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Human Disease And Therapeutics > Test 3 > Flashcards

Test 3 Flashcards

1
Q

What is chemical esophagitis?

A

Irritants to squamous mucosa

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2
Q

What is infectious esophagitis?

A

Usually immunosupressed (often herpes, candidia, or CMV)

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3
Q

CMV affects entire GI tract. the elderly or immunocompromised have ___. It may be associated with ___.

A

Multiple discrete, well-circumscribed superficial ulcers

Irritable bowel disease

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4
Q

True or false… herpes simplex causes large ulcers in GI tract.

A

False.. small ulcers

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5
Q

CMV affects [part of/entire] GI tract. It may be associated with ___. Most likely in ___ epithelium and endothelial cells.

A

Entire

IBS

Glandular epithelium

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6
Q

What is reflux esophagitis?

A

Relaxation or malfunction of gastroesophageal sphincter combined with reflux of gastric acid. Can reflux into sinuses or mouth

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7
Q

What are the symptoms of reflux esophagitis?

A

Burning

Excessive salivation

Choking

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8
Q

What are 5 aggravating factors of reflux esophagitis?

A

Obesity

Pregnancy

Alcohol/tobacco use

Caffeine

Nicotine

Many prescription drugs

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9
Q

What are medical treatments of reflux esophagitis?

A

Antacids

H2 blockers

PPI

Lose weight, stop smoking/drinking

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10
Q

What are the complications involved with reflux esophagitis?

A

Ulceration

Stricture

Barret esophagus

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11
Q

What is Barrett esophagus?

A

Long tongues of extended columns of epithelium cells into esophagus lining. Takes on a small intestine appearance due to chronic irritation.

Metaplasia goes to dysplasia and becomes adenocarcinoma

*barrett esophagus frequently becomes adenocarcinoma

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12
Q

What are three medications used to treat reflux esophagitis?

A

Antacids

H2 blockers

Proton pump

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13
Q

What is reactive (erosive) gastropathy induced by?

A

Alcohol

NSAIDS

Iron

Stress

Bile reflux

Corticosteroids

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14
Q

What is acute gastritis?

A

Acute injury that is asymptomatic with possible significant blood loss

Caused by Alcohol, NSAIDs, iron, stress, physical injury

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15
Q

What are the symptoms and causes of acute peptic ulceration?

A

Symptoms: nausea, vomiting

Causes: NSAIDs, stress, alcohol, radiation

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16
Q

What are different types of chronic gastritis?

A

H. Pylori gastritis

Autoimmune gastritis

Peptic ulcer disease

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17
Q

H.pylori gastritis causes ___ and ___ ulcers and may lead to ___

A

Duodenal

Pyloric

Cancer

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18
Q

___ and ___ are the causative agents of peptic ulcer disease. It causes [decreased/increased] acid production. It causes ___ ulcers that are potential for ______. Can lead to gastric ulcer, ___, and eventually to ___.

A

H.pylori and NSAIDs

Increased

Punched-out

Perforation and hemorrhage

Dysplasia

Adenocarcinoma

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19
Q

True or false… H.pylori can be treated with antibiotics

A

True

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20
Q

What allows H.pylori to thrive in the stomach?

A

Flagella

Secrete urease

Adhesions

Toxins

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21
Q

Gastric polyps are hyperplastic lesions that are a response to ____ around ulcers. It may contain some __

A

Gastric injury

Dysplasia

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22
Q

Gastric adenocarcinoma has two forms: intestinal and diffuse type

Intestinal type forms ___

Diffuse type have ____

A

Glands

Signet cell morphology

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23
Q

What is the most common cause of intestinal obstruction?

A

Usually mechanical (80%) (Hernia or postsurgical adhesions)

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24
Q

What is the second most common cause of an intestinal obstruction?

A

Neoplasm and infarction (20%)

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25
Q

___ disease may cause intestinal obstructions. It is a ___ defect that results in a lack of ___ cells, thus cant stimulate ____ and pass ___.

A

Hirschprung

Congenital

Ganglia

Smooth muscles

Meconium

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26
Q

What is meconium?

