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71 Cards in this Set
- Front
- Back
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define stomatitis |
inflammation of mouth |
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classifaction of stomatitis is based on |
1. site of inflammation - ginigitivits (gums) - cheilosis (lips) - angular stomatitis (angles of the mouth) - glossitis (tingue) 2. cause - Herpes simplex stomatitis |
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what is the cause of gingivitis |
- bacterial irritation and local factors (fod) cause inflammation and damage to underlying structures |
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what are the clincal features of ginvigitis |
1. acute, subacute, chronic or recurrent 2. chronic is most common - painless - non contagious - starts tw teeth and at gigival margin 3. swollen, red/bluishred with tendency to bleed b irritation with toothbrush 4. ulceration with suppuration |
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what is the cause of angular stomatitis (canker sores) |
1. illfitting dentures 2. nutritional deficiency ( niacin, roboflavin, folic acid, B12) |
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what are the clinical features of angular stomatitis |
1. cracks at corners of mouth 2. painful when acute |
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what is the cause of aphtous stomatitis |
1. trauma from braces 2. association with crohns, AIDs and neutropoeania |
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what are the clincial features of aphtous stomatitis |
1. multiple, depressed, spherical ulcers 2. saucer is red grey with elevated margin pain 3. 7-10 days 4. recurrent |
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what is the clincial features of glossitis |
1. smooth, red and swollen tongue |
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what are the clincial features of herpes simplex stomatitis |
1. inflammation around mouth 2. oedema and swelling |
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define thrush |
acute infection of the oral cavity with the east Candida albicans |
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what is the cause of thrush |
1. candida albicans 2. predispoition in: - infancy - debilitated individuals - diabetics - corticosteroid therapy -immunosuppressive therapy |
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list the clincal features of thrush |
1. acute 2. multiple white , curd like patches of irregular distrubution 3. ulceration deep to patches 4. inflammation and fissures of labial commisures 5. encrustation of lips |
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define oesophagitis |
inflmmation of oesphagus either acute or subacute |
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list the cause of oesphagiis |
secondary to 1. hiatus hernia w/ acid reflux 2. GORD 3. prolonged gastric intubation 4. ingesting corrosive chemicals 5. alcohol 6. candida 7. uraemia 8. bacteraemia |
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what is the pathology of oesophagitis |
1. hyperaemia and oedema 2. ulceration/erosion 3. inflammatory exudate 4,. necrosis with strng chemcials 5. leukopplakia (grey thickineing of mucous membrane) 6. pseudomembrane with candida |
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list the clincal features of oesophagitis |
1. dysphagia 2. chest pain 3. nausea, vomting, fever, haematemesis, melena |
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define gastritis |
inflammation of gastric epithelium |
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classification of gastritis |
1. acute/erosive 2. chronic/non erosivie - automimmune gastritis - multifocal atrophic gastritis - superficial |
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lis the causes of gastritis |
1. H. pylori 2. alcohol 3. swallowing corosives 4. aspririn and NSAIDs 5. radiotherapy to ab 6. autoimmune gastritis 7. age 8. CNS trauma 9. stress 10. infective 'gastroenteritits' is usually enterocolitis with vomitting |
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list the pathology of acute gastrtitis |
1. multiple superficial epithelia erosions 2. foci of necrosis 3. petechial haemorhage 4. acute inflammation |
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list the pathology of chronic gastritis |
1. mild +/- lymphocytes and plasma cells in lamina propria 2. mucosal atroph --> pernicious anaemia (decrease in intrinsic factor) 3. precursor to peptic ulcers and gastric cancer |
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list the clincial features of acute gastritis |
1. all ages + races 2. anorexia 3. epigastric pain 4. persistnet vomtting 5. persistent bleeding |
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list the clinical features of chronic gastritis |
1. asymptomatic 2. may have epigastic pain, nausea, vomting and electroyle disturabcen from vomting |
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define peptic ulceration |
range of disorders. break in continuity of mucosa in areas exposed to gastric juice. may be acute or chronic |
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where can peptic ulcers take place |
1. oesophagus 2. stomach and duodenum (1st part) 3. stoma of gastoduodenal anastomosis 4. meckels diverticulum (ectopic pariteal cells secrete HCl) |
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what is the cause of peptic ulceration |
1. multifactoria - hereditary - H. pylori - severe burns, systemic trauma, svere illness |
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what are the risk factors for peptic ulceration |
