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______ ________ is a canker sore. These are from a cold/virus infection but most commonly the cause is unknown. Aphthouse Ulcer
______ ________ is a cold sore or a vessicle. Herpes Simplex
___________ (Thrush) is a yeast infection. It is most common when a person is immunocompromised. Candidiasis
_________ is thick white plaque found in the mouth. It is common with smokers. It can look very similar to Thrush. This can turn into ________ ________ carcinoma. Leukoplakia Squamous Cell Carcinoma
_______ _________ are intraoral granulomas caused by trauma. It is a swolen wound that does not heal well. May also be found on the skin. Pyogenic Granuloma
______ _________ carcinoma is found on the floor of the mouth. It is crusty, does not heal, and is the most dangerous type because it can _________ quickly. 99% of cases must use a biopsy to diagnose. Squamous Cell Carcinoma Metastasize
______ _________ Carcinoma is common on the face and may also occur on the lip. It is much less dangerous than ______ ________ carcinomas. Also known as a ________ Ulcer. Basal Cell Carcinoma Squamous Cell Carcinoma Rodent Ulcer
__________ is inflamation of a salivary gland with 3 different causes. Sialadenitis
3 causes of Sialadenitis are ______ (_______), _________ (________ Syndrome), and ________. Viral (mumps) Autoimmune (Sjogrens Syndrome) Bacterial
Mumps is a _______ infection and mainly involves the _________ gland. In adults it may also involve the _______ or ________ (Mumps orchitis). Viral infection parotid gland pancreas or testis (mumps orchitis)
Sjogrens Syndrome may affect the _________ or _________ glands. Lacrimal or salivary
Sialadenitis is caused by bacterial infection due to ascending bacterial infection from the oral cavity, _______ ____________ by a _______ may cause this. Duct obstruction by stone
Benign salivary gland tumors are known as ________ __________. (Tumor arising in a gland) Pleomorphic adenomas
Esophageal Achalasia is failure of the lower _______ _________ to relax with swallowing. This causes decreased _______ ________. Esophageal sphincter esophageal peristalsis
_______ esophageal achalasia is of uncertain etiology. Primary
_______ esophageal achlasia is due to a known underlying disease. (An example is _______ disease-caused by ________ _________ bacterium which destroys the _______ ________ of the esophagus. When this is destroyed food will not be able to be swallowed) Secondary (Chagas Disease caused by Trypansoma Cruzi Bacterium which destroys the Myenteric plexus)
2 Types of Hiatus Hernia. ________ type is when the stomach and a section of the esophagus join through the hiatus into the esophagus. ________ type is when part of the stomach protrudes under the diaphragm but is next to the esophagus or not part of it. Sliding type Paraesophageal type
A pouch protruding from the esophagus is called ________ diverticulum. This can cause ________, or _____. Zenker's Diverticulum Heartburn or GERD
"Tight bands" on the esophagus near the diaphragm are _________ rings and the cause is unknown. Schatzki's Rings
Esophageal _________ are dialated veins int he esophageal wall. This is caused by obstruction to __________ blood flow (nutrition from small intestine to liver) through the liver and tends to occur in ________ of the liver caused by chronic alcoholism. Esophageal Varices Portal Blood Flow Cirrhosis of the liver
Esophageal Varices cause ________ hypertension. Lacerations in the lower esophagus with tearing of these veins can produce massive life threatening hemorrhage known as __________-______ syndrome. Portal hypertension Mallory-Weiss Syndrome
________ is coughing up blood from the lungs. ________ is coughing/vomiting up blood from the GIT. Hemoptysis Hematemesis
_______ ________ _________ (GERD) causes _______ esophagus which is the replacement of the normal esophageal squamous epithelium by columnar epithelium. This esophagus has an increased risk of __________ developing in the glandular columnar epithelium. Gastroesophageal Reflux Disease Barrett's Esophagus Adenocarcinoma
Esophageal carcinoma is a worldwide _____ cell carcinoma that is the more common type and accounts for 90% of esophageal carcinomas. Squamous
In the US ___________ represents about 50% of esophageal carcinomas and most of these arise in Barrett's esophagus. In the US the other 50% are _______ cell carcinoma. Adenocarcinoma 50% Squamous Cell Carcinoma 50%
