Common GIT Conditions

Question 1

Describe primary function of teeth

Answer 1

Function in mastication of bolus by contact of occlusal surfaces

Question 2

Describe primary function of the tongue

Answer 2

Mechanical processing and assistance in chewing and swallowing

Question 3

Name 3 main salivary glands

Answer 3

1. Parotid
2. Sublingual
3. Submandibular

Question 4

Describe primary function of saliva

Answer 4

Initiation of digestion of complex carbohydrates

Question 5

Name 5 components of saliva

Answer 5

1. Electrolytes
2. Buffers
3. Glycoproteins
4. Antibodies
5. Enzymes

Question 6

Name 2 types of cells found in gastric glands of the stomach

Answer 6

1. Parietal cells

2. Chief cells

Question 7

Describe primary function of parietal cells in the stomach

Answer 7

Secrete HCI and intrinsic factor

Question 8

Describe primary function of chief cells in the stomach

Answer 8

Secrete pepsinogen

Question 9

Describe the 3 stages of increasing the surface area of the intestinal wall

Answer 9

Plica are small folds containing villi which contain microvilli

Question 10

Describe the endocrine function of the pancreas

Answer 10

Secretion of insulin and glucagons

Question 11

Describe exocrine function of the pancreas

Answer 11

Pancreatic juice secretes into small intestine via duct system containing carbohydrases, lipases, nucleases and proteolytic enzymes

Question 12

Describe 2 functions of the liver

Answer 12

1. Perform metabolic and haematological regulation

2. Production of bile secretes into gallbladder and then duodenum

Question 13

Describe primary function of large intestine

Answer 13

Resorption of water, vitamins and bile salts etc.

Question 14

Describe the 2 stages of absorption

Answer 14

1. Breakdown of complex molecules by enzymes

2. Absorption of digested nutrients through brush boarder

Question 15

Name 5 reasons malabsorption may occur

Answer 15

1. Luminal enzymes
2. Mucosal
3. Structural
4. Infective
5. Non-GI disease

Question 16

Name 2 examples of malabsorption caused by issues with luminal enzymes

Answer 16

1. Cystic fibrosis

2. Chronic pancreatitis

Question 17

Name 2 examples of malabsorption caused by issues with mucosa

Answer 17

1. Coeliac disease

2. Lactose intolerance

Question 18

Name 2 examples of malabsorption caused by issues with structure

Answer 18

1. Crohns disease

2. Intestinal resection

Question 19

Name 2 examples of malabsorption caused by issues with infective agents

Answer 19

1. Bacterial overgrowth

2. Parasitic infection

Question 20

Name 2 examples of malabsorption caused by issues with non-GI disease

Answer 20

1. Diabetes mellitus

2. Hyperthyroidism

Question 21

Describe the digestion of carbohydrates

Answer 21

• Glycogen converted to α-dextirins, disaccharides and trisaccharides by luminal digestion
• Products converted to glucose, galactose and fructose by membrane digestion

Question 22

Describe protein digestion

Answer 22

• Low pH of stomach destroys tertiary and quaternary structure
• Pancreatic proteases in duodenum break proteins into peptides and amino acids
• Absorption at brush boarder

Question 23

Describe fat absorption

Answer 23

• Bile salts emulsify lipids
• Pancreatic lipases break down triglycerides
• Micelle formed from dissolving lipids which diffuses into intestinal epithelia

Question 24

What are 3 things to consider in cases of Apthous ulcers?

Answer 24

1. B12 deficiency
2. Folate deficiency
3. Iron deficiency

Question 25

Name 2 conditions which may be caused by vitamin B2 deficiency

Answer 25

1. Glossitis | 2. Angular stomatitis

Question 26

Name 4 conditions which may be caused by vitamin C deficiency

Answer 26

1. Scurvy 2. Gingival oedema and bleeding 3. Delayed healing 4. Bruising

Question 27

Name 2 conditions which may be caused by vitamin A deficiency

Answer 27

1. Blindness | 2. Dry mucous membranes

Question 28

Name 3 conditions which may be caused by vitamin D deficiency

Answer 28

1. Poorly calcified dentition 2. Delayed eruption 3. Rickets

Question 29

Name 1 condition which may be caused by vitamin K deficiency

Answer 29

Poor clotting

Question 30

Name 2 water soluble vitamins

Answer 30

1. B2 | 2. C

Question 31

Name 3 fat-soluble vitamins

Answer 31

1. A 2. D 3. K

Question 32

Name 2 inflammatory bowel diseases

Answer 32

1. Ulcerative colitis | 2. Crohns disease

Question 33

Describe how IBDs may present in the oral cavity

Answer 33

- Pyostomatitis vegetans | - Tiny yellow pustules on oral mucosa

Question 34

How is coeliac disease diagnosed?

Answer 34

Simple blood test points to diagnosis

Question 35

Describe Grade I enamel defects in coeliac disease

Answer 35

Multiple white and cream opacities with clearly defined margins

Question 36

Describe Grade II enamel defects in coeliac disease

Answer 36

Rough enamel surface with patchy symmetric opacities and discolouration

Question 37

Describe Grade III enamel defects in coeliac disease

Answer 37

Deep horizontal grooves with large pits and linear discolouration

Question 38

Describe how CREST syndrome may affect the oral cavity

Answer 38

Difficult opening the mouth due to tight skin and mouth

Question 39

What is Gardner's Syndrome?

Answer 39

- Masses of growths within colon which may turn malignant - Very rare - Enostoses, unerupted teeth and osteomas of mandible present

Question 40

Describe how Peutz Jeghers Syndrome may present

Answer 40

Black of purple dots inside the mouth which need to be referred for cancer risk assessment

Question 41

Describe how Osler Weber Rendu may present

Answer 41

Blebs on the lips and tongue which may bleed further down the GI tract

Question 42

Describe 5 systemic effects of anorexia

Answer 42

1. Dental erosion 2. Hypotension 3. Arrythmias 4. Anaemia 5. Osteoporosis

Question 43

What is the most common dental problem with bulaemia?

Answer 43

Palatal surface of maxillary anterior teeth may show dissolved enamel due to erosion

Question 44

Describe how GORD affects erosion of teeth

Answer 44

- Dental erosion more common in GORD patients - GORD patients have more varied amounts of erosion compared with control - Erosion can be amended by treating underlying cause of reflux - Usually managed using long term PPI twice a day e.g omeprazole 20mg

Question 45

Name 5 symptoms associated with oropharyngeal dysphagia

Answer 45

1. Difficulty controlling food or saliva in the mouth 2. Difficulty initiating a swallow 3. Coughing or choking during swallowing 4. Repeated swallowing to clear oral cavity 5. Nasal regurgitation

Question 46

Name 5 possible causes of oropharyngeal dysphagia

Answer 46

1. Dental problems with chewing or xerostomia 2. Ulceration in oral mucosa 3. Neurological disorders e.g Parkinson's 4. Mechanical obstruction e.g malignancies 5. Medication