6- Rhematological disorders

Question 1

What is arthritis?

Answer 1

It is the inflammtion of the joints. It can be acute, recurring or chronic.

they can lead to permanent changes to the bones and joints

Question 2

What are some of the symptoms of arthritis?

Answer 2

swelling, pain, stiffness, decreased range of motion

Question 3

Who is more prone to arthritis?

Answer 3

Females & elderly

Question 4

What is osteoarthritis?

Answer 4

It is a wear and tear type of injury where the cartilage between the bones becomes eroded & bones rub

Question 5

What is rheumatoid arthritis?

Answer 5

It is a type of autoimmune disease where the body actually attacks the bone and certain parts of the synovial membrane, causing inflammation of the joints & result in destruction

Question 6

What is the most common form of arthritis? what are its risk factors?

Answer 6

Osteoarthritis. risk factors included joint injury, trauma, obesity, & occupation.

Question 7

What are some of the symptoms of osteoarthritis?

Answer 7

1.) Pain with movement, inactivity
2.) Joint stiffness
3.) Bone enlargement
4.) Inflammation

Question 8

What are the medical managements of osteoarthritis?

Answer 8

1.) Pharmacological management: NSAIDS or Corticosteroids

2.) Arthroplasty: resurfacing or replacement of joint

3.) Lifestyle changes: weight loss, exercise, joint protection

Question 9

What are dental considerations we need to take when treating a patient osteoarthritis?

Answer 9

1.) Antibiotic prophylaxis

2.) Limited opening

3.) Home care considerations: manual dexterity may be limited

4.) Pharmacological side effects:
NSAID; bleeding
Corticosteroids; immune suppression, slower healing, opportunistic infections

Question 10

What are treatment considerations needed for patients with osteoarthritis?

Answer 10

1.) Appointment length: may not be able to maintain open mouth for prolonged periods

2.) OHE: adaptations for homecare

3.Patient positioning

Question 11

What is the pathophysiology of rheumatoid arthritis?

Answer 11

It is an autoimmune disorder that often targets the synovium of joints.

It is the thickening and folding of the synovium can result in the formation of a pannus.

It is typically chronic.

Question 12

What are some symptoms of Rheumatoid arthritis?

Answer 12

1.) Symmetrical joint involvement
2.) Joint inflammation
3.) Rheumatoid nodules

Question 13

What are medical managements of rheumatoid arthritis?

Answer 13

1.) Palliative: meaning can only be treated to relieve.

2.)Pharmacological management:
NSAIDs
Diseease modifying antirheumatic drugs (DMARDs)
- Antimalarial drugs
- Gold compounds
- Immunosuppressants

Question 14

What are some dental management strategies for rheumatoid arthritis?

Answer 14

1.) Antibiotic prophylaxis

2.) Short appointment times

3.) Dexterity considerations

4.) Pharmacological side effects

Question 15

What are treatment plan considerations for rheumatoid arthritis?

Answer 15

1.) Appointment length
2.) OHE
3.) Patient positioning

Question 16

What are the causes of systemic lupus erythematosus?

Answer 16

Triggered by environmental factors:
1.) Infections
2.) Diet
3.) Stress
4.) Medications
5.) Sunlight

Question 17

Who is most likely to have symptoms of systemic lupus erythematosus?

Answer 17

1.) Women of childbearing age
2.) African american, hispanic, asian, indigenous peoples

Question 18

What are the pathophysiologies of SLE?

Answer 18

1.) It is an autoimmune disease (an antibody against different components of cell nuclei)
2.) Due to B cell overactivation
3.) Increased apoptosis in multiple cell types
4.) Difficulty removing apoptotic cells
5.) Highly variable, depending on the organ system that is affected

Question 19

What are the non-specific symptoms of SLE?

Answer 19

1.) Fatigue
2.) Fever
3.) Joint pain, arthritis
4.) Weight change
5.) Malar rash (can be on the nose bridge area, cheeks etc.)

Question 20

What are the medical management of SLE?

