Flashcards in Gastroenterology Deck (79)
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1
what are the 8 components of the GI tract?
- esophagus
- stomach
- gall bladder
- liver
- pancreas
- small intestine
- large intestine
- rectum
2
what are the 2 main functions of the gut?
- digestion and absorption of nutrients
3
what is absorbed in the stomach?
- water and alcohol
4
what is absorbed in the duodenum?
iron and vit B12
5
where is folate absorbed?
jejunum
6
what are the 2 divisions of the pancreas?
exocrine and endocrine
7
what is the hormone made by the endocrine division of the pancreas?
insulin
8
what is the function of the gall bladder?
concentration and storage of bile
9
what is the 3 functions of the liver?
- metabolise nutrients and toxins
- protein synthesis
- production of bile
10
what are 9 GI symptoms?
- pain
- dysphagia
- dyspepsia
- nausea and vomiting
- diarrhoea
- constipation
- weight loss
- bleeding
- steatorrhoea
11
define dysphagia
difficulty swallowing
12
define dyspepsia
discomfort in upper GI tract (eg heartburn)
13
what is steatorrhoea?
pale bulky stools
14
what are the main investigations of the GI tract?
- endoscopy
- colonoscopy
- sigmoidoscopy
- radiographs
- ultrasound (esp liver and billary tract)
- MRI
15
what 2 types of medication can be given to suppress acid?
1. antacids
2. gastric acid reduction
16
name 3 types of antacid
- calcium carbonate (rennies)
- aluminium hydroxide
- alginate based (gaviscon)
17
what are the 2 types of gastric acid reducers?
1. proton pump inhibitors
2. histamine receptor antagonists
18
name two histamine receptor antagonists?
- ranitidine
- cimetidine
19
name 2 types of PPIs
- lanzoprazole
- omeprazole
20
what does GORD stand for?
gastro oesophageal reflux disease
21
define GORD as a condition
excess acid at the lower oesophageal spincter
22
name 4 things associated with GORD
- smoking
- lying flat
- obesity
- fatty foods
23
what is the main symptoms of GORD?
heartburn
24
how can a diagnosis of GORD be made?
endoscopy
25
how is GORD treated? 3 things
- lifestyle changes
- drugs (PPIs and antacids)
- rarely surgery
26
name the 2 types of peptic ulcers
1. gastric ulcer
2. duodenal ulcer
27
what is the main worry with a gastric ulcer?
they have the tendency to become malignant
28
what is the aetiology of peptic ulcers?
- NSAIDs (esp for gastric)
- helibacter pylori
29
what are the 4 main symptoms of a gastric ulcer?
- anorexia
- vomiting
- dyspepsia
- epigastric pain
30
what complications can come from a peptic ulcer?
bleeding and perforation
31
what is the treatment of an acute peptic ulcer?
endoscopically stop bleeding (sometimes surgery)
32
what is the treatment for non-acute peptic ulcer disease? 2 things
- acid suppression (PPI)
- treat H. pylori (PPI and antibiotics)
33
what are the symptoms of a hiatus hernia?
heartburn
34
what are the 2 treatment options for a hiatus hernia?
- medication
- surgery (fundoplication)
35
what is a hiatus hernia?
a structural abnormality of the stomach leaving a segment above diaphragm
36
With patients who have a GI disorder you should be cautious with what during dental treatment... 3 things
- NSAIDs
- may have oral ulceration due to anaemia due to chronic blood loss
- NCTSL mat occur due to acid reflux
37
define coeliac disease
multi-system auto-immune disease that is caused by a sensitivity to gluten in the diet.
38
what happens to the villous of the small intestine in those with coeliac disease?
villous atrophy
39
what are 5 symptoms of coeliac disease?
- malaise
- diarrhoea
- weight loss
- iron and folate deficiency
- protein deficiency
40
how is coeliac disease diagnosed? 2 things
- blood test showing TTGA antibodies
- endoscopy with biopsy
41
what does TTGA stand for?
tissue transglutaminase antibody
42
what is the treatment for those with coeliac disease? 2 things
- gluten free diet
- osteoporosis prophylaxis
43
what are the 2 main types of Inflammatory disease?
