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  1. what is an aphtous ulcer?
    • superficial
    • painful
    • pre-menstrual?
  2. what percentage of the population have aphthous ulcers?
  3. how do you treat mouth aphthous ulcers?
    • LA mouth wash
    • topical 0.1% triamcinolone steroids
    • topical choline salicylate
  4. incidence of oral ca?
  5. mortality from oral ca?
  6. why is oral ca more common in asia?
    they chew betel nuts
  7. risk factors for oral ca?
    • poor diet
    • alcoholism
    • smoking
    • betel nuts
  8. clinical picture of oral ca?
    • leukoplakia
    • solitary red patch
    • fixed lump
    • lip numbness
    • trismus
  9. what is trismus?
    difficulty opening mouth
  10. what does PDT, used for treating oral ca, stand for?
    photodynamic therapy
  11. what is vincent's angina?
    invasion of the mucous membrane by BORRELIA VINCENTI a commensual

    esp if the host is immunocompromised
  12. what are the symptoms of vincent's angina?
    • painful, deep ulcers in gums
    • fever
    • halitosis
  13. treatment of vincent's angina?
    • H2O2 mouthwash
    • broad spectrum abx
  14. what is candidiasis caused by?
    • commensal yeast
    • (thrush)
  15. management for candidiasis?
    • nystatin
    • amphotericin¬†suspension
    • lozenges for oral thrush
  16. what is parotitis?
    • painful parotid swelling
    • could cause and abscess
  17. name a viral and bacterial cause of parotitis?
    • mumps
    • any bact post-surg
  18. where in the GI tract can you get ulcers?
  19. what is steven-johnson's syndrome?
    • when the epidermis separates from the dermis
    • due to hypersensitivity
  20. name two systemic non-GI diseases that can cause ulcers?
    • SLE
    • Behcet's disease
  21. name two types of malignancies that can cause oral ulcers?
    • leukaemia
    • kaposi's sarcoma
  22. name some systemic diseases that can cause parotid gland swelling?
    • sjogren's
    • sarcoid
  23. what percentage of the population have GORD?
  24. symptoms of GORD?
    • heartburn
    • regurg
    • worse when lying/bending/night
    • odonophagia
    • dysphagia
    • 'acid laryngitis'
    • weight loss
  25. GORD could mimic what conditions? (2)
    • angina
    • asthma (chronic cough)
  26. risk factors for GORD?
    • smoking
    • obesity
    • asthma
  27. non medical management for GORD?
    • weight loiss
    • stop smoking
    • sleep sitting up
  28. medication for GORD?
    • PPIs
    • antacids
    • histamine receptor antagonists
  29. tests you would do for someone who presents with GORD?
    • endoscopy
    • and measure pH at gastro-oesophageal junction
    • diagnostic is if it's <4
  30. complications of GORD?
    • barrett's oesophagus
    • oesophagitis
    • anaemia from chronic blood loss
    • benign oesophageal stricture
    • gastric volvulus
    • hiatus hernia
  31. what is barrett's oesophagus?
    • metaplasia of the oesophus from squamous to collumnar
    • could lead to dysplagia and ca
  32. foods that are risk factors for GORD?
    • coffee
    • alcohol
    • chocolate
  33. name an infection that can causes oesophagitis?
  34. what is eosinophilic oesophagitis?
    • associated with atopic features and presents with dysphagia
    • kids: treat with elimination diet
    • adults: give PPIs, montelukast, topical steroids
  35. through which muscle does the pharynx herniate in a pharyngeal pouch?
  36. symptoms of a pharyngeal pouch?
    • regurg
    • dysphagia
    • halitosis
  37. what is the pain like in a pharyngeal pouch?
    • like CP
    • NOT like heartburn
  38. tests for a pharyngeal pouch?
    • barium swallow
    • endoscopy if you're suspection a perf
  39. treatment of a pharyngeal pouch?
    surgical myotomy
  40. what is achalasia of the oesophagus?
    • hypertrophy of the lower oesophageal sphincter so it can't relax
    • -> progressive dilatation of the oesophagus
  41. two queried causes of achalasia of the oesophagus?
    • lack of NO release from inhibitory neurones to sphincter
    • dodgey dorsal vagal nuclei in brainstem
    • Chagas disease
  42. what causes Chagas disease?
    trypanosoma cruzi
  43. why do you always endoscopy someone who you suspect has achalasia of the oesophagus?
    ca of the cardia presents the same way
  44. what does manometry show in achalasia of the oesophagus?
    • increased pressure at the sphincter
    • decreased contractility of the dilated oesophagus
  45. complications of a pharyngeal pouch?
    pulmonary aspiration esp at night
  46. describe the dysphagia of oesophageal achalsia?
    • solids get stuck
    • liquids are better
    • standing and moving during eating helps
  47. complications of achalasia of the oesophagus?
    • pulmonary aspiration esp at night
    • oeso squamous cell ca
  48. what is the endoscopic treatment of oesophageal achalasia?
    • forceful pneumatic dilatation of sphincter
    • or inject botox into sphincter
  49. what is the surgical management of oesophageal achalasia?
    • Heller's op: myotomy
    • with partial fundoplication to stop risk of post-op reflux
  50. what is nutcracker oesophagus?
    symptoms? (2)
    • extremely forceful oesophageal peristalsis
    • angina-like pain and dysphagia
    • give nifedipine or nitrates
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2013-07-12 20:14:23

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