1 / 76
Question Bank
- 1Primary dysfunction in GERD
Show answer
Dysfunction of the lower esophageal sphincter - 2List the risk factors for GERD.
Show answer
- Obesity - Tobacco usage - Genetic disposition - Impaired salivary gland secretion - Overconsumption of acidic carbonated beverages - Hernias - 3Risk associated with GERD
Show answer
Adenocarcinoma of the esophagus - 4List the typical symptoms of GERD.
Show answer
Heart burn, regurgitation, and dysphasia - 5What are the atypical symptoms of GERD?
Show answer
Non-cardiac related chest pain, asthma, hoarseness, and pneumonia - 6Oral findings of GERD
Show answer
- Malodor - dysgeusia - tooth erosion - 7What is Barrett's esophagus?
Show answer
- lining of esophagus is replaced by tissue similar to stomach - often due to chronic acid reflux - 8What are the risk factors for Barrett's esophagus?
Show answer
Male, Caucasian, increased age, obesity, smoking, and a history of reflux or GERD. - 9Difference between the superficial layer of epithelium in a normal esophagus and Barret's esophagus?
Show answer
Normal: superficial layer of epithelium = non-keratinized squamous cells Barret's: replaced by columnar cells - 10What are the two types of tumors that can occur in the esophagus?
Show answer
Squamous cell carcinoma and adenocarcinoma - 11What tumor comes from squamous epithelium?
Show answer
Squamous cell carcinoma - 12What tumor comes from glandular epithelium?
Show answer
Adenocarcinoma - 13Significance of tumor island in connective tissue of esophageal cancer?
Show answer
- tumor island into the connective tissue = progression of cancer - key factor in determining the stage and treatment of esophageal cancer - 14Damaging Forces of peptic ulcer disease?
Show answer
Gastric acidity and peptic enzymes - 15What are the 'Defensive Forces' in the context of peptic ulcer disease?
Show answer
- Surface mucus secretion - bicarbonate secretion into mucus - mucosal blood flow - apical surface - paracellular transport - epithelial regenerative capacity - elaboration of prostaglandins - 16What does chronic disease do with peptic ulcer
Show answer
Chronic disease increase risk fpr lymphoma and carcinoma - 17T/F: People with peptic ulcer disease can be asymptomatic
Show answer
True - 18What are the signs and symptoms of peptic ulcer disease?
Show answer
Gastric: occur after eating, nausea/vomiting, and weight loss Duodenal: occur at night; hunger sensations; food, milk, antacids reduces pain - 19What are the oral findings associated with peptic ulcer disease?
Show answer
- Dark, red tongue with a yellow coating - Candidiasis - Signs of anemia in patients with H. pylori-induced ulcers - 20What is pseudomembranous colitis
Show answer
inflammation of intestinal lining with abdominal pain, diarrhea, and fever - 21What is the cause of Pseudomembranous Colitis?
Show answer
Clostridium difficile - Gram positive, anaerobic - produces endotoxins → inflammation + cellular apoptosis - 22Which antibiotics are associated with Pseudomembranous Colitis?
Show answer
Broad-spectrum antibiotics -- Clindamycin - 23What is this a picture of?
Show answer
pseudomembranous colitis - 24What are the symptoms of Pseudomembranous Colitis?
Show answer
Diarrhea, abdominal pain, fever, and tenesmus. - 25Celiac disease etiology
Show answer
- prevalent in US and western europe - hereditary predisposition - 26What is the abnormal reaction to gliadin in celiac disease?
Show answer
Gluten sensitivity - immunologic inflammatory reaction when wheat products are consumed - 27What are the symptoms of malabsorption in celiac disease?
Show answer
GI upset: pain and diarrhea - 28What are the oral manifestations of celiac disease?
Show answer
Resembles malnutrition - Aphthous ulcers (canker sore) - atrophic glossitis - risk of candidiasis - xerostomia - defects to the dentition - 29What is an aphthous ulcer?
Show answer
A small, painful ulcer on the inside of the mouth, commonly referred to as a canker sore - 30What is the difference between IBS and IBD?
Show answer
IBS: Irritable Bowel Syndrome - group of symptoms - stomach pain, diarrhea, and constipation IBD: Inflammatory Bowel Disease - group of inflammatory diseases - ex. Crohn's disease, ulcerative colitis - 31When does IBS usually occur?
Show answer
IBS: late adolescence/early adulthood IBD: before 30, sometimes later - 32IBS vs IBD Increase risk of cancer?
Show answer
IBS: No IBD: Yes - 33IBS vs IBD Complications?
Show answer
IBS: impaired quality of life IBD: joints, eyes, skin, kidneys, bones all effected - 34What is Ulcerative Colitis?
Show answer
Chronic inflammatory disorder - affects the inner lining of the large intestine → inflammation + ulcers - 35Where does the mucosal ulceration in Ulcerative Colitis typically occur?