1. aspiriin and NSAIDs 2. smoking 3. excessive Hcl 4. liver cirrhosis 5. chronic renal failure 6. chronic pulmonary disease 7. endocrine syndromes 8. pyloric stenosis (food stasis --> increase antral asecretion) 9. family hostory |
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in peptic ulceration, gastic ulcerations are caused by |
1. atrophic gastritis 2. impaired mucosal defence 3. H. pyloru |
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in peptic ulceration, duodenal ulcerations are caused by |
1. increased parietal cell mass --> increased HcL (gastric acid and pepsin needed for ulcer formation) 2. accelerated gastric emptying 3. impaired mucousal defence 4. H. pylori |
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in peptic ulceration, gastric ulcers epidemiology is |
1. 50-60s most commonly 2. poor socioeconomic groups |
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in peptic ulceration, duodenlal ulceras epidemiologu is |
1. any age but esp 30-40 2. males |
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in peptic ulceration, the clincial feautes of gastic ulcers are |
1. epigastric pain with eating 2. weight loss 3. days to weeks with periods of relief |
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in peptic ulceration, the clincial feautes of duodenal ulcers are |
1. epigastric pain after a meal or early morning 2. pain relief on eating alkaline food 3. days to weeks with periods of relief |
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list the complications of peptic ulcers |
1. haemorrhage -most common - acute or chronic - causes haematemesis and melena - causes hypochromic, microcytic anaemia 2. perforation - common with duodenal - into peritoneal cavity 3. penetration - into pancreas, liver, clon or retoperitoneal space 4. obstruction - due to oedema = reversible - due to cicatricle stenosis = irreversible 5. malignant change in gastric ulcers |
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define gastroenteritis |
inflammation of lining of stomach and intestines |
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list the main causes of gastroenteritis |
1. non infectious - drugs (leads, arsenic, mercury) - fods (mushrooms, algal toxins from fish) - inflammation - post surgical - psychological factors 2. infectious - viruses - bacteria - protozoa - helminths |
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list the viruses that cause gastroenteritis. how do they cause damage |
1. rotavirus 2. calcivirus 3. adenovirus 4. astrovirus virus infects enterocyte of SI --> destroys cells --> loss of fluid and salt |
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lis tthe bacteria which cause gastroenteritis |
1. E coli 2. Stap aureus 3. clostridium perfringens 4. V cholera 5. campylobactor jejuni 6. salmonella 7. shigella 8. yersinia enterocolitica 9. clostridium botulinum |
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which bacteria produce enteroxins? how do they damage the body? |
Enterotoxigenic E. coli, stap aurea, cl. perfringens, V. cholera toxin increases adenylate cyclase --> increase cAMP --> secretion of water and electryets into lumen |
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what bacteria cause damage by invasion? |
campylobacter jejuni, salmonella, shigella, yersinia enterocolitica, enterohaemorrhagic e. coli and enteropathogenic e. coli. |
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what bacteria produc neurotoxins ? how do they damage the body? |
Cl. botulinum interfers wih release of Ach from peripheral nerves --> dry mouth, diplopia, ptosis, loos of accomdation and light refex |
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what bacteria cause haemolytic uraemic syndrome? how does it cause damage? |
e. coli O15:H7 cytoxin in large intestin --> damage to mucosa, endothelial cells of gut and damge to other endothelium --> haemolytic anaemia, thrombocytopoenia and renal failure |
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list the damage that protozoa cause |
1. giardia --> SI--> steatorhoea 2. cryptosprodiudum (immunocompromised) 3. microsprodiudum (immunocompromised) 4. entomoeba histplytica |
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lis the clinical features of gastroenteritis |
1.diarrhoea 2. vomting 3. abpain and discomfort 4. fever 5. blood and mucous in faces |
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what are the complications of gastroenteritis |
1. fluid and electrolyte loss --> dehydration and vascular collapse (rapid in young, old or with severe diarrhoea) 2. bicarb loss --> met. acidosis 3. hypolkaemia with sever dehydration or mucous excretion 4. hypomagnesaemia --> tetany |
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define crohns disease |
relapsing and progressive grnaulomatous, inflammatory disorder affcting SI or LI esp terminal ileum BUT may affect any part of GIT |
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what is the cause of crohns |
??? AI?? viral, bacterical infection, sarcoidosis??? |
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who does crohns affect |
1. 20-40 YO 2. famial tendency 3. Jewish 4. males and females the same |
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list the pathology of crohns |
1. Gross - red, wollen bowel - cobblestone appearence - narrow lumen due to wall thicken - skip lesions - enlarged lymoh nodes 2. Micro - inflammation in all layers - oedematous mucosa with linear ulceration - hyperplasia of lymphoid follicles - non casseating granulomas |
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ist the clincial features of crohns |