_______ _________ ______ _______ is caused by excess alcohol consumption and heavy NSAID use. The gastric mucosa shows hemorrhage and sometimes superficial _______ (erosions). May cause ________ (vomiting of blood), which may be severe. Acute Hemorrhagiv Erosive Gastritis Superficial Ulcers (erosions) Hematemesis
3 Main types of Chronic gastritis. __________ chronic gastritis, Chornic _______ and _____ _______ gastritis, and Chronic ________ gastritis. Which 2 are autoimmune and which one is caused by bacteria. Autoimmune chronic Gastritis (Autoimmune) Chronic Antral and distal body gastritis (Bacteria H Pylori) Chronic Fundus Gastritis (Autoimmune)
Autoimmune chronic gastritis is __________ destruction of _______ cells in the fundus and body of the stomach. This is less than __% of chronic gastritis. Autoimmune destruction of parietal cells less than 10% of chronic gastritis
Chronic Antral and Distal body gastritis is caused by _________ which increases _____. The bacteria can cause chronic __________ leading to multifocal atrophy. H Pylori increases acidity pangastritis
Chronic fundus gastritis is an organ specific autoimmune disease with autoantibodies against the gastric __ cells resulting in destruction of these cells. These cells produce ___ ___ and ___ ___ so with increasing loss of these cells ____ ____ will occur. parietal cells which produce gastric acid and intrinsic factor without that pernicious anemia will happen (due to Vit B12 deficiency) and Achlorhydria (decreased gastric acid)
Chronic gastritis results in gastric ________. It is a precursor for intestinal _______ and epithelial _______ which may develop into gastric adenocarcinoma. This is therefore a premalignant condition in the stomach. (All forms of gastritis are dangerous) Atrophy intestinal metaplasia epithelial dysplasia
________ ulcers occur in the GI tract where there is exposure to acid-______ gastric juice. More than 98% of these ulcers are in the first part of the duodenum or in the antrum of the stomach. _:_ ration of duodenum and stomach. Peptic ulcers acid-petic gastric juice 4:1
There is a strong relationship between ______ bacteria and peptic ulcers. It is present in 90% of duodenal ulcer patients and 70% of gastric ulcer patients. It onl grows on gastric type mucosa in the surface mucus layer. Antibiotic treatment heals ulcers H Pylori
Three complications of peptic ulcers are ______, __________, and _______ _________. Bleeding, perforation, and duodenal obstruction
________ Diverticulum is located in the ilium. It is a pouch in the ilium that is mainly congenital. Meckel's Diverticulum
A congenital disease in the colon is known as ______ ______ disease or Megacolon. It is the absense of myenteric auerbach plexus so there is little to no peristalsis. This is caused by weak gut or __________. Hirsch Prung's Disease Gastroperesis (Weak gut)
Infectious __________ _________ is when bacteria multiply on the mucosal surface and secrete an enterotoxin. This does not invade the bowel wall and does not damage mucosal epithelial cells. Caused by ____________ E.Coli and Vibrio Cholerae. Enterotoxigenic Enterocolitis Enterotoxigenic E. Coli and Vibrio Cholerae
Infectious ______ _____ is when bacteria invade the bowel wall and damage mucosal epithelial cells to cause necrosis E Coli (_______ type), Shigella, _______, Yersinia, Campylobacter, Clostridium difficile. Infection may occur with use of oral antibiotics Enteroinvasive Enterocolitis E Coli (Enteroinvasive type) Salmonella
Both enterotoxigenic enterocolitis and enteroinvasive enterocolitis cause ___________ and increased secretion of fluid into the bowel leading to ______. Hyperperistalsis diarrhea
Viral _________ is caused by 4 improtatn viruses. These infect superficial epithelial cells in the sall intestine and cause diarrhea. ______ (Common in children), Caliciviruses (Norwalk), Adenovirus, Astrovirus._ Viral Gastroenteritis Rotavirus
__________ Disease is caused by T ______ bacteria. It is very rare and causes diarrhea, joint pains, CNS involvement (headaches, seizures). Caused by Malabsorption syndrome. Whipple's Disease T Whippilli Bacteria
_____ syndromes result from a failure of normal absoption of fat, carbs, protein, fat soluble vitamins, and water. This happens when the gut is ____. 3 most common causes in the US are ____ ____ (cystic fibrosis), celiac and chron's disease. Malabsoption syndromes pancreatic insufficiency (cystic fibrosis) Celiac disease Crohn's disease
_______ disease is gluten sensitive enteropathy caused by gluten sensitivity. Inflamation is in the small bowel mucosa and destroys and flattens the mucosal villi, mucosal nutrient absoption is reduced leading to malabsoption. Celiac Disease clinical symptoms of malabsoption improve rapidly once gluten is gone, inflammation improves over a longer period of time
________ ______ (Mucoviscidosis) is abnormal function of an epithelial cell membrane chloride channel. Can result from chronic ________. Progressively destructive of the exocrine secretory pancreas with decreased secretion of pancreatic digestive enzymes. Cystic Fibrosis (Can cause malabsoption of fats, protein, carbs) Chronic pancreatitis
Diverticula of sigmoid colon can cause _________ and that can also cause Divertulosis of the colon. Constipation
