Upper aerodigestive tract disorders

Question 1

Normal swallowing can be affected by damage or disease to which areas of the upper GI tract?

Answer 1

Oral cavity, pharynx, hypopharynx and oesophagus

Question 2

How can poor swallow affect food intake?

Answer 2

Increased time to eat, decreased amount and variety of foods

Question 3

How long is cell turnover for epithelial cells?

Answer 3

3-7 days

Question 4

B12 deficiency can lead to _____ anaemia

Answer 4

Megaloblastic

Question 5

Which anaemias lead to a red tongue?

Answer 5

IDA and pernicious anaemia

Question 6

What happens as a result of pernicious anaemia?

Answer 6

Immune cells attack parietal cells so they cannot produce IF - leading to malabsorption of B12

Question 7

What are common causes of B12 deficiency?

Answer 7

Pernicious anaemia
Undiagnosed coeliac
Crohns
Ulcerative colitis

Question 8

Why do PPIs result in B12 deficiency?

Answer 8

Inhibit the production of gastric acid needed to liberate B12

Question 9

Symptoms of B12 deficiency (Mount Doms)

Answer 9

Megaloblastic anaemia
OrthoHypo
Unsteady, parasthesia
Neuron demyelination
Tired

Diarrhoea
Osteoporosis
Megaloblastic madness
Sore tongue

Question 10

Where is intrinsic factor secreted

Answer 10

Parietal cells of stomach

Question 11

Where is B12 absorbed

Answer 11

Ileum

Question 12

How long before b12 deficiency would typically present?

Answer 12

3-5 years due to liver stores (50%) only releasing around 0.1% per day.

Question 13

Key oral sign of riboflavin deficiency

Answer 13

Angular stomatitis/cheilitis

Question 14

Cheilosis is typical caused by which deficiency?

Answer 14

Niacin (pellagra)

Question 15

Xerostomia is typical of which deficiency?

Answer 15

Vitamin A

Question 16

Recommended oral feeding for jaw fractures

Answer 16

soft diet, nutritionally complete fluids

Question 17

What usually causes oesophagitis?

Answer 17

GORD

Question 18

What is oesophagitis

Answer 18

inflammation of mucosal lining of oesophagus

Question 19

Achalasia

Answer 19

Weak oesophageal peristalsis - LOES unable to relax

Question 20

Common symptoms of achalasia

Answer 20

Regurgitation without bitter/acid taste, aspiration, weight loss, secondary oesophagitis

Question 21

Consequence of oesophageal perforation

Answer 21

Food is able to enter the thoracic cavity

Question 22

Oesophageal strictures usually result from

Answer 22

mucosal injury, GORD, intubation with wide bore gastric tubes, spasm or scarring and thickening

Question 23

Symptoms of oesophageal strictures

Answer 23

Difficulty swallowing solids, food sticking, dysphagia, weight loss

Question 24

Treatment for oesophageal strictures

Answer 24

Acid suppression; treat inflammation; dilation