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Flashcards in GI Deck (33)
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1
Q

MCC for Dental caries

A

Streptococcus Mutans

others: lactobacillus, bufidobacterium, low pH tolerant strep

2
Q

Leading cause of tooth loss in children

A

Dental caries

3
Q

Dental caries VF

A
  1. ) Adhesions
  2. ) Acidogenicity (make acid from sucrose)
  3. ) Acidoduricity
  4. ) EPS (keeps biofilm from being washed off)
  5. ) Internal polyscaharide (energy during famine)
4
Q

Leading cause of tooth loss in adults

A

Periodontal disease

5
Q

Patient presents with painless bleeding of her gums after brushing her teeth

A

Gingivitis

6
Q

A 25 y.o first year medical student presents with fever, malaise, lymphadenopathy and painful inflamed gingiva. Patient states he has been under extreme stress since starting second semester and barely gets time to take care of himself. Past history of Gingivitis is noted in the chart.

A

Trench Mouth (Acute Necrotizing Gingivitis)

7
Q

War veteran presents to the clinic with fever, swelling of the lower face and neck, membranous pharyngitis, ulcers on the gingiva, buccal mucosa, and pharynx

A

Vincent’s Angina

8
Q

Patient presents with facial swelling and complaint of his gum hurting. Upon examination you note discoloration of his incisor, upon tapping on the tooth the patient yelps in pain. On xray you see an abscess near the root of the painful incisor.

A

Dentoalveolar abscess (likely caused by a dental carrie to the end of the tooth root)

9
Q

Patient presents with facial swelling and complaint of his gum hurting. Upon examination you note erythematous inflammation of the gum near the incisor upon tapping on the tooth the patient yelps in pain. On xray you see an abscess along the root of the tooth.

What is the condition? What always precedes this condition?

A

Periodontal abscess

Always preceded by periodontal disease

10
Q

23 year old female with known history of sickle cell anemia presents with fever, swelling and erythema under their chin/neck. Upon examination you note they have foul smelling breath, drooling, trismus, and that the tongue is moved up and back. You make note that the patient has a tongue piercing. You instruct the patient to protrude their tongue and they moan in severe pain.

What is the condition?
What is your primary concern?
What is the likely etiology?

A

Ludwigs Angina- cellulitis of the sublingual and submaxillary spaces

Primary concern –> airway management!

Streptococcus, Bacteroides (anaerobe), Fusobacterium(anaerobe), and Staph aureus
** . in this case foul breath is a strong indication that it is caused by anaeobes

11
Q

19 year old female presents with complaint of painful sores in her mouth. On examination you notice clusters of blisters on her mouth, cheeks, and lips. Upon culture the lab reports MNGC, Cowdry A inclusions, Tzanck positive.

What is the most likely cause ?

The patient returns to your office several months later with a similar complaint- how would her presentation differ?

A

HSV 1 (80%) - HSV 2 (20%)

Recurrence usually doesnt usually occur inside the mouth. Depending on time of second presentation the ulcers may be broken down and appear as shallow grey ulcers on a red base

12
Q

4 week old baby boy is brought to your office and appears to have white plaques in his mouth and a severe diaper rash. You are able to remove the plaque with some difficulty but it bleeds and the baby begins to cry.

what is the condition 
what is the most common etiology? 
what other populations are suceptible? 
What are the VF? 
Mom asks you how on earth this happened. What do you tell her?
A

Pseudomenbranous Candidiasis

Candida albicans

immunocompromised and women (vaginal infections)

VF= biofilms, germ tubes, pseudomembranes

often acquired through the birth canal

13
Q

82 year old female presents with erythematous hard palate. You note her tongue is swollen, bright red, and depapillated. History reveals she wears dentures and has a prescription for an albuterol inhaler for her asthma

What is the condition?
What is the etiology?
What is the progression?

A

Erythematous Candidiasis

Candida albicans

Can follow pseudomembranous candidiasis, occur de novo in AIDS patients, or occur after a prolonged drug reaction, commonly seen in denture wearers

14
Q

63 year old male presents with a lesion near the angles of his mouth and on the underside of his tongue that cannot be scraped off. History reveals that he is a chronic smoker and is on medication that “makes his mouth feel really dry”

What is the condition?
What is the etiology?
What are you concerned about with the progression of this condition?

A

Hyperplastic (leukoplakia) candidiasis

Candida albicans

has the potential to become malignant

15
Q

26 year old HIV positive male presents with white plaques on the lateral aspect of his tongue. Lab finds Cowdry type A inclusions

What is the likely etiology?
What other populations are at risk?

