Fundamentals of Disease
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| Oral neoplasms | new growth that commonly occurs on the floor of the oral cavity, tongue, and inferior oral labia.
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| Labial carcinoma | associated with pipe and cigar smoking
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| Carcinomas associated with tobacco and dipping: | carcinoma of the buccae, tongue, or palate
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| Leukoplakia | A premalignant sign of an oral neoplasm
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| Dx of an oral neoplasm are confirmed with: | Bx
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| Oral neoplasms respond well to: | surgery and radiation therapy
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| Signs/symptoms of an esophageal malignancy include: | dysphagia, vomiting, halitosis, WT gain, aphagia
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| Dx for an esophageal malignancy includes: | UGI AKA barium swallow
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| The Px for an esophageal malignancy is poor because: | metastasis usually occurs before detection
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| Esophagitis | an inflammation of the esophagus
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| GERD | Gastroesophageal reflux disease - caused by esophagitis
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| GERD is caused by: | an incompetent cardiac sphincter , which allows the stomach contents to regurgitate up the esophagus
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| Signs/symptoms of GERD: | dyspepsia, eructation, dysphagia, halitosis, hematemesis, thoracodynia
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| Signs/symptoms of GERD may follow: | eating, drinking, bending over and lying down
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| GERD is more common with: | obesity and pregnancy
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| Dx of GERD: | confirmed with an EGD (esophagealgastroduodenoscopy)
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| Tx for GERD: | nonirritatin diet, antacids, antiulcer drugs (Pepcid)
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| Hiatal Hernia (HH) | A protrusion of the stomach through the diaphragm AKA diaphragmatic hernia
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| Signs and symptoms of a HH include: | dyspepsia, postprandial dyspepsia, SOB, also may cause GERD
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| Dx for a HH: | CXR and UGI
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| Tx for a hiatal hernia includes: | avoid spicy foods, ETOH, and caffeine, WT loss for obese patients, abdominal supports, hernioplasty (surgical repair)
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| Acute gastritis: | inflammation of the stomach frequently accompanied by hematemesis
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| Gastritis is usually caused by irritants such as: | NSAIDS, caffeine, tobacco, spicy food, ETOH, infection
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| Dx of gastritis: | confirmed with a gastroscopy and Bx
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| Signs and symptoms of gastritis include: | LUQ abdominal pain, hematemesis
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| Tx for gastritis: | removal of irritants, antacids, antiulcer drugs
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| PUD | peptic ulcer disease of the stomach or duodenum
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| Primary symptom of PUD: | abdominal pain, relieved temporarily by antacids and food
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| Causes of PUD: | poorly controlled stress, excessive production of HCl, NSAIDs (such as ASA, Motrin and Naprosyn), Helicobacter pylori (bacteria)
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| Tx of PUD: | stress mangement, reduction of irritants, antiulcer drugs (Nexium), antacids, antibiotic therapy (amoxcillian)
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| A complication associated with PUD is: | ulcer perforation and hemorrhage
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| Signs of perforation include: | extreme ab. pain, hematemesis, melena; requires surgery
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| Dx of PUD: | confirmed with a barium swallow
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| peritonitis | A complication of ulcer perforation
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| Ulcer perforation requires: | surgery
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| Gastroenteritis: | inflammation of the stomach and small intestine
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| Causes of gastroenteritis: | bacteria (e.coli, salmonella, listeria), chemical toxins, lactose, food allerigies
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| Signs and symptoms of gastroenteritis include: | colicky dysentery, N+V, pyrexia, diarrhea
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| Dx of gastroenteritis: | stool CX
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| Tx of gastroenteritis: | IV hydration, antibiotics,antiemetics, antidiarrheals, GI antispasmodics
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| Salmonella | food poisoning caused by an enterobacteria; can cause gastroenteritis 6 to 48 hours after
ingestion of tainted food
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| Dx of salmanoellosis: | stool CX
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| Symptoms of salmonellosis can last up to: | 2 weeks
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| The primary complication of salmonellosis is: | dehydration
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| Prevention of salmonellosis includes: | Proper refrigeration of foods, Thorough cooking of foods, Prevent cross contamination of food, Proper frequent hand washing.