A

Earliest stool of a mammalian infant. (Formed during the time the infant spends in the uterus)

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27
Q

Peptic ulcers are most frequently formed in the ___ (__%)

A

Duodenum (80%)

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28
Q

Name four selected diarrheal diseases

A

Celiac sprue

Irritable bowel syndrome

Infectious self-limiting colitis

Pseudomembranous colitis

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29
Q

Celiac sprue is a diarrheal disease which is ___-mediated. It is triggered by ___, its metabolite causes ___ and will cause ____ of the villi.

A

Immune mediated

Gluten (metabolite causes tissue damage especially in the small bowel)

Tissue damage

Blunting

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30
Q

What are three oral effects of celiac sprue?

A

Enamel defects

Delayed eruptions

Recurrent aphthous ulcers

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31
Q

What are the symptoms of irritable bowel syndrome?

A

Relapsing pain, bloating, constipation/diarrhea

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32
Q

What are the causes of IBS?

A

Diet

Abnormal motility

Stress

IBS is diagnosed when everything else is ruled out

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33
Q

What are the microscopic abnormalities of irritable bowel syndrome?

A

There are no gross microscopic abnormalities

Everything is functional, without structural correlates

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34
Q

What is infectious self-limiting colitis caused by?

A

Microorganisms such as salmonella and E.coli

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35
Q

Pseudomembranous colitis is usually caused by ____ (heat resistant and difficult to destroy). It is spread via ___. Pseudomembranous colitis usually follows ___. It is the most common ___ infection in older adults. Toxin cause ____ formation, ___, and ___. ___% of neonates are carriers

A

Clostridium difficile

Person to person

Antibiotic therapy

Nosocomial

Pseudomembranous formation, fluid secretions, and ulcerations (may cause perforation of intestinal wall)

50%

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36
Q

True or false.. inflammatory bowel disease may result in some oral lesions

A

True

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37
Q

What are two examples of inflammatory bowel disease?

A

Crohn disease

Ulcerative colitis

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38
Q

Crohn disease is similar to ___. It has skipped areas that are ____ and has ___. Crohn disease will involve the formation of ___, ___ and ___. It usually affects the [upper/lower] GI tract but may affect the other. It can lead to ___. It may form ___ lesions. Oral manifestations are typically associated with ___ changes to mucosal layers

A

Ulcerative colitis

Non-lesioned and has intermediate strictures

Granulomas, fistula, and perianal disease

Upper but may affect lower (including rectum)

Can lead to cancer

Transmural lesions

Rectal

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39
Q

Ulcerative colitis is more ___ and ___ than crohn disease

A

Continuous (especially in the colon and no strictures)

Superficial

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40
Q

True or false.. hyperplastic colon polyps have significant malignant potential

A

False. They have no malignant potential

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41
Q

True or false… adenoma colon polyps may become malignant

A

True

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42
Q

Invasive colonic adenocarcinoma causes __% of cancer death in the U.S.

A

15%

43
Q

What are the prognostic factors for invasive colonic adenocarcinoma?

A

Depth of invasion and lymph node involvement

The deeper the involvement the more likely to metastasize

44
Q

What are the dietary factors that may influence invasive colonic adenocarcinoma?

A

Low vegetable soluble fiber

High fat/carbohydrate diet

45
Q

Malabsorption is typically due to nutrient not being absorbed by the ___. It can be associated with ___ (high fat content in stools)

A

Small intestine

Steatorrhea

46
Q

What is pernicious anemia? How is it detected?

A

Pernicious anemia is malabsorption of B-12.

It is detected by the schilling test

47
Q

Zollinger-elision syndrome causes ___ and ___ in the ___.

A

Causes tumors and ulcers in the duodenum

48
Q

Autoimmune gastritis is usually ___. It does not cause ___. It causes destruction of ___ and ___ cells with antibodies. It causes generalized ___. It can cause a vitamin ___ deficiency leading to ___.

A

Genetic

Ulcers

Parietal and chief cells

Metaplasia

B12

Adenocarcinoma

49
Q

Where does peptic ulcer disease typically occur?

