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HD 4 - dental relevance > Gastroenterology + nutrition > Flashcards

Gastroenterology + nutrition Flashcards

(62 cards)

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1
Q

what is the difference between Crohn’s and ulcerative colitis?

A

crohns = any part of GI - ORAL MANIFESTATIONS

ulcerative colitis = just colon - large bowel

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2
Q

2 types of IBD

A

crohns + ulcerative colitis

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3
Q

how do you diagnose IBS

A

diagnosis of exclusion - not IBD

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4
Q

oral complication of IBD related to inflammatory activity

A

aphthous stomatitis - repeated formation of benign + non-contagious ulcers

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5
Q

3 common causes of aphthous ulcers

A

menstruation, gut problems, medications

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6
Q

how do you test for sarcoidosis

A

serum ACE levels raised

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7
Q

rectal bleeding in IDB may cause mouth ulcers because..

A

patient anaemic

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8
Q

what is protocolitis

A

inflammation of anus + rectum lining

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9
Q

what is Barretts oesophagus?

A

complication of GORD - disease in which ep cells in oesophagus undergo dysplastic change

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10
Q

3 components of the anti-reflux barrier

A
  1. Lower oesophageal sphincter - LOS
  2. diaphragm - external sphincter
  3. small part of stomach rolled up
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11
Q

In GORD what damages the oesophageal mucosa

A

hydrochloric acid + pepsin

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12
Q

2 components of oesophageal clearance

A

gravity + peristalsis

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13
Q

what does saliva contain to neutralise acid?

A

bicarbonate - therefore xerostomia = erosion/caries

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14
Q

3 protective components of GI mucosa - against GORD + peptic ulcers

A

mucosa, bicarbonate, prostaglandins

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15
Q

how can hiatus hernia affect GORD

A

impairs oesophageal clearance

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16
Q

6 risk factors for GORD

A

genetic
smoker
diet - late at night, high fat content, caffeine, xs alcohol
pregnancy
hiatus hernia
drugs - TCAs, anticholinergics, nitrates, Ca2+ blockers

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17
Q

typical symptoms of GORD

A 
heartburn 
retrosternal discomfort
acid brash
water brash
odynophagia
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18
Q

atypical symptoms of GORD

A

non cardiac chest pain
dental eroding
resp symptoms

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19
Q

what is Russell sign

A

callous at back of fingers where vomiting induced

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20
Q

what would you do if patient complained of acute gastro-intestinal bleeding

A

sign post to GP, for them to refer immediatly

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21
Q 
what would you do if a patient presented with indigestion and any of the following:
gastrointestinal bleeding
weight loss unintentional
progressive difficulty swallowing
persistent vomiting
iron deficiency anaemia 
epigastric mass
A

refer immediately for endoscopy

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22
Q

what is the drug treatment for GORD

A

proton pump inhibitors - omeprazole/lansoprazole

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23
Q

what is haematemesis

A

vomiting blood

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24
Q

what is melaena

A

pooing blood

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25
signs + symptoms of upper GI bleeding
``` abdominal discomfort haematemesis melaena signs of shock change in orthostatic vital signs ```
26
3 main causes of oesophageal varices
1. portal hypertension 2. chronic alcohol abuse + liver cirrhosis 3. ingestion of caustic substance
27
how are peptic ulcers formed
erosion caused by gastric acid
28
3 mains causes of peptic ulcers
NSAID use alcohol/tobacco h. pylori
29
2 types of drugs used to treat peptic ulcers
histamine blockers (H2 receptor antagonists) (less acid made) + long term antacids (neutralises acid)
30
inflammation of gingiva/mucosa may be caused by 3 conditions
1. gingivitis 2. crohns 3. sarcoidosis - granulomatous
31
2 common drugs causing aphthous ulcers
nicorandil + methotrexate
32
most common oral manifestations of GI disorder
ulcer + sore throat
33
what common medications must patients not take if they suffer from peptic ulcers?
NDAIDs
34
2 types of peptic ulcer
gastric + duodenal
35
infection by which bacteria causes peptic ulcers
h. pylori
36
how do H2 receptor agonists treat peptic ulcers
reduce acid secretion - block histamine H2 receptor | -idine
37
how do prostaglandin analogues treat peptic ulcers
inhibit acid secretion + increase mucus + bicarbonate
38
how do proton pump inhibitors treat peptic ulcers
stop final step in acid production - action of H+/K+ atlases pump
39
how do antacids treat peptic ulcers
weak base that interact with acid to produce salts + neutralise - this inactivates pepsin
40
how to chelates treat peptic ulcers
coat mucosa - physical barrier, stimulate bicarb + mucous, inhibit pepsin e.g. sulfracate - xerostomia + metallic taste
41
3 components of triple therapy against h. pylori
proton pump inhibitors, clarithroymicin (do not give in history of UC), metronidazole/amoxicillin
42
dental side effect of omeprazole
xerostomia
43
what antibiotics does antacids reduce absorption of?
tetracyclines - dentists can prescribe doxycycline
44
how does omeprazole effect dental IV sedation?
inhibits metabolism of diazepam - may overstate
45
if a patient with a peptic ulcer needs prednisolone or NSAIDs what might you have to co-prescribe?
Proton pump inhibitor
46
3 ways individuals become malnourished
1. inadequate intake 2. excessive loss 3. increased metabolic requirements
47
nutritional screening vs nutritional assessment
``` screening = any health care workers assessment = nutritional expert ```
48
parenteral vs enteral delivery of nutrition
``` parenteral = IV enteral = tube to gut ``` enteral > parenteral (except when non functioning GI tract)
49
what is MUST?
malnutrition university screening tool
50
2 solid GI organs
pancreas + liver
51
what autoimmune disease may cause dysphagia ? - autoantibodies against ACH receptors at neuromuscular junctions
myasthenia gravis
52
what is pernicious anaemia?
autoimmune disease - ab against intrinsic factor
53
3 complications of peptic ulcers
perforation, bleeding, stricture
54
-oscopys also offer opportunity for what?
biopsies
55
what is diverticulitis?
mucosa out-patches through wholes in walls - popular in 65+yrs = diverticular disease if become inflamed = diverticulitis
56
which parts of GI system can you not get direct vision?
jejunum + ileum
57
which medications cause indigestion? and how can this be combated?
aspirin + NSAIDs give PPI
58
why is hiatus hernia important if patient having GA?
causes acid reflux - pt can spill over
59
what can you view with an OGD?
oesophagus to upper jejunum
60
3 signs of jaundice
1. yellow skin 2. dark urine/pale stool 3. itch
61
3 components of charcot's triangle
fever, pain, jaundice sign of ascending cholangitis
62
3 main categories of benign hepatic-pancreato-biliary disease
1. biliary obstruction - stones (choledocholithiasis) + strictures 2. pancreatitis - acute vs chronic 3. gallbladder disease - symptomatic gallstones

HD 4 - dental relevance (12 decks)

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