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| Gastric malignancies are more common in: | men over age 55
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| Signs and symptoms of a gastric malignancy include: | anorexia, dyspepsia, N+V, PA (pernicious anemia caused by B12 deficiency), achlorhydria
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| Dx of a gastric malignancy: | gastroscopy and Bx
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| Risk of gastric malignancies increases with: | H. pylori, dried,smoked,salted or preserved foods, chronic gastritis, family Hx
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| Tx for a gastric malignancy includes: | chemo, radiation, surgery
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| Appendicitis: | inflammation of the appendix
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| Signs and symptoms of appendicitis include: | N+V, pyrexia, leukocytosis, right inguinal rebound tenderness
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| Tx for appendicitis: | appendectomy
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| Complications of appendicitis: | gangrene, appendorrhexis, peritonitis
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| Malabsorption syndrome is the: | inability to absorb fat from the small intestine
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| Malabsorption syndrome causes the stool to become: | unformed, fatty, pale, pungent, floaters
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| A complication of malabsorption syndrome is: | the inability to absorb the fat soluble vitamins A, D, E, + K
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| Vitamin K deficiency can cause | bleeding tendencies
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| Tx for malabsorption syndrome: | INJ A, D, E, K supplements
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| Diverticulitis | an inflammation of diverticula - blister-like pouches or sacs that develop in the large intestine
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| The primary symptom of diverticulitis: | LLQ cramp-like abdominal pain
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| A complication of diverticulitis is | bowel obstruction and abcesses
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| Dx of diverticulosis: | BE (barium enema)
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| Tx for diverticulitis: | antibiotics, fiber, decrease gas causing foods
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| Crohn's Disease | AKA RE (regional enteritis) chronic, idiopathic IBD
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| CD may be exacerbated by: | poorly controlled stress
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| Signs and symptoms of CD: | appendicitis like pain, bloody diarrhea and constipation, melena, anorexia, N+V, WT loss
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| Dx of CD: | colonoscopy and Bx
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| Periods of exacerbation and remission are common with some cases of CD ending in: | perforation or ileus
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| Tx of CD: | immunosuppressant meds, SAIDS, antibiotics, avoiding trigger foods
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| Ulcerative Colitis: | idiopathic IBD affecting the colon and rectum, increases risk of colon malignancies
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| UC usually occurs in young adults, especially women, and usually begins between ages: | 15 and 20
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| Signs and symptoms of UC: | sudden diarrhea w/ pus and blood, cramps in the lower abdomen, anemia
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| Dx of UC | colonoscopy and BaE )barium enema)
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| Tx for UC: | Lialda, stress management, diet, mild sedation, corticosteriods, psych. counseling, colostomy
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| Most malignancies of the large bowel are found in the : | rectum or sigmoid colon
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| Dx of carcinoma of the colon and rectum is made with: | DRE, sigmoid/colonoscopy, Bx
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| Colorectal malignancies detected early respond well to: | surgical treatment
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| Early signs and symptoms of carcinoma of the colon and rectum include: | change in bowel habits, abdominal discomfort, occult blood in stools or melena, anemia
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| Early detection of colorectal malignancies can occur with: | physical exams, regular stool guaiac tests (Hemoccult)
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| Risk factors for colorectal malignancies include: | long standing UC, polyps, a diet rich in red meat and fat, deficient Ca
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| A bowel obstruction is AKA: | ileus
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| An ileus caused by a reduction of peristaltic activity is called a: | paralytic ileus
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| volvus | an ileus caused by the bowel twisting on itself
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| intussusception | An ileus caused when the intestine telescopes on itself
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| An ileus can also be caused by: | adhesions
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| Signs and symptoms of an ileus: | severe abdominal pain, distended abdomen, vomiting and constipation
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| Dx of an ileus: | abdominal CT
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| Tx for an ileus: | laparoscopic bowel resection
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| IBS usually affects women between their: | late teens and early 40's
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| Signs/symptoms of IBS: | sudden diarrhea, constipation, abdominal pain, flatulence
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| The difference between IBS and other intestinal disorders: | no lesions present on examination
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| IBS is a disorder of: | motility and intestinal wall muscle spasms
