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Gastrointestinal disease, image, image, image, image, image keratin…

- - - - Lesi patch putih
        
        tidak dapat peel off
        
        menonjol
        
        less pain
    - - Alcohol, tobacco/rokok
      - gigi irreguler tajam
      - Hyperkeratosis / dysplastic change
    - - Squamous complex non-keratinized -> jadi keratinized
  - - - Lesi precancer
        
        batas tidak jelas
        
        kemerahan
        
        sulit dibedakan dr gusi
  - - - HPV : non-keratinized
      - non-HPV : keratinized
    - - HPV
        
        orofaring (oral sex)
        
        Younger
        
        lesi primer kecil
        
        bulky nodal
      - non-HPV
        
        oral cavity
        
        older (alcohol,tobacco)
        
        lesi primer besar
        
        nodal bervariasi
    - - Lower lip
        
        nyeri
    - - Surgery
      - Radiation
  - - - Mandibular : ramus/molar
    - - Neoplasma jinak, ganas scr klinis
        
        destruktif
    - - Perifer
        
        Ameloblast, silindris
      - Central
        
        Stellate reticulum
- - - - Alergi makanan/alergi umum
        
        Atopic dermatitis
        
        rhinitis allergy
        
        Asthma
    - - Epitel irregular/ elongasi subepithelial
      - Eosinophil banyak di epitel
    - - Nyeri sekali
      - Ring-like (esofagus)
      - GERD-like symptoms
    - - Diet (allergynya)
      - PPI dosis tinggi
  - - - Komplikasi GERD kronik
      - Karna frequent reflux
    - - Intestinal metaplasia
        
        Squamous complex jadi columnar
    - - heart burn
      - bleeding stricture
    - - Endoskopi, biopsi
        
        intestinal goblet cells
  - - - Tobacco, alcohol
      - High intake barbecued meat, low intak sayur buah
    - - 2/3 esofagus
    - - Malignant squamous cells penetrate basement
        membrane into lamina propria or deeper.
    - - Dysfagia
      - Weight loss
      - retrosternal/epigstric pain
- - - - Akut
        
        Etiologi
        
        Inflamasi
        
        Tidak diketahui
      - Kronik
        
        Etiologi
        
        Infeksi H. Pylori
        
        Hyperchlorhydria
        
        Antibody pylori (+)
        
        Treatment
        
        Triple drug (PPI, Amoxicilin, Macrolide)
        
        Microscopic
        
        Warthin-Starry silver stain
        
        H.pylori Spiral-shaped
        
        Autoimun atropi
        
        defective gastric excretion
        
        hypochlorhydria / achlorhydria
        
        Antibodi parietal cell , intrinsic factors
        
        hypergastrenemia
  - - - Duodenum
    - - Nyeri ulu hati
      - Worse at night
    - - Diskontinuitas sel
  - - - Severe burns atau trauma
      - Proximal duodenal
    - - Gastric, duodenal, esofagus
      - Intracranial disease
    - - Multiple
      - Ulcus terlihat jelas, sekitar normal
      - Serositis bisa terjadi