chapter 13 Flashcards
(33 cards)
1) Caused by irritants: __________,_______,______
2) Caused by infectious agents
________HSV-1): Vesicles involving oral mucosa that rupture & results in shallow, painful, red ____. Primary infection occurs in childhood; lesions heal, but virus remains dormant in ______ of the ______ nerve. Stress and hormonal changes cause reactivation of the virus, leading to vesicles on the ____ (cold sores).
__________ (thrush,) is a local white, membranous lesion caused by _________. It occurs most commonly in _____ and ______, ___________ and _______ patients.
stomatitis alcohol, tobacco, stress herpes virus ulcers ganglia trigeminal lips oral candidiasis Candida albicans infants and children immuno-compromised diabetes
• Classified as squamous cell carcinomas
• Often related to _________
• _____ of the mouth is common location
• Oral leukoplakia and erythroplakia are precursor lesions.
Morphologically present as the following:
• _______: White plaque which cannot be scraped away represents squamous cell dysplasia.
• ________: Red plaque (vascularized) represents squamous cell dysplasia.
oral cancer tobacco smoking floor leukoplakia erythroplakia
infectious or autoimmune Clinically presents as swelling of glands by ______
• Prevented by ____ vaccine
• Neoplasms (greatest in women 20-40 years old)
– Most common localization of the _____glands
– Most common tumor is ________ adenoma (benign)
Sialadenitis mumps MMR parotid pleomorphic
Upper end of the esophagus is intact but ends in a blind pouch.
• ___________ : Lower part of the esophagus is normal but it tappers at the ____ end which communicates with trachea.
• Clinical symptoms: Fetus can not swallow _______ and neonates appear to be healthy. But, when fluids are administered they come out via ____ and ____ causing ________
• Treatment: ________
esophageal atresia tracheo esophageal atresia with fistula proximal amniotic fluid nose, mouth respiratory distress surgery
Disorder with esophageal motility with inability to relax the lower esophageal sphincter (LES).
• The condition is caused by a loss of ______ cells in the __________, which leads to the progressive dilation of the _________. One important source (principally in South America) is _______(parasite) infection in Chagas disease. In other cases, ganglion cells are lost for reasons that are not known.
• Clinical characteristics include difficulty in ________
• Achalasia can lead to esophageal _______ cell carcinoma in about 5% of
achalasia ganglion myenteric plexus esophagus Trypanosoma cruzi swallowing squamous
____________: Protrusion of the abdominal contents through abdominal wall to thoracic cavity
__________: Above the diaphragm (90%) ____________: Below the diaphragm origin but rolls alongside the distal esophagus
hiatal hernia
sliding hernia
paraesophageal/rolling hernia
Hernia protrudes through the inguinal canal & extends into the _______is known as
scrotum
inguinal hernia
Hernia occurs through the Femoral canal in the ______ is also known as
groin
femoral hernia
- Reflux of gastric juice into esophagus.
- Characteristics usually include _____ pain relieved by ______. Manifestations often include substernal pain (_____).
- Most commonly,associated conditions include incompetent lower esophageal _____ & ______ hernia. GERD is also associated with excessive use of _____ and _____
- ______ and ______ are late complications.
gastroesophageal reflux disease (GERD) burning antacids heartburn sphincter hiatal alcohol tobacco ulceration, Barret esophagus
Lower portion of the esophagus is affected by this disorder. The _____ cell lining is replaced by ______ epithelium. Most aggressive form of _______
• Common cause is _____ where the glandular _______ happens due to the acid injury.
• Treatments for GERD or peptic ulcer: a) ______ are not permanent solution. b) H-2 blockers like Zantac blocks the _______ which in terms inhibit ______ secretion. c) __________ drugs like Nexium which decrease the acid production via acid pump.
Barret's esophagus squamous columnar epithelium adenocarcinoma GERD metaplasia antacids h-2, histamine, gastric acid acid pump reducer
diseases of stomach: clinical symptoms Pain—\_\_\_\_\_\_, upper abdomen • \_\_\_\_\_\_ • Bleeding • \_\_\_\_\_\_: upset stomach • Systemic consequences—e.g., \_\_\_\_\_\_\_\_\_ anemia caused by chronic blood \_\_\_, vitamin \_\_\_\_ malabsorption– related \_\_\_\_\_\_\_ anemia
midline vomiting dyspepsia iron deficiency loss b12 megaloblastic
diseases of stomach: developmental abnormality
Congenital hypertrophy of pyloric smooth muscle; more common in _____ Seen in two weeks of birth.
• Prevents _____ of the stomach& results in ______
•______ of the contracted muscle
congenital stenosis of pylorus males 2 emptying projectile vomiting surgical incision
Acidic damage to the stomach
• In most cases self-limited,of _____ duration
• May be associated with _____ , with bleeding
• Risk factors: ______: aspirin, ibuprofen, naproxen,
Heavy _____ consumption, severe ___ patients (____ ulcer: hypovolemia leads to decrease blood supply), Increased ______ pressure (_____ ulcer): Increased stimulation of ____ nerve resulting in acid production.
Treatment:___ blocker or _______ (proton pump inhibitor).
acute gastritis short mucosal ulceration NSAIDs alcohol burn curling intracranial cushing vagal h-2 acid pump reducer
characterized by chronic mucosal inflammation and _____ of the mucosal glands. Two types:
• _____:Autoimmune gastritis is associated with the presence of antibodies to _____ cells (and sometimes to ______), lack of gastric acid secretion, ______ anemia, and other autoimmune diseases, such as chronic _____ and ______ disease. It is also associated with ____, gastric ____, and gastric ______
- Type B: caused by _____ bacteria & common form of chronic gastritis. H. pylori is also strongly associated with ____ and _____ peptic ulcers and is thought to play a role in the development of ______ of the stomach and gastric ______ of the mucosa-associated lymphoid tissue (MALT) type.