- Crohn's disease
- Ulcerative colitis
44
where in the body is affected by chron's disease?
the whole GI tract from the mouth to anus
45
where in the body is affected by ulcerative colitis
the large intestine
46
what type of conditions are inflammatory bowel diseases?
auto-immune with unknown aetiology
47
what type of inflammation occurs in chron's disease?
transmural - at walls or organs and blood vessels
48
what type of inflammation occurs in ulcerative colitis?
mucosal - of mucous membranes in the intestine
49
true or false - the symptoms for inflammatory bowel conditions can relapse and remit?
true
50
what are the 5 symptoms of Chron's disease
- malabsorption
- abdominal pain
- bleeding
- abscess formation
- oral features
51
what are the main two symptoms of ulcerative colitis?
- bloody stools
- abdominal pain (less than with chrons)
52
what is the extra-intestinal symptoms of IBD? 5 things
- autoimmune arthritis (rarerly in TMJ)
- skin lesions
- autoimmune hepatitis
- DVT and PE
- ocular (eye) inflammation
53
which IBD are you more likely to have long term complications that can lead to cancer?
Ulcerative colitis
54
how is IBD diagnosed in the lower GI tract? 4 things
- clinical
- radiology
- colonoscopy
- stool sample
55
what are the 2 uses of taking a stool sample?
- rule out an infective cause
- faecal calprotectin
56
what is the drug treatment of IBD? 4 things
1. 5-aminosalicylic acid preperations
2. corticosteroids (oral/enema)
3. immunosuppressants
4. biologics (anti-TNF agents)
57
what kind of surgery can be done on those with IBD?
- remove diseased bowel
- abscess drainage
58
is is curative to remove diseased sections of the bowel in IBD?
yes, for ulcerative colitis
no, for Chron's disease
59
True or false : patients with IBD should NOT undergo "bowel resting" during acute episodes?
False, they should have parenteral nutrition/elemental diet
60
how common is diverticula in over 50s?
50%
61
what are the symptoms of diverticula?
- usually none
- bleeding
- pain (abscess formation and obstruction)
62
what % of GI patients have symptoms but no demonstrable disease?
80%
63
what are 5 symptoms of Irritable bowel syndrome?
- cramps
- wind
- diarrhoea
- constipation
- bloating
64
what is the treatment of a patient with functional bowel disease (ie IBS)?
1. reassurance
2. dietary changes (increases fibre)
3. anti-spasmodics
4. amitriptyline or SSRIs
65
what is acute liver disease described as?
hepatitis
66
what is chronic liver disease described as?
cirrhosis
67
what are 7 causes of liver disease?
1. alcohol
2. viruses (hepatitis a-e)
3. iron overload (heamachromatosis)
4. drugs (formulary and herbal)
5. auto-immune
6. diabetes
7. cryptogenic (unknown)
68
what are the 7 clinical features of liver or biliary tract disease?
- jaundice
- ascites (abdominal fluid accumulation)
- telangiectasia (dilation of capillaries that leads to spider like purple appearance)
- encephalopathy (impaired consciousness/confusion)
- variceal haemorrhage (life treatening bleed)
- coagulopathy (impaired clotting)
- prone to infections
69
treatment of liver disease is... 3 things
remove underlying cause
supportive (possibility of regeneration)
transplant
70
when treating patients with liver disease you must consider which 3 things..
1. their reduced platelets (less clotting)
2. their susceptibility to infections
3. immunosuppressants following transplant
71
what are the symptoms and treatment for gall stones?
- pain
- jaundice
- pancreatitis
all can be alleviated by
1. endoscopic surgery
2. open cholecystectomy (removal of the gall bladder)
72
how would you diagnose someone who had pancreaitits?
blood test - if shows high amylase in blood then pancreatitis
73
what is the 2 common causes for pancreaitis?
1. gall stones
2. alcohol/drugs
74
what type of patients are at highest risk of getting mouth cancer?
patients who already have cancer of the GI tract.
75
what are 4 non-specific signs that could indicate mouth cancer?
- angular cheilitis
- burning mouth syndrome
- candidal infections
- recurrent oral ulceration
76
what is burning mouth syndrome usually cause by?
deficiency in
-iron
-folate
-vitB12
having anaemia
77
in 20% of cases recurrent oral ulceration indicates..
underlying anaemia
78
can you get primary oral side effects in patients with ulcerative colitis?
no as it only affects the large intestine
79