A

Proximal duodenum and lower stomach

50
Q

What is the treatment for Hirschprung disease?

A

Remove section of colon that can’t contract

51
Q

A variety of colitis-related disorders are ___-based and cause diarrhea

A

Inflammatory

52
Q

True or false… inflammatory bowel disease is chronic and contagious.

A

False. Although it is a chronic colitis, it is not contagious

53
Q

What is the difference between GERD (gastroesophageal reflux disease) and “acid reflux”?

A

GERD is chronic

Acid reflux is acute (isolated incidences)

54
Q

Episodes of acid reflux is referred to as __ and occurs daily in __% of the population

A

Heartburn

7%

55
Q

What are the aggravating factors of GERD?

A

Empty stomach

Inclined position

Increased age

Obesity

Fatty foods

Caffeine/alcohol/smoking

Large meals

Some drugs

56
Q

What things relieve GERD?

A

Small meals

Reduced fat

Reduced weight

Elevated head of bed

Avoid aspirin/NSAIDs

57
Q

What are the dental tips that should be given to GERD pts?

A

Protect teeth from erosion by gastric acids

Use mouth guard, neutralize acid with basic solution, don’t brush teeth after gastric juices are in mouth

58
Q

Antacids are used to treat GERD as they neutralize gastric HCl. Name four different antacids and their side effects.

A

Magnesium salts - can cause diarrhea

Bicarbonate - causes gas

Calcium carbonate - chalky and constipation

Aluminum salts - not very effective

59
Q

H2 receptor blockers are used to treat GERD. They are not effective at the __ receptors, thus not good antihistamines for ___. H2 blockers reduce ___ ___ by blocking H2 receptors in gut.

A

H1

Allergies

Gastric secretions

60
Q

Name three different types of H2 blockers for GERD?

A

Cimetidine (Tagamet)

Ranitidine (Zantac)

Famotidine (Pepcid)

61
Q

What are three side effects of H2 blockers?

A

Headaches

Diarrhea

Drowsiness

62
Q

True or false… proton pup inhibitors (PPIs) are available by Rx only

A

False. Also available OTC

63
Q

What is the mechanism of PPIs?

A

Disrupts hydrogen exchange for K in gastric parietal cells, which blocks production and release of HCl into cut.

64
Q

What are 4 side effects of PPIs?

A

Diarrhea

Interferes with digestion

Increases food allergies

Oral sores/ulcers

65
Q

True or false… PPIs are often combined with H2 blockers

A

True

66
Q

Name four different drugs/drug combinations of PPIs

A

Omeprazole (Prilosec)

Omeprazole + sodium bicarbonate for fast release

Lansoprazole (Prevacid)

Esomeprazole (nexium)

67
Q

Peptic ulcer disease includes gastric and duodenal ulcers. Name three causes of peptic ulcer disease.

A

Inflammation of epithelium

Erosion (can be caused by NSAIDs)

Infection by H. Pylori (70-80% incidence)

68
Q

Peptic ulcer disease causes __ burning, which is [alleviated/worsened] by eating or taking antacids

A

Epigastric

Alleviated

69
Q

Peptic ulcer disease pain is worse on [empty/full] stomach and during the [day/night]

A

Empty

Night

70
Q

True or false… peptic ulcer disease pain is often mistaken for a heart attack and vice versa

A

True

71
Q

What is hematemesis?

A

Bleeding in stools or in vomit

A symptom of peptic ulcer disease

72
Q

What are the treatments of peptic ulcer disease?

A

Antacids

PPIs

H2 blockers

(Same as GERD)

73
Q

True or false… the drugs taken for peptic ulcer disease may actually cure the disease.

A

False.. it suppresses acidity to heal sores but does not cure

74
Q

When can peptic ulcer disease actually be cured?

A

If it is H.Pylori related.

75
Q

True or false… H pyloria is contagious

A

True. Especially within family members.

76
Q

Name two drugs that may be taken if peptic ulcer disease is caused by H.pylori

A

Prevpac (combination of Iansoprazole (a PPI) and the antibiotics amoxicillin and clarithromycin

Milk of magnesia (magnesium based) may also help kill bacteria

77
Q

What is prevpac?

