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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

can you get primary oral side effects in patients with Crohn's disease?

yes.