esophageal cancer)
Squamous Cell Carcinoma
65
Eating fruits and veggies decreases the risk of what Esophageal Tumors?
adenocarcinoma
66
Esophageal Adenocarcinomas develop where in the esophagus?
the distal 1/3
67
Where in the esophagus do Esophageal Squamous Cell Carcinoma occur?
middle 1/3
68
Stomach mucosal ulcerations that lead to hemorrhage will see what symptoms?
Hematemesis “coffee grounds” vomit and melena (black, "tarry" feces)
69
Which form of gastritis has acute onset, transient mucosal inflammation, and is multifactorial?
acute gastritis
70
What has a dose-dependant relationship with NSAIDs?
Acute Gastritis
71
What are 4 complications with Acute Peptic Ulceration?
- severe PHYSIOLOGICAL stress
- high dose of NSAIDs
- Cushings ulcers
72
What organism is ass. with Chronic Gastritis?
Helicobacter pylori
73
The presence of Chronic Gastritis causes a 5x increase of producing what?
Gastric adenocarcinoma
74
What pathology has solitary “punched-out” lesions in the proximal duodenum?
peptic ulcer disease
75
Who's MC has PUD? and what organism causes it 70-90% of the time?
males; H. pylori
76
Only ___% of people that are infected with H. pylori actually get PUD.
5-10%
77
When does PUD MC cause pain?
at night & 1-3 hrs. postprandial (after eating)
78
What are gastric polyps ass. with?
chronic gastritis
79
What pathology is 90% of all stomach cancers?
Gastric Adenocarcinomas
80
What type of prognosis do Gastric Adenocarcinomas have?
poor, 5 years survival
81
What population of people MC get Gastric Adenocarcinomas?
Japanese
82
What pathology is ass. with Projectile vomiting? and how is it treated?
Pyloric Stenosis; pyloromyotomy (sphincter is cut)
83
What location are Intestinal Obstructions MC?
SI
84
What pathology is ass. with the rules of 2s?
Meckel Diverticulum (2 inches long, 2% of pop., males at 2x risk, 2% are symptomatic)
85
What disease is a lack of neurologic ganglia in the rectum that obstructs the bowel?
Hirschsprung Disease
86
How do you diagnosis Hirschsprung Disease?
failure to pass meconium (48 hrs.)
87
Hirschsprung Disease is MC in _____ but more severe in _____.
males; females
88
Ischemic Bowel Disease affects what 3 arteries?
- Superior mesenteric
- Inferior mesenteric
- Celiac
89
What form of Ischemic Bowel Disease has episodic bloody diarrhea, mimics IBD?
chronic
90
What form of Ischemic Bowel Disease has sudden/severe abdominal pain (rigidity), nausea, vomiting, frank blood in stool?
acute
91
What pathology does this describe... IDIOPATHIC submucosal and mucosal vessels that are tortuous, malformed dilations?
Angiodysplasia
92
Where are Angiodysplasia located?
the cecum (MC) or ascending colon
93
A thinned wall varicose from high intra-abdominal pressure and frank blood in stool, also ass. with liver cirrhosis?
hemorrhoids
94
Difference beween int. and ext. hemorrhoids?
int- above anorectal line
| ext- below anorectal line
95
What describes excessive fat in feces
| causing bulky, frothy, greasy, yellow/gray diarrhea?
Steatorrhea
96
What describes bloody diarrhea painful, may be of small volume?
Dysentery
97
What disease is a immune mediated VILLOUS ATROPHY from wheat, barely, and rye? What % of US and Europeans have it?
Celiac Disease; 1%
98
Whats it called when celiac disease manifests on the skin? what cells does it recruit?
Dermatitis Herpetiformis; neutrophils
99
What autoimmune pathology flattens villi as a response to antibiotic, stunting growth? MC affects who?
Environmental Enteropathy tropical sprue; children 2-3
100
What type of Lactose Intolerance is MC? what test is ass. with it?
acquired (during childhood); breath hydrogen test
101
What microbial infection is a major global heath problem but not so much in the US?
Infectious Enterocolitis
102
Cholera opens the ____, leading to massive chloride ion secretion.
CFTR
103
Whats the MC bacterial enteric pathogen in US? whats it from?
Campylobacter Enterocolitis; enterotoxins in contaminated chicken
104
An antibiotics disrupting intestinal flora causing Clostridium difficile to overgrow in colon?
Pseudomembranous Colitis
105
Pseudomembranous contain what 2 things?
Cellular debris and leukocytes
106
Half of all gastroenteritis cases are form what pathology?...what affects children? adults?
Viral Gastroenteritis;
children- rotavirus;
adults- norovirus
107
What parasitic disease alters SI enzymes, resists cold and chlorine, and is nicknamed 'Beaver fever'?
Giardia lamblia
108
Acquired diverticulum in the colon that may become infected via hemorrhage?
Sigmoid Diverticulitis
109
What sensation do people with Sigmoid Diverticulitis have?
Tenesmus (sensation of inadequate BM)
110
Who gets Sigmoid Diverticulitis and how are they treated?
50% of people > age 60; modify diet to have more fiber
111
Does IBS have cellular abnormalities?
no, just alters bowel habits
112
Where is Crohns disease and what does it effect?
in ileum; transmural
113
Where is Ulcerative Colitis and what does it effect?
in rectum; mucosa and submucosa
114
What disease is ass. with 'skip lesions'? how common is it?
Crohn Disease' 1:500 people get it
115
What disease ass. with pseudopolyps, has decreased incidence from smoking?
Ulcerative Colitis
116
What disease has grossly bloody and mucoid 'stringy' stools?
Ulcerative Colitis
117
What autosomal dominant disease with numerous adenomas, is MC before the age of 30, and 100% of them develop colon cancer?
Familial Adenomatous Polyposis
118
What % of the US population develops colorectal cancer?
5%
119
What is the MC form of colorectal cancer? and why does it occur?
Colorectal Adenocarcinoma (80%); because of a highly processed diet with little fiber
120
What is the MC place for the Colorectal Adenocarcinoma to mets?
the liver
121
Although Neoplasms of the Small Intestine are rare where are the MC located?
duodenum (50% adenocarcinomas, 50% carcinoid tumors)
122
Whats the MC acute abdominal condition? ass. with what pain?
Acute Appendicitis; RLQ tenderness
123
What disease is common caused by obstruction and if ruptured, mortality is high?
Appendicitis
124
Whats the MC tumor of the Appendix?
carcinoid