________ _________ disease causes varying symptoms depending on the size of the involved blood vessel and the degree of obstruction. The symptoms vary from abdominal pain, diarrhea (maybe bloody), to hemorrhagic bowel infarction. Ischemic Bowel Disease
Ischemic Bowel Disease has widespread ________ throughout the small intestine. If the intestine becomes revolving or _________ it will require surgery. nercrosis volvulus
Telescoped or ________ bowel is when the bowel curves and food cannot pass. intussusception of bowel
Two noninfectious inflammatory bowel disease are ________ disease and ______ ________. Crohn's disease and ulcerative colitis
________ disease (regional enteritis) can affect any part of the GI tract but usually involves the distal small bowel and colon. It may have skip lesions (disease section of gut, then no disease section, then disease section), and granulomas. Crohn's disease
_____ _______ only involves the colon and begins distally in the rectal area. It may have pseudopolyps and cause higher chance of colon cancer. Ulcerative Colitis
Inflammatory bowel diseases have a strong __ factor. Immune response against normal bowel flora.There are also defects in the normal intestinal epithelia barrier which allow normal bowel flora to access to the mucosal lymphoid tissue and initiate an __ __ genetic factor initiate an immune response
15% of Inflammatory bowel disease patients have affected first degree _______. relatives
Chrohn's disease the inflammation extends through the entire _______ of the bowel wall and may show small granulomas. ________ may form between bowel loops because of the transmural inflammation. This might require surgical ________ which is not curative. thickness of the bowel wall Fistulae Surgical resection.
Chonic ulcerative colitis is when the inflammation is confined to the mucosa and submucosa. ________ may be required for complications such as severe diarrhea and bleeding. Cannot absorb anything, weight loss, bleeding. Colectomy
Both crohn's disease and chronic ulcerative colitis are associated with an increased risk of developing ______ or small bowel ___________ in the diseased areas. Also associated with enteropathic ________. Colonic or small bowel adenocarcinoma Enteropathic arthritis
__________ polyps account for 90% of the epithelia polyps of the colon. Usually occur in people over 50, virtually no malignant potential. Hyperplastic polyps
_________ (_____________) polyps usually occur under age 5 but may occur in adults. Juvenile (Hamartomatous) polyps
________ polyps are seen in patients with severe Crohn's disease or culcerative colitis Inflammatory polyps
Benign _______ _________ polyps can be tubular (majority of theses polyps 90%), or they can be villous (smaller 1% of these polyps). Also they can be tubulovillous which is a mixture of the above two (5-10% of the total). Benign Adenomatous Colonic Polyps
Decrease in ________ can cause polyps. Most colonic adenocarcinomas arise in pre-existing _________ ______ polyps fiber adenomatous colonic polyps
4 premalignant conditions of the gastrointestinal tract. _______ esophagus caused by GERD, chronic _____ _____ caused by chronic fundus-body or antral gastritis, _____ _____ disease cuased by crohn's or chornic ulcerative colitis, and _____ colon polyps Barrett's Esophagus Chronic Atrophic gastritis Inflamatory Bowel Disease Adenomatous Colonic Polyps
______ _________ is inflammtion of the appendix . Now they believe the appendix may be immune related due to lymphoid tissue. Acute appendicitis
2 Complications of severe liver disease is _______ syndrome (Renal failure secondary to liver disease with no intrinsic kidney disease), and _______ ______ (elevated blood amonia which impairs brain function and causes cerebral edema). Hepatorenal Syndrome Hepatic Encephalopathy
___________ is mostly formed in the spleen from the breakdown of old RBC at the end of their 120 day life span. Bile is formed in the _______ and stored in the ________. Bilirubin formed in liver stored in gallbladder
Hereditary ____________ is either unconjugated (Gilbert's sydnrome, Crigler-Najjar Syndrome) or conjugated (Dubin Johnson Syndrome, Rotor Syndrome). Hyperbilirubinemia
Conjugated bilirubin has been processed by the _______ for excretion in the bile. Unconjugated bilirubin has not been processed by the ________ and causes ________. liver liver (Jaundice)