1. Acute - appendicitis (terminal ileum foftem involved) 2. Chronic - subacute obstruction with ab distension. mass is palpatable - malabsorbtion (decreased SA and interference with enterohepatic bile salt circulation) - diarrhoea, fresh blood and melena stools - anal lesions - anal fissure (tear in anus and stool follows new passage) 0 weight loss, fever, anaemia - clubbing - uveitis, arthritis, skin rahses, rnal stones |
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define ulcerative colitis |
non specific chronic inflammatory bowel disease with ulceration of signmoid and rectum |
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what causes ulcerative colitis |
??? AI? allergic ?? psychosomatic??? |
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ulcerative colitis commonly affects |
20 -40 YO male = female |
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list the pathology of ulcerative colitis |
1. rectum always involved. may spread to distal or entire colon 2. continuous inflammation on affected part 3. swollen, red and contact bleeding to mucos 4. part of mucosa may slough 5. reaminain may be hyperplastic 6. dilation --> thin walls --> rupture 7. fibrosis --> rigid bowel --> bowel damage |
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what are the symptoms of ulceratic colitis |
1. diarrhoea 2. bloody stools with mucous 2. defacation with pain 3. proctitis and tenesmus (spasm of rectum) 4. tender colon 5. fever, tachycardia and dehydration |
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what are the 3 patterns o presentation for ulceratic colitis |
1. single, sort, mild episode o f diarrhorea that settles but may relapse 2. long periods of ill health and diarrhoea. secnd degree complications are freqeuent 3. severe acute bloody diarrhoea with continual fever, toxaaemai and ab distension from toxic megacolon and causes perforation of intestines |
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list the general complications aof ulceratice colitis |
1. fever 2. anaemia 3. weight loss 4. affects of steroid use |
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list the colonic complications of ulcerative colitis |
1. perforation 2. haemorrhage 3. stricture 4. fistula -in-ano, fistula into vagina 5. perianal abscess. 6. lost protein --> hypoalbunaemia --> oedema 7. lost electrolytes -->lethargy and interstinal dilation 8. malignant change. more common if - whole colon involved - long duration - first attack severe - first attack was when young |
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list the non colonic complications of ulcerative colitis |
1. skin rash (erythema nodosum) abd leg ulcers 2. arthritis 3. liver disease 4. ocular (iritis and episscleritis) 5. stomatitis |
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define peritonitis |
infection of peritoneum. may be local or generalised |
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what is the cause of peritonitis |
bacteria entering peritoneal cavity via 1. exteriori (penetrating wound or infection due to operation) 2. intraabdominal viscus - gangrene (acute appendcitis, diverticulitis) - perforation - post op leakage of suture 3. bllod stream (septicaemia from pnemococci pr TB) 4. female genital tract (salpingitis, child birth infection |
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what is the pathologoly of peritonitis |
1. absorpton of toxins 2. paralytic ileus with loss of fluid, electrolyte and protein 3. ab distension and elevaede diaphragm --> lung collapse |
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lis thte clinical features of peritonitis |
1. severe pain, patient lies still 2. irritated diaphragm --> shoulder pain 3. vomiting 4. fever and tachycardia 5. silent bowels 6. advanced = ab distenstion, free fluid, toxic patient |
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define appendicitis |
acute inflammation of appendix |
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what is the cause of appendcicitis |
1. ostruction - faecolith, kink of adhesion, elarged lymphnodes |
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appendicitsi is common in --- and rare in |
young adults very young and very old western diet implicated |
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explain the pathogeneis of acute appendicitis |
lumen obstructed --> increased fluid from mucosa of appendix --> increased luminal pressure --> collapse of appendix vessel walls --> predisposition to infection --> acute inflammation --> early acute appendiciits-->acute suppurative appendicitis --> acute agangrenous appendivitis --> perforation |
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lis t the clinicla features of acut appendicitis |
1. referred pain to umbilical reginon which moves to R iliac fossa due to inflammation of peritoneum 2. pain on movement 3. maliase and anorexia 4. nausea and vomiting after pain 5. gynaecoogical, urinary and GIT symptoms 6. histroy of milder attacks 7. perforation gives temporary reilef as distension of appednic is releived. as peritonitis develops --> severe and generalised pain |
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on exxamination, a patient with acute peritonitis presents with |
1. fever and tachycardia 2. flushing 3. foetor oris 4. positive mcburneys signs 5. distended and tmpanic abdomen indicates peritonitis 6. rectal exam = tenderness in R iliac fossa 7. positive psoas or obturator test |
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what are the complications of appendicitis |
1. peritonitis 2. localised periappendcieal abscess 3. phlebitis with thrombosos of portal venous system 4. liver abscess 5. septicaemia |
