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BDS4 ORAL MEDICINE > BDS4 Oral Med PPs > Flashcards

BDS4 Oral Med PPs Flashcards

1
Q

What would the pathologist report be on immunofluorescence analysis of pemphigus vulgaris?

A

basket weave pattern

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2
Q

What would the pathologist report be on histopathological analysis of pemphigus vulgaris?

A
  • suprabasilar split
  • tzank cells
  • acantholysis
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3
Q

How would pemphigus vulgaris be treated?

A
  • topical steroids (beclomethasone + betamethasone)
  • systemic steroids (prednisolone)
  • azathioprine
  • hydroxychloroquine
  • DMARDs
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4
Q

List 2 risk factors for oral squamous cell carcinoma development:

A
  • smoking
  • alcohol
    (betel chewing, UV exposure, immunodeficiency, poor OH, socioeconomic factors, poor diet)
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5
Q

How would you grade dysplasia histopathologically?

A
  1. Hyperplasia (increased cell numbers, no cellular atypia, regular stratification)
  2. Dysplasia = [Mild = changes in lower 1/3, mild atypia such as pleomorphism, hyperchromatism] OR [Moderate = changes in mid third, moderate atypia such as pleomorphism, loss of polarity] OR [Severe = changes in upper third, severe atypia and numerous mitoses and high loss of polarity]
  3. Carcinoma-In-Situ [malignant but not invasive, abnormal architecture]
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6
Q

What intervention, other than surgery, could an oral squamous cell carcinoma patient have?

A
  • Chemotherapy
  • Radiotherapy
  • Immunotherapy
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7
Q

Name 2 microorganisms involved in angular cheilitis:

A
  • candida albicans
  • staph aureus
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8
Q

What type of sample should be taken for potential angular cheilitis?

A

swab of the commissures

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9
Q

Name an immune deficiency and a GI bleeding disorder that can increase risk of candida infections & why they cause patients to be more susceptible:

A
  1. HIV = patient is immunocompromised (harmless commensals can become pathogenic and cause infection)
  2. Crohn’s Disease = impaired nutrient absorption and malnourishment leads to increased likelihood of infections
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10
Q

Why is miconazole prescribed to a patient when microbiological sampling of potential angular cheilitis is unavailable?

A

2% miconazole is effective against candida and gram positive cocci bacteria (eg staph aureus) so appropriate in all patients

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11
Q

What instructions would you give to a denture wearing patient that presents with angular cheilitis?

A
  • take denture out overnight
  • clean dentures after cleaning
  • clean mouth with brush/TB or chlorhexidine mouthwash
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12
Q

Why does trigeminal neuralgia occur?

A
  • vascular compression of the trigeminal nerve
  • demyelination of trigeminal nerve
  • secondary to MS
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13
Q

What clinical investigations would you do on a patient with suspected TN?

A
  • FBC/U&Es
  • Cranial Nerve exam
  • OPT to rule out dental cause
  • MRI of brain
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14
Q

What 2 neurological disorders can give rise to trigeminal neuralgia?

A
  • Multiple Sclerosis
  • Space occupying brain lesion
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15
Q

What is the first line drug management for trigeminal neuralgia?

A

Carbamazepine 100mg x2 per day (for 5 days so send for 20 tablets)

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16
Q

What blood tests must be done before starting carbamazepine?

A
  • LFTs
  • FBC
  • U&Es
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17
Q

What are the side effects of carbamazepine?

A
  • liver dysfunction
  • dizziness
  • vomiting
  • nausea
  • allergy
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18
Q

What are 2 indications for surgical treatment of trigeminal neuralgia?

A
  • reaching peak medication intervention levels
  • adverse side effects from medication
19
Q

Name some surgery examples that can be carried out to treat trigeminal neuralgia:

A
  • microvascular decompression
  • radio-surgery gamma knife
  • trigeminal nerve balloon compression
20
Q

What are the clinical signs of Paget’s disease?

A
  • localised pain and tenderness of bone
  • increase in bone size
  • dentures become ill fitting
  • decreased range of motion
21
Q

What are the radiographic signs of Paget’s disease?