A

Combination of…

Iansoprazole (a PPI)

Amoxicillin

Clarithromycin

78
Q

What is absorbed in the stomach?

A

Water

Alcohol

79
Q

What is absorbed in the duodenum?

A

Fe

Ca

Mg

Na

Fats

Water

Proteins

Vitamins

80
Q

What is absorbed in the jejunum?

A

Carbohydrates

Proteins

81
Q

What is absorbed in the ileum?

A

Bile salts

B12

Cl

82
Q

What is absorbed in the colon?

A

Water

Electrolytes

83
Q

What is constipation?

A

Mobility too slow

Too much water absorption

84
Q

What are the drugs used to treat constipation?

A

Laxatives such as…

Bisacodyl

Docusate

85
Q

Bisacodyl is a laxative that is a stimulant of ___. It is __-acting. It is available by [OTC/Rx]. It is used orally or suppository. It may cause ___ as a side effect.

A

Smooth muscle

Fast

OTC

Cramps

86
Q

Docusate is a laxative that causes ___ retention in stools in order to ___. It is available OTC (dulcelax).

A

Water

Soften stools

87
Q

What is diarrhea?

A

Loose, watery stools

Motility too fast

Not enough absorption

88
Q

What are the consequences of diarrhea?

A

Dehydration

Malnutrition

*worse in young and elderly

89
Q

What are three medications used to treat diarrhea?

A

Loperamine-Imodium

Bismuth subsalicylate (pepto-bismol)

Anti-cholinergics such as atropine

90
Q

What is loperamine-Imodium?

A

Mild opioid agonist

If severe, use a stronger opioid agonist

91
Q

IBS (irritable bowel syndrome) cause is unknown. There is no ___ defect. IBS typically causes ___ pain and bloating. It could be a ___-dependent neuromuscular disorder.

A

Structural

Episodic

5HT

92
Q

___% of the population have suffered IBS. It is the most common GI disorder

A

20

93
Q

IBS is most common in ____ and ____. It has a possible association with ___ and ___.

A

Young adults and adults ~50 years old

Stress and poor diet

94
Q

What drugs are typically used for IBS?

A

Drugs to treat symptoms (deal with diarrhea or constipation with diet and anti-stress changes)

95
Q

What is the only FDA approved drug for IBS with constipation?

A

Linaclotide (linzess)

96
Q

Linaclotide is a ___ agonist. It [increases/decreases] bowel movement and fluid secretion. It relieves pain.

A

Guanylate-cyclase-C

Increases

97
Q

What are the side effects of linaclotide?

A

Diarrhea

Gas

98
Q

___% of the population has IBD (inflammatory bowel disease)

A

<1%

99
Q

IBD is a spectrum of disorders. One IBD is Crohn’s disease. Crohn’s disease causes chronic ___ problems. It can affect entire GI, but it is most intense in ___ and ___. It has intermittent areas with ___ between. This leads to ___, ___, and ___

A

Diarrheal

Ileum and colon

Strictures

Ulcerations, swelling, scarring

100
Q

Crohn’s disease causes ___ pain. ___ fissures/fistules. These pts have a higher incidence of ___.

A

Hypogastric

Perianal

Arthritis

101
Q

Crohn’s disease pts have a ___ liver. The disease has a possible ___ link. It is possible caused due to an abnormal inflammatory response to ___. Crohn’s disease [does/does not] have remission. It increases the incidence of ___.

A

Fatty

Genetic

Normal flora

Does

Colon cancer

102
Q

What are the medications used to treat Crohn’s disease?

A

Mesalamine (topical anti-inflammatory)

corticosteroids (act systemically)

Metronidazole (antibiotic mechanism (?))

103
Q

What is ulcerative colitis?

A

Similar to Crohn’s disease but limited to colon and more generalized. (No strictures)

104
Q

True or false.. the medications used to treat ulcerative colitis are similar to Crohn’s disease

A

True

Human Disease And Therapeutics (13 decks)

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