Exam 1: GI Flashcards
(123 cards)
1
Q
Aphthous Ulcer
A
Painful ulceration of oral mucosa and pharynx
2
Q
Aphthous ulcers are self limiting, ____ but commonly recur
A
Noncontagious
3
Q
Physical characteristics of aphthous ulcer
A
White exudate
Red rim
4
Q
Aphthous ulcer present in ____, and risk factors include
A
40% population
Females, < 20 yo Genetics Celiac / IBD Smoking Stress Trauma Fever
5
Q
Supplementation with ___ can reduce aphthous ulcers
A
Vitamin B12
6
Q
Behcet disease
A
Aphthous ulcers that travel down into esophagus
More intense
In women can effect vaginal region
7
Q
Oral herpes caused by
A
Herpes simplex virus
8
Q
60% of adults are carriers for
A
Oral herpes
9
Q
HSV is latent in what ganglion
A
Trigeminal
10
Q
HSV 1
A
Orofacial
11
Q
HSV 2
A
Genital
12
Q
Herpesviral encephalitis
A
Life threatening
Acute inflammation
MC HSV1
13
Q
Intense initial reaction to HSV in childhood
A
Acute hermetic gingivostomatitis
14
Q
Oral candidiasis aka
A
Thrush
15
Q
Causative fungus of thrush
A
Candida albicans
16
Q
Characteristics of thrush
A
Gray/white pseudomembranes
Underlying erythema
17
Q
Thrush is ____
A
Opportunistic
18
Q
2 oral proliferative lesions
A
Fibroma
Pyogenic granuloma
19
Q
Fibroma
A
Modular mass following chronic irritation
Usually along bite line
20
Q
Pyogenic granuloma aka
A
Pregnancy tumor
21
Q
Pyogenic granuloma
A
Hemangioma of gingiva
Red/purple
Grows rapidly
22
Q
Pyogenic granuloma can be on ____ or ____
A
Skin
Oral cavity
23
Q
Leukoplakia
A
Raised, white patch that can’t be scraped off
24
Q
Leukoplakia present in ___
A
3% population
25
Risks for leukoplakia
Inflammation (tobacco, alcohol, candidiasis)
Males
Age 40-70
26
25% of leukoplakia are pre-cancerous and can progress to
Squamous cell carcinoma
27
Erythroplakia
Red, velvety organ lesion with irregular borders
28
Risks fro erythroplakia
Males
Age 40-70
Tobacco
29
>50% of erythroplakia transition into
Squamous cell carcinoma
30
Oral cancer is _____ MC in ___
2X MC in males
31
Thrush present in ___
40% kids
32
Thrush is characteristic of
AIDS
Diabetes
Antibiotics
33
Mutation common in oral cancer
TP53
34
95% of cases of oral cancer are what type?
Squamous cell carcinoma
35
Leukoplakia is considered a
Preneoplasic lesion
36
Erythroplakia is more __ and ___ than leukoplakia
Rare
| Aggressive
37
SCC has ___ prognosis
Poor
| <50 % long term survival
38
Risks for SCC in oral cavity
Alcohol
Tobacco
> 30 yo
HPV 16
39
Oropharyngeal pain and dysfunction are observed in
SCC (oral cancer)
40
Multiple primary tumors are common in
SCC (oral cancer)
41
MC locations for oral SCC
```
Ventral tongue
Floor of mouth
Lower lip
Soft palate
Gingiva
```
42
Appearance of oral SCC can be ___ or ___
Whitish-gray or erythematous
43
HPV associated Oral SCC location
Base of tongue
| Tonsillar crypts
44
HPV associated oral cancer due to what pathogen
HPV 16
45
MC lymph node affected by oral SCC
Cervical nodes
46
Composition of saliva
99% water
IgA
Enzymes
47
Primary salivary gland pathologies are ___
Rare
48
MC primary salivary gland affected in pathologies
Parotid
49
Xerostomia
Dry mouth due to low saliva production
50
Characteristics of xerostomia
```
Age related (20% > age 70)
Tongue may fissure/ ulcerate
Risk for dental caries and candidiasis
Dysphagia
Dysarthria
```
51
Autoimmune attack on salivary and lacrimal glands
Sjogren syndrome
52
Sialadenitis
Inflammation and enlargement of salivary glands
Due to trauma, autoimmunity, infections
53
Viral sialadenitis MC due to
Mumps
54
Bacterial sialadenitis MC due to
Staph aureus
55
Mumps in adults can cause ___ and ___
Pancreatitis
| Orchitis
56
Mumps in kids is ___
Self-limited
57
Mumps affects what gland?