A
  • radiopaque lesions due to hypercementosis
22
Q

What are the clinical signs of Albrights diease?

A
  • skin pigmentation
  • endocrine hyperfunction
  • polycystic fibrous dysplasia
23
Q

What are the clinical signs of cherubism?

A
  • Painless bilateral enlargment of the jaws
  • Rounded face and swollen cheeks
  • Dental malocclusion
24
Q

What are the radiographic signs of cherubism?

A
  • Multilocular radiolucencies in posterior quadrants of mandible
  • Mandible/maxilla replaced by fibrous tissue
  • Facial sinuses appear obliterated
25
Q

What conditions may have trigeminal neuralgia as a side effect?

A
  • MS
  • Space occupying brain lesion
26
Q

What are the side effects of Carbamazepine?

A
  • liver dysfunction
  • allergy
  • ataxia
  • nausea
  • sedation
27
Q

What are 2 ways that trigeminal neuralgia can occur? (not conditions associated)

A
  1. VASCULAR COMPRESSION of CNV near the brainstem
  2. DEMYELINATION of CNV leading to abnormal nerve signalling
28
Q

What are the intra-oral manifestations of Herpes:

A
  • Vesicles that burst to form blisters
  • 1-3mm
  • Ulceration
29
Q

What are the histological features of a pleomorphic adenoma?

A
  • Duct like structures
  • Myxoid areas
  • Fibrous capsule
  • Variable epithelium
30
Q

What are the histological signs of Warthin’s tumour?

A
  • Cystic architecture
  • Lymphoid stroma
  • Fibrous capsule
  • Lack of malignant features
31
Q

Name the type of anaemia from MCV:

A

MICROCYTIC <80fL
- iron deficiency
- thalassemia

NORMOCYTIC 80-95fL
- pregnancy
- bleeding

MACROCYTIC >96fL
- vit B12
- folate

32
Q

List 3 salivary proteins:

A
  • IgA
  • mucins
  • lactoferrin
33
Q

List 3 salivary enzymes:

A
  • amylase
  • lipase
  • lysozyme
34
Q

Give 5 ways antibiotics work?

A
  • cell wall destruction
  • protein synthesis inhibition
  • cell membrane inhibition
  • DNA synthesis inhibition
  • DNA replication inhibition
35
Q

What are the mechanisms of antibiotic resistance?

A
  • enzymatic degradation or modification
  • altered target sites
  • efflux pumps that remove antibiotics out of cells
  • reduced permeability or altered membrane transport
  • biofilm formation & antibiotics cannot penetrate
  • acquisition of resistance genes
36
Q

What is orofacial granulomatosis?

A

Type IV hypersensitivity reaction
- results in chronic inflammatory infiltrate of lymphocytes causing lymphoedema

37
Q

What is the aetiology of OFG?

A
  • autoimmune
  • hypersensitivity reaction to SLS/benzoates/cinnamon
38
Q

What is the histological appearance of OFG?

A
  • giant cells
  • oedema
  • dilated lymph
39
Q

What are the signs and symptoms of OFG?

A
  • lip swelling
  • angular chelitis
  • buccal cobblestoning
  • full thickness gingivitis
40
Q

What are the grades of mucositis?

A

0 - no signs of mucositis

1 - mild, soreness or erythema of mucosa but no ulceration or significant discomfort

2 - moderate mucositis, painful erythema and ulcers, soft diet

3 - severe mucositis, extensive erythema and significant ulceration, liquid diet

4 - life-threatening, IV fluids/tube feeding required

41
Q

How does white sponge naevus appear histologically?

A
  • parakeratosis
  • oedema in prickle layer
42
Q

Give 3 causes of generalised pigmentation & 3 causes of local pigmentation:

A

GENERALISED
- racially related
- Addison’s disease
- medication related

LOCAL
- amalgam tattoo
- melanotic macule
- melanoma

43
Q

Name 2 types of haemangioma:

A
  • capillary
  • cavernous

BDS4 ORAL MEDICINE (21 decks)

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