- Treatment: _________ (antibiotic) to treat H. pylori. ________ test and lack of _____ antigen confirm H.pylori
chronic gastritis atrophy type A parietal intrinsic factor pernicious thyroiditis Addison's aging ulcer carcinoma type B H.pylori gastric duodenal adenocarcinoma lymphoma triple therapy negative urea breath stool
Most often, the stomach ulcer (punch out margins) occurs at or near the ____ curvature, in the _____ and ______ regions with hypertrophy of ____ glands. Caused by H. pylori (95 %)
• The ulcer is not a precursor lesion of _____ of the stomach.
• Unlike peptic ulcer that occurs elsewhere, peptic ulcer of the stomach is not dependent on increased gastric acid secretion; however, ____ and ____ are believed to play a role.
• Presents with _______ that improves with meals. Rupture causes the risk of _____ from gastric arteries.
_____ ulcer is mediated by H. pylori, in which bacterial ____ and _____ break down ______ in gastric mucus, thus interfering with ______ protection.
• Increased permeability of the gastric mucosa to _______ ion, resulting in back diffusion of hydrogen ion with injury to the gastric mucosa.
• ______ gastritis leading to gastric ulceration.
• Treatment: same as ______
• Note a precursor to _______ .
peptic ulcers: gastric & duodenal lesser antral pre-pyloric Brunner carcinoma acid, pepsin epigastric pain bleeding gastric ureases proteases glycoproteins epithelial hydrogen bile-induced GERD gastric carcinoma
complications of peptic ulcer diseease
_________: (most common)—_______ (vomiting of blood), ______ (black stool),_________ anemia
hemorrhage
hemetemesis
melena
iron deficiency
Malignant proliferation of surface epithelial cells (_________ ). Carcinoma of the stomach is most common after ___ years of age, with an increased incidence in ___. It occurs more frequently in persons with blood group __, suggesting a genetic predisposition. Incidence varies greatly from one geographic area to another, with incidence much higher in Japan, Finland, and Iceland. The incidence is decreasing in the US. Two main types:
• 1) ______ (more common) presents as a large, irregular ulcer with heaped up margins; most commonly involves the ____ curvature of the ____(similar to
gastric ulcer).
• 2) _____ is characterized by _____cells that diffusely infiltrate the gastric wall (leather bottle stomach).
gastric carcinoma adenocarcinoma 50 men A intestinal type diffuse signet ring lesser antrum
gastric carcinoma: causative factors
• _____ is a high suspect.
• _____ from dietary amines and ____ used as food preservatives may play a role. Incidence of the disease is greatly increased in populations who eat large amounts of ______, _____ And pickled ______
• Increased incidence is also associated with excessive ___ intake and a diet low in fresh fruits and vegetables
• Chronic gastritis with or without pernicious anemia
Treatment: Surgical resection with or without ______ chemotherapy.
h. pylori nitrosamines, nitrites smoked fish, meat, veggies gastritis pernicious perioperative
Developmental Diseases of the Intestines
• Developmental abnormalities: Congenital diverticula (e.g., Meckel’s diverticulum) mimics the symptoms of ______ but pain ___ corner of abdomen. ______ of all three layers of the _____wall.
appendicitis
left
outpouching
bowel
_______ (marked dilation of large intestine) is notable proximal to the narrowing of the ___. Due to congenital failure of ____cells (neural crest-derived) to descend into ______ and ______ plexus. Clinical features include failure to pass ______, or chronic _____ with abdominal _____ early in life, may present as acute ______ with watery/foul smelling stool or rupture of the colon.
• Treatment: resection of the involved ____; _____ cells are present in the bowel proximal to the diseased segment.
Hirschsprung's disease megacolon rectum ganglion myenteric submucosal meconium constipation bloating enterocolitis bowel ganglion
Out pouching of colonic mucosa through weak areas in wall (diverticulum) causing _______. most frequently involve the ____ colon. They are almost always ___. Diverticula are most common in ______ persons. Chronic ______ and ______ diet predisposes to this condition.
• Most diverticula are _______ but occasionally problems arise.
• When bits of fecal material become trapped within the pouches and incite inflammation, this reaction is called ______ . Complications:_________,_______ and bright red rectal _______.
• Treatment: High ____ diet and ______ (diverticulitis)
diverticulosis sigmoid multiple older constipation low-residue asymptomatic diverticulitis inflammation, perforation bleeding fiber antibiotics
Pathophysiology
– Mass of swollen ___ in anus or rectum
– Idiopathic
– Internal (veins of the lower ____) and predispose to bleeding.
– External (veins of the ___ region) and may or may not bleed.
–________ and increased _____ predispose to development
• Signs and symptoms
– Limited bright red bleeding and painful ____ – Consider ______ bleeding
• Treatment : _______, high ____ diet and rectal ____
hemorrhoids veins rectum anal constipation, straining stools lower GI stool softener, fiber, ointment
localized vascular lesion in colon and ______ bleeding in old people.
angiodysplasia
unexplained
decrease blood flow in the intestine (acquired malformation of mucosal layer) due to the ________ occlusion of at least two of the major ______ vessels.
ischemic bowel disease
atherosclerotic
mesenteric