Answer 20

1.) No cure
2.) Tx is symptomatic or palliative (managing the symptoms)
3.) Avoid sunlight
4.) Anti-inflammatories: NSAIDs & Corticosteroids
5.) Anti-malarial drugs
6.) Immunosuppressantnts

Question 21

What are the dental management of SLE?

Answer 21

1.) Recurrent non-infectious pharyngitis
2.) Mouth sores
3.) Thrombocytopenia
4.) Drug interactions

Question 22

What are the treatment planning considerations for SLE?

Answer 22

1.) There are no specific modifications
2.) Care plan may need to take into consideration bleeding times
3.) Patient comfort: physical supports & positioning

Question 23

What is lyme disease?

Answer 23

It is a multisystem inflammatory disease that is caused by the Borrelia burdorferi spircohete bacteria (spread by bites from infected ticks which are relatively rare in AB)

Question 24

What are the pathophysiologies of Lyme disease?

Answer 24

They are bacterias that enter the skin and migrates to surrounding areas which migrates throughout the body via lymphatics

Question 25

What is one characteristic of B. burgdoferi?

Answer 25

It can evade immune responses, meaning it can go undetected by the immune system if the bacteria is present in our body.

Question 26

What can be seen in lyme diseases if its early localized?

Answer 26

1.) Classic "bullseye" rash (erythema migrans) 2.) Flu-like symptoms 3.) 1-4 weeks after infection

Question 27

What can be seen in lyme diseases if its early disseminated?

Answer 27

1.) Expanding and spread of rash 2.) Muscle weakness, numbness or pain 3.) Cognitive impairments 4.) Joint pain 5.) Heart palpitations 6.) 1-4 months post infection

Question 28

What can be seen in in lyme diseases if its late disseminated?

Answer 28

1.) Arthritis 2.) Extreme fatigue 3.) Loss of facial muscle control 4.) Cognitive mpairements 5.) Possible heart problems 6.) Months-years after infection

Question 29

What are the medical management of lymes disease?

Answer 29

1.) Antibiotic therapy: early stages - treated with oral antibiotics later stages - may require IV administration 2.) Corticosteroids may be used to reduce musculoskeletal symptoms 3.) Recovery can be slow

Question 30

What are the dental managements for lyme's disease?

Answer 30

1.) Facial or trigeminal nerve paralysis may manifest as early sign 2.) Facial neuralgias 3.) TMJ disorders commonly associated with disease: synovial inflammation.

Question 31

What are treatment planning considerations for lyme's disease?

Answer 31

1.) patient comfort: - physical supports and positioning - alternate fulcrums if neuralgia - limited opening due to TMJ disorder and/or facial nerve paralysis

Question 32

What is Sjorgren syndrome?

Answer 32

It is known to be a syndrome combined from a genetic and environmental factor.

Question 33

What are some characteristics of Sjorgren syndrome?

Answer 33

1.) Keratoconjunctivitis sicca (drye eye) 2.) Xerostomia 3.) Connective tissue disease

Question 34

Who does Sjogren syndrome primarily affect?

Answer 34

It usually affects women in their 40s or 50s

Question 35

What are the pathophysiologies of Sjogren's syndrome?

Answer 35

1.) It is an autoimmune disease: antibodies against exocrine glands 2.) Inflammatory infiltrates into exocrine glands

Question 36

What are the symptoms of Sjogren's syndrome?

Answer 36

1.) Dry eyes 2.) Dry mouth 3.) Light sensitivity 4.) Dry skin 5.) Tingling or numbness in toes or fingers 6.) Swollen glands 7.) Stiffness, swelling 8.) Trouble urinating 9.) Chronic dry cough

Question 37

What are the medical managements of Sjogren's syndrome?

Answer 37

1.) Primary palliative 2.) Lubrication: replacement, local stimulation, systemic stimulation 3.) Immune suppresant drugs

Question 38

What are the dental management used for Sjorgren's syndrome? (consequences of xerostomia)

Answer 38

1.) Increased caries 2.) Taste disruption 3.) Candida infections 4.) Halitosis