Viral Hepatitis. Which 3 types are blood borne? Which 2 types are food borne? Which two types coexist? Which 2 types are the most dangerous Blood borne HBV, HCV, HDV Food Borne HAV, HEV Coexist HBV and HDV Most dangerous HBV and HCV (STDS)
Viral Hepatitis is asymptomatic. Acute _______ hepatitis is with no jaundice. Acute ________ is with jaundice. Acute anicteric no jaundice Acute icteric with jaundice
________ hepatitis has massive hepatic necrosis. Most dangerous and usually caused by drugs. Fulminant hepititis
Carrier state, chronic, asymptomatic is only with hepatitis ___, ___, and ___. B, C, and D
Chronic active hepatitis is only with hepatitis ___, __, and _. B, C, and D
Food borne hepatitis is spread by the _______ (oral route). This is never a cause of _______ hepatitis. Person develops lifelong immunity and recovers from the illness. The liver returns to normal. fecal (oral route) chronic hepatitis
Hepatitis ___ is most cases in the US that is food borne while hepatitis ___ is most cases in other parts of the world. Pregnant women have a mortality rate of close to 20% with hepatitis __. Hep A in US Hep E in the rest of the world Hep E 20% mortality rate of pregnancies
Hepatitis B is _____ borne and mianly spread by _____. It can also be spread by sexual contact, and maternal child route is very common. 90% of persons develop immunity and recover. 5% become asymptomatic chronic carriers and 5% develop chronic active hep blood borne needle drug use
HBV has 3 antigens termed hep B surface antigen HBsAg, hep B core antigen HBcAg and Hep B e antigen HBeAg. _____ and _______ appear in the blood and ________ does not. There are 3 corresponding antibodies that all appear in blood. HBsAg and HBeAg appear in blood HBeAg does not Anti HBc, anti HBe, and Anti HBs all appear in blood
4 important serologic markers to evaluate HBV infection. _________ is the first to appear after infection. _______ is the next to appear. Anti ________ is the next. Anti _________ is the last to appear. The last one appears in 90% of ppl and indicates ___ First HBsAg Second HBeAg Third Anti HBc 4th Anti HBs indicates immunity and they recover
In 5% of patients who become asymptomatic chronic HBV carriers Anti ___ does not appear in the blood, ________ persists in the blood and _______ disappears form the blood. Anti HBs does not appear HBsAg persists HBeAg disappears
Persistance of HBeAg indicates _________ viral replication and _________ in the liver. continued inflamation
______ _________ is persistence of symptoms or biochemical or serological evidence of infection beyond 6 months. ____, ____ and _____ can cause this. _____ can only coinfect with ____. _____ may infect a person previously infected with HBV. Chronic Hepatitis HBV, HCV, HDV HDV coinfect with HBV HDV may infect a person previously infected with HBV
Hepatitis ___ virus is an incomplete virus that does not have an envelope and only co-infects with H_V. This coninfection may of occur at the same time or it may infect at a later time in a person with chronic preexisting H_V infection. Hepatitis D virus HBV HBV
Hepatitis _ virus is a ___ borne virus usually caused by _______. It can also be sexually transmitted or 4% of cases are transfusion hepatitis. A high percent of people develop chronic hepatitis. Hepatitis C blood borne mostly needle drug use
At time of infection of HCV most patients are _________. 15-30% recover from this acute infection and develop immunity. Antibodies against HCV do not produce immunity to the virus so there is a high rate of progression to ______ ___________. asymptomatic chronic hepatitis
2 adverse outcomes to chronic HBV or HCV infection are development of post ________ _________ (10% of cases), or _________ ______ (a primary malignant tumor of liver cell orgin). Fulminent hepatitis or hepatorenal syndrome may happen as well. Post hepatitic cirrhosis and hepatocellular carcinoma
3 stages of alcoholic liver disease. _______ ________ which is reversible, lipid triglyceride droplets in liver cells. Alcoholic _______ which is reversible, lipid plus inflammation, may be fatal. __________ which is irreversible. Fatty Metamorphosis Alcoholic hepatitis Cirrhosis
Cirrhosis is irreversible but progress may be halted if ______ ________ stops. This happens in 10-15% of chronic alcoholics. IT shows _______ fibrosis and nodular regeneration of hepatocytes. 85-90% results in _______ _________. alcohol excess stops hepatic fibrosis liver failure
________ ________ disease has mallory bodies. This is common with alcoholic hepatitis and cirrhosis. They are ___________ aggregates of protein in the cytoplasm of hepatocytes.