Show answer
From the rectum to the more proximal portion of the large intestines - 36What is the clinical presentation of Ulcerative Colitis?
Show answer
Abdominal pain and bloody diarrhea - 37What is the oral manifestation of Ulcerative Colitis?
Show answer
Pyostomitis vegetans - 38How many layers are involved in Ulcerative colitis
Show answer
1 or multiple - 39What is Crohn's Disease?
Show answer
Chronic inflammatory disease that can affect any part of the gastrointestinal tract - most commonly: small intestine and colon - 40How many layers does Crohn's Disease involve
Show answer
All 4 can be involved - 41What are 'skip lesions' in the context of Crohn Disease?
Show answer
- areas of inflammation that skip over other areas of the colon - pattern of affected and unaffected segments. - 42What are the clinical symptoms of Crohn Disease?
Show answer
abdominal pain and bloody diarrhea - 43Endoscopy of what disease
Show answer
Crohn's - 44Endoscopy of what disease
Show answer
Ulcerative colitis - 45Histology of what disease
Show answer
Crohn's; circle is granulomatous inflammation - 46Histology of what disease
Show answer
Ulcerative colitis - 47What is granulomatous inflammation
Show answer
inflammation characterized by the formation of granulomas - collections of immune cells that surround/encapsulate foreign substances or dead tissue - 48What is the difference between Crohn's disease and ulcerative colitis based on the histology shown?
Show answer
Crohn's disease shows granulomatous inflammation, while ulcerative colitis does not. - 49Indications for aminosalicylates - IBD
Show answer
Ulcerative colitis – distal ileum and colon small role in Crohn’s disease - 50Aminosalicylates dental considerations
Show answer
CBC w/Diff, renal and liver function should be tested Oral inflammation (stomatitis) - 51Corticosteroids Indication for IBD
Show answer
Combo with other meds to reduce “flares” Periods of severe disease - 52Corticosteroids dental considerations for IBD
Show answer
- Risk of infections - poor wound healing - periodontal disease - potential adrenal crisis - 53Immunomodulator indications for IBD
Show answer
- Cases not responding to corticosteroids - Weaning patients off steroids - Limited use due to toxicity - 54Dental considerations for immunomodulators
Show answer
- Risk of infection and lymphoma - oral inflammation (stomatitis) - gingival hyperplasia (Cyclosporine) - 55Antibiotic indications for IBD
Show answer
Manage abscesses, maintain remission, and post intestinal surgery - 56Antibiotics dental considerations - IBD
Show answer
avoid alcohol - 57Biologics indications for IBD
Show answer
- Severe cases that fail to responds to other meds - IV infusion - 58Biologics dental considerations for IBD
Show answer
- Risk of lymphoma - Risk of progressive multifocal leukoencephalopathy - 59Common IBD surgical procedures
Show answer
• bowel resection • colectomy • proctolectomy • strictureplasty • fistulotomy - 60What is the surgical removal of a portion of the small and/or large intestine called?
Show answer
Bowel Resection - 61What is the surgical removal of the entire colon (large intestine) called?
Show answer
Colectomy - 62What is the surgical removal of the entire colon AND rectum?
Show answer
proctocolectomy - 63What is the surgical widening of the intestinal passageway called?
Show answer
Strictureplasty - 64What is the surgical treatment of anal fistula
Show answer
fistulotomy - 65What is a colon polyp?
Show answer
A protrusion into the lumen of the colon - 66What are the two main types of colon polyps?
Show answer
Hyperplastic and Adenomatous (dysplastic) - 67What is the potential outcome of adenomatous polyps?
Show answer
give rise to adenocarcinoma → screen via colonoscopy and polypectomy - 68First hit of carcinoma pathophysiology
Show answer
Germline or somatic mutations of cancer suppressor genes - 69Second hit of carcinoma pathophysiology
Show answer
Muscosa at risk • methylation abnormalities • inactivation of normal alleles - 70What is the most common malignancy of the colon?
Show answer
Adenocarcinoma - 71What are carcinoids, and where are they most commonly found?
Show answer
Carcinoids are rare, except for rectal carcinoids. - 72Types of neoplasms
Show answer
• adenocarcinoma • carcinoids • lymphoma • metastatic carcinoma - 73What are hereditary colon cancers
Show answer
A syndrome with mutations that can cause patients to develop cancer at a young age. - 74What syndromes associated with FAP?
Show answer
Gardner Syndrome - 75What syndrome is associated with Hereditary Nonpolyposis Colon Cancer (HNPCC)?
Show answer
Lynch syndrome - 76What dental mods should be made for GI disorders?
Show answer
• chair positioning • dry mouth products - fluoride to help • delay treatment for ppl with active GI upset • use nonNSAIDs analgesics • early screening for ppl with familial history of GI cancers • avoid antibiotics associated with pseudomembranous colitis