Parotid
58
Mucocele
Mucous cyst due to ductal obstruction
Saliva collects within tissue
59
Mucocele common location
Lower lip
| Postprandial
60
Smaller salivary gland neoplasms are less common but ______
Greater cancer risk
61
Salivary gland neoplasms are ___ and make up what percentage of tumor diagnosis
Rare
<2%
62
Salivary gland ca MC what age and sex
60-80
Females
63
3 MC salivary gland ca and percentage
1. Parotid - 75%
2. Submandibular - 10%
3. Sublingual and minor glands - 15%
64
Sublingual and minor salivary gland ca are ___ malignant
75%
65
Parotid gland neoplasms are characterized by ___, ___ growth
Large,rapid
66
MC benign tumor
| > half of parotid gland tumors
Pleomorphic adenoma
67
Up to 10% of pleomorphic adenomas progress to ___
Cancer
68
Pleomorphic adenomas are mixed tissues and are usually ___ and ____
Painless
Encapsulated
69
Aggressive parotid gland neoplasm that has a 30-50% 5 year survival
Carcinoma ex pleomorphic adenoma
70
Zenker’s diverticulum aka
Phargyngoesophageal diverticulum
71
Zenker’s diverticulum
Lower pharyngeal outpouching superior to UES
72
Zenker’s diverticulum is usually from increases pressure in pharynx, which can be due to ___ or ___
Uncoordinated swallowing
Cricopharyngeus muscle spasm
73
In zenker’s diverticulum, bolus accumulates, which can cause
Halitosis
74
Beginning of GI tract
Esophagus
75
Ectopic gastric mucosa
Inlet patch of stomach tissue
Upper 1/3 of esophagus
MC asymptomatic or cancer
76
Triad of achalasia
Incomplete LES relaxation
Increased LES tone
Esophageal aperistalsis
77
Achalasia
Failure to relax
78
Radiologic sign of achalasia
Bird beak sign
79
Primary achalasia
MC
Loss of inhibitory innervation to LES
Idiopathic
80
Secondary achalasia
Co-morbidity impairs LES function
81
Secondary achalasia can be due to
```
Chagas’ disease
Irradiation
Polio
Diabetes
Inflammation near Auerbach’s plexus
```
82
Achalasia cause dysphagia and ____ esophagus
Dilated
83
Esophageal Varices develop from
Portal HTN
84
90% of esophageal varices come from
Cirrhosis (alcoholic liver disease)
85
Hepatic schistosomiasis
Flat worm cause of cirrhosis
86
Esophageal varices can cause lethal ___
Hemorrhage
50% bleeds lethal
87
Hepatic encephalopathy
Seen in advanced cirrhosis
Toxins into CNS
Severe swelling of brain (hepatic coma)
88
Odynophagia
Pain when swallowing
89
MC cause of esophagitis
GERD
90
Rate of GERD in US adults
25-40%
91
MC GI complaint
GERD
92
GERD due to
Idiopathic LES dysfunction
93
Signs of GERD
Dysphagia
Heartburn
“Sour brash”
94
Risks for GERD
```
Obesity
Alcohol
Smoking
Increase gastric volume
Hiatal hernia
Pregnancy
>40yo
```
95
Managing GERD
```
Avoid trigger foods
Maintain healthy weight
Eat smaller portions
Avoid swallowing air
Reduce stress
Avoid lying down after eating
Probiotics
```
96
Chemical esophagitis due to
```
Tobacco
Alcohol
Pill-induced
Hot liquids
Acidic foods
Chemo
```
97
Infectious esophagitis MC develops following ___
Ulcer
98
Causative organisms for infectious esophagitis
Fungal - candida esophagitis
Viral - HSV, CMV
99
Esophageal lacerations due to _____
Intense coughing/ vomiting
100
2 types of esophageal lacerations
Mallory-Weiss syndrome
Boerhaave’s syndrome
101
Mallory Weiss Tear
Longitudinal tear at G-E Junction
Forceful vomiting
102
Signs of Mallory- Weiss tear
Hematemesis
Upper GI bleeds
103
Hiatal hernia
Stomach protrudes into thorax
Congenital, acquired, or idiopathic
104
Axial hiatal hernia (sliding)
MC
Bell shaped dilation
105
Non-axial hiatal hernia (rolling)
Separate portion of stomach protrudes
Prone to strangulation or obstruction
106
20% of all adults affected by ___, with 70% of those over 70 yo
Hiatal hernia
107
Most hiatal hernias are ___
Asymptomatic
108
Symptoms with hiatal hernia
Mimics GERD
MC with non-axial type
109
Esophageal metaplasia; squamous cells —> columnar with goblet cells in distal esophagus
Barrett esophagus
110
10% of symptomatic GERD patients will develop
Barrett esophagus
111
Risks for Barrett esophagus
```
Caucasians
Males
Obesity
History
40-60 yo
```
112
Characteristics of Barrett esophagus
Red, velvety mucosa
Bands or “tongues”
113
2 common complications of Barrett esophagus
Esophageal adenocarcinoma
Ulcerations and strictures
114
3 esophageal tumors
Leiomyoma
Adenocarcinoma
Squamous cell carcinoma
115
MC esophageal tumor in US
Adenocarcinoma
116
MC esophageal tumor worldwide
SCC
117
Specific area SCC common to
Rural/ underdeveloped areas
118
Bulimia can characteristically lead to ___
Mallory - Weiss tear
119
Boerhaave’s syndrome is rare but very __
Serious (life-threatening)
120
Prognosis of adenocarcinoma
Poor
| <25% at 5 years
121
Fruits and veggies can decrease which esophageal tumor
Adenocarcinoma
122
Risks for SCC
```
>45 yo
Males
African Americans
Rural/underdeveloped
Nitrosamines
Irritants
```
123
Prognosis for SCC
Poor
| <10% 5 year survival