Cirrhosis is most commonly caused by _________. 2 Defining chages in the liver are ____________ producing bands of fibrous tissue. _______ regeneration of hepatocytes. alcohol fibrosis nodular regeneration
The results of fibrosis and nodular liver cell regeneration in cirrhosis is obstruction of ______ and ________ flow through the liver which becomes worse as it progresses. blood and bile
2nd biggest cause of cirrhosis is _________ cirrhosis 10-15%, ______ _________ _ and _ 10%, Biliary disease 5-10% ,Hereditary hemochromatosis (iron deposition), Wilsons disease (copper matabolism) and alpha 1 deficiency. cryptogenic cirrhosis, viral hepatitis B and C
_______ _________ is increased pressure in the portal venous system. Cirrhosis impairs blood flow throught he liver and is the major cause of this. It seeks alternative routes into the right atrium. Portal Hypertension
Five consequences of portal hypertension are _________ (accumulation of fluid in the abdominal cavity), formation of ________ venous shunts, Congestive __________, hepatic ____________, and esophageal ________ or _______ (Mallary Weiss Syndrome). Ascites (accumulation of fluid in abdomen) portosystemic venous shunts congestive splenomegaly hepatic encephalopathy esophageal lacerations or varices
Cirrhosis with portal hypertension has symptoms like _______, Muscle ________, ________ (yellowing or eyes and skin), esophageal _______, and ankle swelling. ascites, muscle wasting, jaundice, esophageal varices
Lab test for cirrhosis with portal hypertension is called ______ _______ ________ (LFT) it measures ______ _________ and ________. Liver Function tests liver enzymes and bilirubin
______ _______ ________ (NAFL) has predisposing conditions such as obesity, diabetes type 2, glucose intolerance, and high cholesterol. When it is associated with inflammation and hepatocyte destruction it is termed ______ _________. May become cirrhosis Nonalcoholic Fatty Liver (NAFL) Nonalcoholic steatohepatitis (NASH) Alcohol is not the cause
Hereditary (Genetic) __________ is excess iron absorption in the ________ and upper jejunum where iron is normally absorbed. Normally 2-6 grams of iron increases to __ grams. Hemochromatosis duodenum 60 grams
4 organs that accumulate iron from hereditary hemochromatosis are ________ (may lead to cirrhosis), _______ (may lead to diabetes mellitus), _______ (gets bronze color), and __________ (may cause enlargement). liver, pancreas, skin, myocardium
Iron accumulation is called __________ and may accumulate in other organs other than the 4 main ones from hemochromatosis. Hemosiderin
_______ ___________ is a disorder of copper metabolism. It results in failure of copper to be secreted from the liver bound to the protein ceruloplasmin. It accumulates in 3 organs, ______, _________ and ________. Wilson's Disease Liver (May cause cirrhosis), Brain (lenticular nucleus degeneration), Eyes (copper rings)
Copper rings in the eyes caused by Wilson's Disease is called ______-______ rings. Kayser-Fleischer rings
3 Diagnostic biochemical findings in Wilson's Desease are decrease in serum _________, increase in copper in the ______, increase copper excretion in the ________. ceruloplasmin liver urine
2 Types of Acute pancreatitis are acute ________ pancreatitis which is _______ and Acute _______ ________ pancreatitis which is more ______. Acute interstitial pancreatitis milder Acute necrotizing hemorrhagic pancreatitis more severe
2 Main causes of pancreatitis are _______ (45%) and ________ (30-035%). Mumps, hypercalcemia, and hyperlipoproteinemia are unusual causes. 10-20% of cases hae no detectable predisposing cause. gallstones alcoholism
_______ pancreatitis is due to repeated episodes of inflammation with loss of normal pancreatic tissue and replacement by ________ tissue. Chronic pancreatitis replacement by fibrous tissue
Chronic pancreatitis is most common in middle aged _______ especially chronic ___________ 50%. The other half of the patients have no apparent predisposing cause and are ________. men, chronic alcoholics idiopathic
2 predisposing factors for chronic pancreatitis are __________ and _________. hypercalcemia and hyperlipoproteinemia
Pancreatic _____ is the 5th leading cause of cancer death in US. The five yr survival rate is less than _%_. 60% is found in the ______ of the pancreas and causes obstructive jaundice. 10% is in the ____ and 10% in the _____ of the pancreas. Adenocarcinoma 5% 60% in head 10% in body 10 % in tail
Chronic __________ is infection of the gallbladder caused by gall stones. Chronic Cholecystitis
_________ are gallstones. In order to see them you must use _______ or _________ because an x-ray will not show them. Cholelithiasis ultrasound or MRI
Created by: T1NWHSU