A

Oral Hairy Leukoplakia

EBV

Organ transplant patients and cancer patients.

16
Q

29 year old female presents with fatigue. On physical exam you note what crust on the corners of her mouth. Lab values show iron deficiency anemia and deficiency of B12 and other vitamins.

What is the condition
What is the etiology
What if the crust was yellow

A

Angular chelitis

Candida albicans

Staphylococcus aureus

17
Q

3 year old male presents with swollen salivary gland. Mom states he had flue like symptoms a few days ago but she thought nothing of it. You notice that while you and mom are talking he keeps tugging on his left ear and crying. Upon examination you note the swelling is not warm and feels like jelly and no obvious purulent fluid protrudes from the gland upon palpation.

What is the condition?
What is this baby at risk for?
Mom tells you she is exhausted trying to raise a 3 year old and just finding out that she is 6 weeks pregnant… what is your concern?
What is the VF?

A

Mumps

Aseptic meningitis (more likely due to gender), severe encephalitis, deafness

Mumps can cause fetal demise in the first semester if it is contracted by the mother

Hemagglutinin-neuramindase

18
Q

72 year old 2 day post op patient complains of dry mouth and a painful cheek. You notice erythema and swelling on the left side of his cheek. He states he hasnt been eating because chewing hurts. Upon examination you notice the cheek feels hot and when you palpate it you notice purulent material is expelled out of the parotid gland

What is the condition?
What is the etiology?

A

Acute Bacterial Parotitis

Stapylococcus aureus

19
Q

45 year old male presents with complaints of difficulty and pain on swallowing. Based on history you order and EGD.

EGD shows curd like material within the esophagus

What is the most likely etiology

A

Candida esophagitis

20
Q

45 year old male presents with complaints of difficulty and pain on swallowing that started all of a sudden. Based on history you order and EGD.

EGD shows volcano like lesions

What is the most likely etiology

A

HSV esophagitis

21
Q

45 year old HIV positive male presents with complaints of difficulty and pain on swallowing that has been getting worse over the last few weeks. Based on history you order and EGD.

EGD shows a large shallow ulcer. Biopsy reveals Owl eye inclusions

What is the most likely etiology

A

CMV esophagitis

22
Q

45 year old male presents with complaints of difficulty and pain on swallowing that began after he was told he has HIV. He has also noticed some blood dark blood in his stool. Based on history you order and EGD.

EGD shows giant deep ulcers

What is the most likely etiology

A

HIV esophagitis

23
Q

45 year old male presents with complaints of difficulty and pain on swallowing. He also says he has a weird rash that is only on the left side of his trunk and runs across his chest. Based on history you order and EGD.

EGD shows multiple lesions

What is the most likely etiology

A

VZV esophagitis

24
Q

56 year old female presents with ULQ pain. She appears to be pale and sweaty. HR 110 and shes says she fells like she is going to faint. When asked about her bowel movements she says they are dark, sticky, and smell really bad.

What is the condition?
What is the etiology?
What tests could you order to confirm?
What risk factors are associated with this condition?

A

Chronic active gastritis

H.pylori

serology, C13 labeled urease breath test, EGD with biopys, stool EIA antigen test

gastric adenocarcinoma, lymphoma

25
Q

58 year old Male presents with gnawing, burning pain in his epigastrium area, he complains of fatigue, weakness, and black stools. He says the pain gets worse when He eats

What is the condition?
What is the etiology?

A

Gastric Ulcer

H.pylori

26
Q

58 year old Male presents with gnawing, burning pain in his epigastrium area, he complains of fatigue, weakness, and black stools. He says the pain gets worse better when he eats

What is the condition?
What is the etiology?

A

Duodenal Ulcer

H.pylori

27
Q

Which populations are at a higher risk for chronic hepatitis

A

Children - they are more likely to be asymptomatic

28
Q

how long must HBsAg remain in the blood before it is considered chronic

A

6 months

29
Q

HBeAg

A

indicates chronic active

30
Q

Anti-HBe

A

indicates chronic persistent

31
Q

80% of Hepatocellular carcinoma are associated with what hepatitis?

A

B

32
Q

20 year old male presents with projective vomiting He has no fever and his stool is negative for FWBs. He stated he at the potato salad at a campus picnic about 3 hours ago.

What is the condition
What is the eitiology?
What is the VF

A

Food intoxication

S. aureus

8 Heat stable enterotoxins (cause serratonin release causing emesis)

33
Q

MCC of food poisoning

A

Clostridoum perfringins type A