Gastroenterology

Question 1

Define oral leukoplakia (2)

Answer 1

premalignant condition of the oral mucosa characterised by white patches that do not rub off

Question 2

What causes oral hairy leukoplakia?

Answer 2

EBV

Question 3

Oral hairy leukoplakia is typically seen in patients with which condition?

Answer 3

HIV

Question 4

Define aphthous ulcers (2)

Answer 4

shallow, painful ulcers on the tongue or oral mucosa that heal without scarring

Question 5

Give 4 causes of aphthous ulcers (4)

Answer 5

• Crohn’s disease
• coeliac disease
• Behcet’s disease
• trauma
• erythema multiforme
• lichen planus

Question 6

Outline the management of minor aphthous ulcers (3)

Answer 6

• avoid trauma
• avoid acidic foods or drinks
• tetracycline or antimicrobial mouthwash

Question 7

Outline the management of severe aphthous ulcers (4)

Answer 7

• systemic steroids
• thalidomide
• biopsy after 3 weeks (to exclude malignancy)
• referral to oral surgeon

Question 8

Give 4 risk factors for oral candidiasis (4)

Answer 8

• extremes of age
• diabetes
• antibiotics
• immunosuppression

Question 9

Outline the management of oral candidiasis (3)

Answer 9

• nystatin suspension
• amphotericin lozenges
• fluconazole

Question 10

Give 3 causes of cheilitis (angular stomatitis) (3)

Answer 10

• denture problems
• candidiasis
• iron deficiency
• vitamin B2 deficiency

Question 11

Give 3 causes of gingivitis (3)

Answer 11

• poor oral hygiene
• drugs (e.g. phenytoin, ciclosporin, nifidepine)
• pregnancy
• vitamin C deficiency
• AML

Question 12

Define microstomia (1)

Answer 12

Small, narrow mouth

Question 13

Give 3 causes of microstomia (3)

Answer 13

• burns (causes skin tightening and thickening)
• epidermolysis
• systemic sclerosis

Question 14

Give 3 causes of oral pigmentation (3)

Answer 14

• Peutz-Jegher’s syndrome
• Addison’s disease
• drugs (e.g. antimalarials)

Question 15

What causes a blue-line at the gum-tooth margin?

Answer 15

Lead poisoning

Question 16

What causes yellow-brown discolouration of the teeth?

Answer 16

Prenatal or childhood tetracycline exposure

Question 17

Give 3 causes of xerostomia (dry tongue)

Answer 17

• dehydration
• drugs (e.g. TCAs)
• radiotherapy
• Crohn’s disease
• Sjogren’s syndrome

Question 18

Give 3 causes of glossitis (3)

Answer 18

• iron deficiency
• folate deficiency
• B12 deficiency

Question 19

Define geographic tongue (2)

Answer 19

Glossitis with loss of papillae leading to ulcer-like lesions that change in colour and size

Question 20

Give 3 causes of macroglossia (3)

Answer 20

• myxoedema
• acromegaly
• amyloidosis

Question 21

Give 3 mechanical causes of dysphagia (3)

Answer 21

• malignant stricture
  (e. g. oesophageal, gastric, pharyngeal cancer)
• benign stricture
  (e. g. oesophageal web, peptic stricture, pharyngeal pouch)
• extrinsic pressure
  (e. g. retrosternal goitre, lung cancer, mediastinal lymph nodes, aortic aneurysm, LA hypertrophy)

Question 22

Give 3 motility-related causes of dysphagia (3)

Answer 22

• achalasia
• diffuse oesophageal spasm
• systemic sclerosis
• neurological disorders
  (e. g. pseudobulbar palsy, Wilson’s disease, Parkinson’s disease, syringobulbia, bulbar poliomyelitis, Chagas’ disease, myasthenia gravis)

Question 23

Give 3 causes of Dupuytren’s contracture (3)

Answer 23

• alcoholism
• diabetes
• drugs (e.g. phenytoin)
• trauma
• Peyronie’s disease