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Flashcards in Topic 53 Deck (26)
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1

Chronic Gastritis (etiology)

-prolonged Helicobacter pylory infections
-alcoholism
-hepatitis
-endocrin diseases
-infectious diseases
-autoimmune diseases

2

Chronic Gastritis (symptoms)

-not always painful
-occasional epigastric pressure
-discomfort

Accompanying symptoms:
-loss of appetite
-nausea
-loss of weight
-abdominal fullness

3

Chronic Gastritis (oral symptoms)

-erythematous, atrophic oral mucosa
(especially the dorsal surface of the tongue)
-atrophic dorsal lingual surface (lingua fuliginosa)
-glossopyrosis
-increased candidiasis tendency

4

Chronic Gastritis (differential diagnosis)

-anaemia
-folic acid deficiency

5

Chronic Gastritis (therapy)

-internal medical treatment
-local antiseptic and analgesic th. (Tantum Verde)

6

Gastroesophageal reflux disease (etiology)

-Motility problems of the esophagus
-Chronic chemical irritation
- increased risk of dysplastic (precancerous) alterations and epithelial transformation
- increased incidence of adenocarcinoma and epithelial cancers

7

Gastroesophageal reflux disease (symptoms)

Due to irritative, chemichal effects:
- The oral mucosa of the pharynx and
- the posterior lingual surface
-erythematous
-atrophic
-erosions
-rarely ulcers
-coated tongue
(yellowish-whitish)
-hairy tongue
-oropyrosis
-glossopyrosis
-permanent dental erosions

8

Gastroesophageal reflux disease (differential diagnosis)

-acute atophic candidiasis
-anemia
-Sjögren’s sy.

9

Gastroesophageal reflux disease (therapy)

-internal medical treatment
-locally antiseptics
-steroid treatment

10

Crohn’s disease - terminal ileitis (etiology)

unknown origin - presumably immunpathological disease

Pathogenesis:
-affect the entire digestive system from the oral cavity to the rctum
-extraintestinal, metastatic Crohn’s disease may also occur
-primarily affects the ileum

11

Crohn’s disease - terminal ileitis (internal symptoms)

-enteritis
-diarrhea
-constipation
-malabsorbtion
-anemia
-arthralgia

12

Crohn’s disease - terminal ileitis (dermatological symptoms)

-pyoderma vegetans
-erythema nodosum (reddish nodules on the extensor side of the skin of the extremities)
-periorificial erythema

13

Crohn’s disease - terminal ileitis (oral symptoms)

Pyostomatitis vegetans:
- erythematous and swollen mucosa
- ulcerated, deeply fissured alteration, becomes unevenly „lacerated” and resembles cobble-stone „appearence”:
- hyperplastic, granulomatous, necrotic tissues are easily detachable, and a bleeding area remains without any epithelial layers
- diffuse, red, indurated and granulomatous nodules
evolve on the lips (especially on the upper) and gingiva
- cheilitis granulomatosa (may be the firs sign of Crohn’s disease)
- multiplex fissures on the lips
- pareititis granulomatosa (granulomatous inflammations on the bucca)
- aphtous ulcers, most commonly on the palate
- angular cheilitis

14

Crohn’s disease - terminal ileitis (differential diagnosis)

-pemphigus vegetans
-granulomas due to candidiasis
-Quincke’s oedema
-granulomatous cheilitis
-hydantoin-hyperplasia

15

Crohn’s disease - terminal ileitis (therapy)

Internal medical treatment
-corticosteroids
-sulfonamids
-sulphasalazin
-azathioprin (Imuran)
-steroid gél (for the treatment of the oral mucosa)

16

Ulcerative Colitis (etiology)

-chronic, inflammatory disease of the colon which has an unknown etiology
-commonly accompanied by psychosomatic symptomes
Pathogenesis:
-the disease has a tendency to relapse and then alleviate again
-the disease may be accompanied by hypocromatic anemia, leucocytosis, hypoproteinaemia, increased erythrocyte sedimentation rate
-systemic complications:
*pyostomatitis vegetans
*gangraenous pyoderma

17

Ulcerative Colitis (oral symptoms)

-non-specific granulomatous alterations
-bleeding, ulcerative, aphtoid and aphtous alterations
-painful deep ulcers and characteristic,hypertrophyc tissue acccumulations make the surface of these alterations uneven and deeply fissured
-yellowish pustules
-desquamativ gingivitis

Accompanied symptoms on the skin:
-nodular erythema
-gangrenous pyoderma
-whitish discoloration of the fingernails(frosted glass nails)

18

Ulcerative Colitis (therapy)

-internal medicine
-symptomatic treatment locally (susp. anesth., corticosteroid gel)

19

Celiac disease-enteropathy caused by sensitivity to gluten (etiology)

-genetical faktors
-gluten toxicity
-intestinal peptid deficiency
-immune response

Pathogenesis:
-usually begins in childhood
-symptoms may persist in adulthood as well
-pathological function, malabsorbtion and motility disorders of the small intestine cause:
*GI protein loss
*vitamin deficiencies
*malabsorption of lipids, carbohydrates, water and iron

20

Celiac disease-enteropathy caused by sensitivity to gluten (symptoms)

-anemia (usually microcytic hypocromatic)
-anorexia
-sore bones
-eczema of the skin
-bleeding tendency
-finger clubbing

21

Celiac disease-enteropathy caused by sensitivity to gluten (oral symptoms)

- aphtous ulcers (iron and folic acid deficiency) (small aphtae)
- tongue: erythematous, atrophic, burning, painful
- angular cheilitis
- in childhood: dental hypoplasia

22

Celiac disease-enteropathy caused by sensitivity to gluten (differential diagnosis)

-anemia
-vitamin deficiencies

23

Celiac disease-enteropathy caused by sensitivity to gluten (therapy)

-primarily internal medical treatment
-gluten-free diet
-combined vitamin substitution
-local antiseptic treatment

24

Hepatitis (etiology)

-viral infections
-toxic liver damage
-obstruction of biliary pathways - obstructiv jaundice (caused by malignancies or stones)

Details of Pathogenesis:
-vitamin K malabsorption
-hemophylia (purpuras on the face)
-haemorrhage tendencies
-impaired drug metabolism

25

Hepatitis (symptoms)

-jaundice (commonly the first symptome)
-discoloration not associated to melanin
-caused by bilirubin deposited from the circulation into the sclera and skin
-oral mucosa (especially palate) becomes yellow
-purpuras
-brownish-red papules
-non-itching lichenoid alterations (2-6 mm)
-the tongue becomes atrophic
-painfully enlarged liver
-pruritus

26

Hepatitis (therapy)

Internal medicine