NGR6605 Exam 1 - GI PPT's: – Questions With
Solutions (100% Accurate)
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Terms in this set (95)
• "Bad breath" - 3rd most common reason for dental
care, "dental problem"
• Usually originates in mouth
• Less oxygen during sleep; greater odor upon
awakening
• 25% have persistent (chronic) halitosis
• Most common causes:
Halitosis
- Bacteria on back of tongue
- Faulty dental work
- Trapped food between teeth
- Abscesses
- Unclean dentures/ bridges
- Dry mouth
- Sjogren's
- Type of Genuine Halitosis
- malodour arises through putrefactive process in oral
Pathophysic Halitosis cavity, no disease cause found
origin is mainly dorsoposterior region of the tongue
temporary halitosis due to dietary factors
Oral Causes include:
- Disease, pathogenic condition, or malfunction in
oral tissue
- From tongue coating, modified by pathologic
condition (ie periodontal disease, xerostomia)
Pathologic Halitosis
Extroral Causes include:
- Nasal, paranasal andor laryngeal lesions
- Pulmonary tract, or upper GI tract problems
- Disorders anywhere where it is bloodborne and
emitted from the lungs (ie. DM, liver disease,
internal bleeding)
, - Pathophysic -oral tissue issue, putrefacation in
oral cavity
- Pathologic - disease, tongue coating, lung illness
Classes of Halitosis:
- Psuedo-halitosis: thinks they have bad breath, but
none
- Halitophobia - no actual bad breath
- Obvious malodour is not perceived by others, but Pt
reports bad breath
Psuedo-halitosis -
- Condition is improved by counseling, literature,
education and hygeine
- After Tx the pt persists in believing they still have bad
Halitophobia - breath
- No phys evidence exists halitosis is present
Treatment Needs (TN) for Explanation of halitosis and instructions for oral hygiene
Halitosis: ie) support and reinforcement in self care
TN-1
Treatment Needs (TN) for Oral prophylaxis, professional cleaning, and Tx for oral
Halitosis: diseases
TN-2
Treatment Needs (TN) for Referral to MD or specialist
Halitosis:
TN-3
Treatment Needs (TN) for Explanation of clinical exam data, professional
Halitosis: instruction, education and reassurance
TN-4
Treatment Needs (TN) for Referral to clinical psychologist or psychiatrist
Halitosis:
TN-5
, - Difficulty swallowing - Odynophagia: painful
swallowing
- Increasing prevalence with age - Male = female
- Rapidly progressive symptoms:
- And/or profound weight loss suggestive of
malignant process;
- Requires immediate attention!
- Age > 50: R/O esophageal CA, though neuro
problem more likely
• Urgent Considerations:
- Foreign Body
- Caustic Injury
- Stroke
- Epiglottitis
Dysphagia:
• Causes:
- Pharyngitis, esophagitis, spasms
- Stoke, Parkinson's
- GERD
- Hiatal hernia
- Cervical lymphadenopathy
- Autoimmune disorders
- Scleroderma, MS
- Achalasia (loss of peristalsis plus stricture)
- Radiation therapy
- Cancer
• Evaluation of Dysphagia:
• Refer to GI
• Need to find the cause
• Need EGD & Barium swallow study
, - Reflux of gastric contents into esophagus, larynx,
or lungs with or without esophageal inflammation
20% of population have GERD
- Barrett esophagus in 1.5%
- 65% have had heartburn
- 20% have weekly symptoms
- 10% daily symptoms
Risk Factors (Strong)
- Family history of heartburn or GERD
- Older age (risk increases with age)
- Hiatal hernia
- Obesity
- Pregnancy
- Middle aged men (esp ETOH)
Other Risk Factors:
- Meds that decrease lower esophageal sphincter
tone smooth muscle relaxants; anticholinergics:
(including nitrates, CCBs, alpha & beta blockers)
- Psychological stress
- Asthma (GERD triggers)
- NSAIDs
- Possibly Dietary factors - caffeine, carbonated
drinks, mint, chocolate, citrus, high fat foods, milk,
GERD:
garlic, spicy foods, tomato juice
Signs and Symptoms:
- Heartburn (70-85%)
- Regurgitation of digested food (60%)
- Angina-type chest pain (33%) (r/o cardiac 1st)
- Abdominal pain (29%)
- Hoarseness (21%)
- Dysphagia for solids (if liquids also consider
another cause) (20%)
- Bronchospasm (asthma) (15-20%)
- Aspiration (14%)
- Chronic cough
- Loss of dental enamel
Complications:
- Peptic stricture: 10-15%
