Upper aerodigestive tract disorders Flashcards
Normal swallowing can be affected by damage or disease to which areas of the upper GI tract?
Oral cavity, pharynx, hypopharynx and oesophagus
How can poor swallow affect food intake?
Increased time to eat, decreased amount and variety of foods
How long is cell turnover for epithelial cells?
3-7 days
B12 deficiency can lead to _____ anaemia
Megaloblastic
Which anaemias lead to a red tongue?
IDA and pernicious anaemia
What happens as a result of pernicious anaemia?
Immune cells attack parietal cells so they cannot produce IF - leading to malabsorption of B12
What are common causes of B12 deficiency?
Pernicious anaemia
Undiagnosed coeliac
Crohns
Ulcerative colitis
Why do PPIs result in B12 deficiency?
Inhibit the production of gastric acid needed to liberate B12
Symptoms of B12 deficiency (Mount Doms)
Megaloblastic anaemia OrthoHypo Unsteady, parasthesia Neuron demyelination Tired
Diarrhoea
Osteoporosis
Megaloblastic madness
Sore tongue
Where is intrinsic factor secreted
Parietal cells of stomach
Where is B12 absorbed
Ileum
How long before b12 deficiency would typically present?
3-5 years due to liver stores (50%) only releasing around 0.1% per day.
Key oral sign of riboflavin deficiency
Angular stomatitis/cheilitis
Cheilosis is typical caused by which deficiency?
Niacin (pellagra)
Xerostomia is typical of which deficiency?
Vitamin A
Recommended oral feeding for jaw fractures
soft diet, nutritionally complete fluids
What usually causes oesophagitis?
GORD
What is oesophagitis
inflammation of mucosal lining of oesophagus
Achalasia
Weak oesophageal peristalsis - LOES unable to relax
Common symptoms of achalasia
Regurgitation without bitter/acid taste, aspiration, weight loss, secondary oesophagitis
Consequence of oesophageal perforation
Food is able to enter the thoracic cavity
Oesophageal strictures usually result from
mucosal injury, GORD, intubation with wide bore gastric tubes, spasm or scarring and thickening
Symptoms of oesophageal strictures
Difficulty swallowing solids, food sticking, dysphagia, weight loss
Treatment for oesophageal strictures
Acid suppression; treat inflammation; dilation