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| Tx for IBS: | fiber, avoiding caffeine, ETOH, fat, spicy food, citrus, cabbage, and legumes, stress management, GI antispasmodics, antidiarrheals, sedatives
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| Cirrhosis: | chronic degeneration of the liver
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| Cirrhosis is caused by: | ETOH, HBV/HCV, drugs
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| Dx of cirrhosis: | liver Bx
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| Signs/symptoms of advanced cirrhosis: | tremors, somnolence (sleepiness), confusion, gynecomastia (breast growth in males), loss of chest hair, testicular atrophy, splenomegaly/hepatomegaly, dilated abdominal veins, hemorrhage, pedal edema, esophageal varcies, jaundice, ascites, hepatic coma
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| Dx of cirrhosis: | LFTs and liver Bx
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| LFTs include: | SGOT (AST), SGPT (ALT), Alk.Phos (ALP), LDH (LD), bilirubin
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| Viral hepatitis is an inflammation of the liver caused by a family of viruses called: | hepatitis A, B, C, D, and E
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| The HAV is the least serious and is usually transmitted in: | feces
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| Signs and symptoms of the HAV can occur: | 2-7 weeks after exposure and usually last 2 months
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| Signs/symptoms of the HAV: | fatigue, anorexia, RUQ pain, cephalalgia, diarrhea, dark urine, nausea, pale stools, myalgia, low pyrexia, jaundice
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| Px for HAV: | is good with no pernament liver damage and lasting immunity
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| HBV can lead to: | chronic hepatitis and cirrhosis
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| Signs and symptoms of the HBV are similar to the: | HAV
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| Signs and symptoms of the HBV can occur: | 2-6 months after exposure
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| Parenteral transmission usually refers to: | needle sticks and exposure to certain body fluids
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| Potentially hazardous body fluids include: | blood, synovial fluid, pleural fluid, CSF during an LP, pertioneal fluid, amniotic fluid and breast milk
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| Damage from the HBV can cause fulminating hepatitis where the patient can suddenly become: | comatose and die
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| A lasting immunity can be achieved for the HBV by vaccination or: | contracting the disease and recovering completely
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| Tx for HBV: | antiviral therapy
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| The HCV is: | insidious
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| The incubation period for HCV is: | 20-30 yrs to damage the liver
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| 80% of ppl with HCV will develop: | cirrhosis
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| The HCV is transmitted: | parenterally, sexually, perinatally
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| Tx for HCV: | antiviral therapy, liver transplant
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| Hepatic malignancies are usually secondary tumors that: | metastasize from the colon, rectum, stomach, pancreas, esophagus, lung, and breast
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| Hepatocarcinoma is a primary malignancy commonly associated with: | ETOH, HBV, HCV
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| Signs and symptoms of a liver malignancy include: | WT loss, RUQ abdominal mass and pain
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| Dx of a liver malignancy is confirmed with: | AFP and liver Bx
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| Cholecystitis: | an inflammation of the gallbladder
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| Cholecystitis is caused by: | an obstruction due to chloelithiasis
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| Increased incidence of cholelithiasis includes: | postpartum, BCPs, DM, cirrhosis, pancreatitis
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| Signs and symptoms of cholelithiasis include: | Right rib cage pain radiating to the right shoulder, especially after eating a meal rich in fat, chills, pyrexia, N+V, jaundice
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| Dx of chloelithiasis: | GB ultrasound, hepatobiliary scan (HILDA), ERCP, EUS, MRC
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| Tx for cholelithiasis: | laparoscopic cholecystectomy before perforation occurs, Laparoscopic cholelithectomy if stones are present in the common bile duct
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| Pancreatitis: | inflammation of the pancreas
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| Pancreatitis is commonly associated with alcoholism in men and: | GB disease in women
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| Pancreatitis can cause: | pancreatic enzymes to activate prematurely
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| These activated pancreatic enzymes will : | digest the pancreas
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| Pancreatic enzymes include: | Trypsin, Chymotrypsin, Lipase, Amylase
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| High levels of these pancreatic enzymes will confirm the diagnosis of pancreatitis especially the enzyme: | amylase
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| Signs and symptoms of pancreatitis: | severe ab. pain, N+V, jaundice
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| Risk factors for a pancreatic malignancy include: | male gender, smoking, high protein/fat diets, alcohol, DM
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| Signs and symptyoms of a pancreatic malignancy include: | severe ab. pain, anorexia, WT loss, clay colored stools, jaundice
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| Dx of a pancreatic malignancy is confirmed with a: | CT, MRI, PET and Bx
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