What is Xerostomia, its symptoms and risks?
- Dryness of the mouth Risks: - Infection prone - reduced antimicrobial action - dental caries - Difficult to swallow (dysphagia) - Altered taste (Dysgeusia) - Difficulty in talking - Burning/tingling in mouth
What are the causes of and diseases associated with Xerostomia?
Causes: - medication - dehydration - surgery - smoking - mouth breathing Associated diseases: - Sjogren’s Syndrome - HIV/AIDS - Diabetes - Hypertension - Hepatitis C - Lymphoma
What is constipation and it’s symptoms?
- Failure to defecate in more than 4 days
- Slight anorexia, abdominal discomfort and distention
What are the causes and treatment of constipation?
Causes - decreased motility of the colon Treatment: - Laxatives: mineral oil, castor oil, magnesium and aluminum salts - Fibre
What is Megacolon, and what is its treatment?
- Accumulation of feces that causes distention of the colon, due to lack of ganglion cells in myenteric and meissner’s plexuses. (Hirschsprung’s disease)
- Causes failure of peristalsis
- Relieved by resectioning the portion without ganglion input
What is diarrhea and it’s causes?
- Rapid movement of fecal matter through l. intestine
Causes: - Virus (rotavirus) and bacteria (cholera) - explain
- Nervous tension due to increase in sympathetic input
- Ulcerative colitis when walls becomes inflamed and ulcerated - gluten intolerance
What are the complications of pathogen caused diarrhea?
- Loss of sodium and potassium
- Loss of water - dehydration
- Hypovolemia
- Shock
- Cardiovascular collapse
- Severe hypokalemia
What are the oral rehydration therapy methods of diarrhea?
- Antibiotics with KHCO3 to prevent hypokalemia and metabolic acidosis
- Glucose (or AA) with NaCl to facilitate absorption of electrolytes and water
What are the symptoms, causes and complications of Gastritis?
- Inflammation of gastric mucosa
- Acute or severe - ulcerative removal of stomach mucosa
- Mucosa becomes trophic with little to no gastric gland activity in chronic gastritis
- Complications: achlorhydria; pernicious anemia
What are the symptoms, causes and complications of Achlorhydria?
- Failure of stomach to secrete HCL linked to failure to secrete pepsinogen
- Lack of pepsinogen, leads to lack of pepsin, leads to protein deficiency
- Diminished HCl secretion called hypochlorhydria
What is Acalasia?
Failure to relax of LES during swallowing.
Food accumulated in oesophagus leading to megaoesophagus.
Megaoesophagus causes and complications
Incomplete relaxation of LES during swallowing
Myenteric plexus is defective
Release of NO and VIP is defective
Prone to aspiration pneumonia
What are the symptoms of gastroesophageal reflux disease?
- Heartburn
- Oesophagitis leading ulcers
- Stricture of the oesophagus
What is the cause of gastroesophageal reflux disease?
- Incontinence of LES due to decrease in neural drive to sphincter
- Permits reflux of gastric contents
What are the possible treatments for gastroesophageal reflux disease?
- Acid receptor blockers or omeprazole
- Surgical: fundoplication
What is the cause of Zollinger-Ellison syndrome?
- Gastrin secreting time-outs of the pancreas and small bowel
- Two variants:
1. Sporadic
2. PTH and pituitary tumour associates Multiple Endocrine Neoplasia 1
What are the symptoms of Zollinger-Ellison syndrome?
- Pain
- Vomiting blood (sometimes)
- Diarrhea
What are the signs and tests used to check for ZES?
- Increased gastrin level
- Calcium and secretin stimulation tests are positive
- Abdominal ocreotide/CT scan shows tumour
What is jaundice?
Free/conjugated bilirubin accumulates in blood, skin, sclera and mucous membranes - turn yellow
What is jaundice icterus?
- Build up of pressure in blocked common bile duct
- Bilirubin (normally secreted in bile) filters into tissues, producing yellowing of skin, sclera and mucous membranes
What are some other causes of Jaundice?
- Hyperbilirubinemia - excess production of bilirubin due to hemolytic anemia
- Hemolytic jaundice (prehepatic) - increased RBC breakdown leading to increased bilirubin in blood
- Hemolytic disease of newborn - breakdown of fetal Hb usually clearing spontaneously
What are the initiates of vomiting?
- Excessive distention of stomach or s. intestine
- Substances acting on chemoreceptors in intestinal wall or brain
- increased pressure within the skull
- motion sickness
- intense pain
- tactile stimuli to back of throat
What are the harmful consequences of vomiting?
- Loss of water and salts from stomach
- Hypovolemia
- Metabolic alkalosis
What is the mechanism of Typhoid fever?
- Bacteria enters macrophages
- Bacteria then spreads into lymphatic system while in macrophages
- Bacteria induce apoptosis of macrophages and spreads through blood causing systemic infection