- Barrett's esophagus: 10% of these develop
Solutions (100% Accurate)
Save
Terms in this set (95)
• "Bad breath" - 3rd most common reason for dental
care, "dental problem"
• Usually originates in mouth
• Less oxygen during sleep; greater odor upon
awakening
• 25% have persistent (chronic) halitosis
• Most common causes:
Halitosis
- Bacteria on back of tongue
- Faulty dental work
- Trapped food between teeth
- Abscesses
- Unclean dentures/ bridges
- Dry mouth
- Sjogren's
- Type of Genuine Halitosis
- malodour arises through putrefactive process in oral
Pathophysic Halitosis cavity, no disease cause found
origin is mainly dorsoposterior region of the tongue
temporary halitosis due to dietary factors
Oral Causes include:
- Disease, pathogenic condition, or malfunction in
oral tissue
- From tongue coating, modified by pathologic
condition (ie periodontal disease, xerostomia)
Pathologic Halitosis
Extroral Causes include:
- Nasal, paranasal andor laryngeal lesions
- Pulmonary tract, or upper GI tract problems
- Disorders anywhere where it is bloodborne and
emitted from the lungs (ie. DM, liver disease,
internal bleeding)
, - Pathophysic -oral tissue issue, putrefacation in
oral cavity
- Pathologic - disease, tongue coating, lung illness
Classes of Halitosis:
- Psuedo-halitosis: thinks they have bad breath, but
none
- Halitophobia - no actual bad breath
- Obvious malodour is not perceived by others, but Pt
reports bad breath
Psuedo-halitosis -
- Condition is improved by counseling, literature,
education and hygeine
- After Tx the pt persists in believing they still have bad
Halitophobia - breath
- No phys evidence exists halitosis is present
Treatment Needs (TN) for Explanation of halitosis and instructions for oral hygiene
Halitosis: ie) support and reinforcement in self care
TN-1
Treatment Needs (TN) for Oral prophylaxis, professional cleaning, and Tx for oral
Halitosis: diseases
TN-2
Treatment Needs (TN) for Referral to MD or specialist
Halitosis:
TN-3
Treatment Needs (TN) for Explanation of clinical exam data, professional
Halitosis: instruction, education and reassurance
TN-4
Treatment Needs (TN) for Referral to clinical psychologist or psychiatrist
Halitosis:
TN-5
, - Difficulty swallowing - Odynophagia: painful
swallowing
- Increasing prevalence with age - Male = female
- Rapidly progressive symptoms:
- And/or profound weight loss suggestive of
malignant process;
- Requires immediate attention!
- Age > 50: R/O esophageal CA, though neuro
problem more likely
• Urgent Considerations:
- Foreign Body
- Caustic Injury
- Stroke
- Epiglottitis
Dysphagia:
• Causes:
- Pharyngitis, esophagitis, spasms
- Stoke, Parkinson's
- GERD
- Hiatal hernia
- Cervical lymphadenopathy
- Autoimmune disorders
- Scleroderma, MS
- Achalasia (loss of peristalsis plus stricture)
- Radiation therapy
- Cancer
• Evaluation of Dysphagia:
• Refer to GI
• Need to find the cause
• Need EGD & Barium swallow study
, - Reflux of gastric contents into esophagus, larynx,
or lungs with or without esophageal inflammation
20% of population have GERD
- Barrett esophagus in 1.5%
- 65% have had heartburn
- 20% have weekly symptoms
- 10% daily symptoms
Risk Factors (Strong)
- Family history of heartburn or GERD
- Older age (risk increases with age)
- Hiatal hernia
- Obesity
- Pregnancy
- Middle aged men (esp ETOH)
Other Risk Factors:
- Meds that decrease lower esophageal sphincter
tone smooth muscle relaxants; anticholinergics:
(including nitrates, CCBs, alpha & beta blockers)
- Psychological stress
- Asthma (GERD triggers)
- NSAIDs
- Possibly Dietary factors - caffeine, carbonated
drinks, mint, chocolate, citrus, high fat foods, milk,
GERD:
garlic, spicy foods, tomato juice
Signs and Symptoms:
- Heartburn (70-85%)
- Regurgitation of digested food (60%)
- Angina-type chest pain (33%) (r/o cardiac 1st)
- Abdominal pain (29%)
- Hoarseness (21%)
- Dysphagia for solids (if liquids also consider
another cause) (20%)
- Bronchospasm (asthma) (15-20%)
- Aspiration (14%)
- Chronic cough
- Loss of dental enamel
Complications:
- Peptic stricture: 10-15%
- Barrett's esophagus: 10% of these develop
