BDS4 Oral Med PPs Flashcards
What would the pathologist report be on immunofluorescence analysis of pemphigus vulgaris?
basket weave pattern
What would the pathologist report be on histopathological analysis of pemphigus vulgaris?
- suprabasilar split
- tzank cells
- acantholysis
How would pemphigus vulgaris be treated?
- topical steroids (beclomethasone + betamethasone)
- systemic steroids (prednisolone)
- azathioprine
- hydroxychloroquine
- DMARDs
List 2 risk factors for oral squamous cell carcinoma development:
- smoking
- alcohol
(betel chewing, UV exposure, immunodeficiency, poor OH, socioeconomic factors, poor diet)
How would you grade dysplasia histopathologically?
- Hyperplasia (increased cell numbers, no cellular atypia, regular stratification)
- 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]
- Carcinoma-In-Situ [malignant but not invasive, abnormal architecture]
What intervention, other than surgery, could an oral squamous cell carcinoma patient have?
- Chemotherapy
- Radiotherapy
- Immunotherapy
Name 2 microorganisms involved in angular cheilitis:
- candida albicans
- staph aureus
What type of sample should be taken for potential angular cheilitis?
swab of the commissures
Name an immune deficiency and a GI bleeding disorder that can increase risk of candida infections & why they cause patients to be more susceptible:
- HIV = patient is immunocompromised (harmless commensals can become pathogenic and cause infection)
- Crohn’s Disease = impaired nutrient absorption and malnourishment leads to increased likelihood of infections
Why is miconazole prescribed to a patient when microbiological sampling of potential angular cheilitis is unavailable?
2% miconazole is effective against candida and gram positive cocci bacteria (eg staph aureus) so appropriate in all patients
What instructions would you give to a denture wearing patient that presents with angular cheilitis?
- take denture out overnight
- clean dentures after cleaning
- clean mouth with brush/TB or chlorhexidine mouthwash
Why does trigeminal neuralgia occur?
- vascular compression of the trigeminal nerve
- demyelination of trigeminal nerve
- secondary to MS
What clinical investigations would you do on a patient with suspected TN?
- FBC/U&Es
- Cranial Nerve exam
- OPT to rule out dental cause
- MRI of brain
What 2 neurological disorders can give rise to trigeminal neuralgia?
- Multiple Sclerosis
- Space occupying brain lesion
What is the first line drug management for trigeminal neuralgia?
Carbamazepine 100mg x2 per day (for 5 days so send for 20 tablets)
What blood tests must be done before starting carbamazepine?
- LFTs
- FBC
- U&Es
What are the side effects of carbamazepine?
- liver dysfunction
- dizziness
- vomiting
- nausea
- allergy
What are 2 indications for surgical treatment of trigeminal neuralgia?
- reaching peak medication intervention levels
- adverse side effects from medication
Name some surgery examples that can be carried out to treat trigeminal neuralgia:
- microvascular decompression
- radio-surgery gamma knife
- trigeminal nerve balloon compression
What are the clinical signs of Paget’s disease?
- localised pain and tenderness of bone
- increase in bone size
- dentures become ill fitting
- decreased range of motion
What are the radiographic signs of Paget’s disease?
- radiopaque lesions due to hypercementosis
What are the clinical signs of Albrights diease?
- skin pigmentation
- endocrine hyperfunction
- polycystic fibrous dysplasia
What are the clinical signs of cherubism?
- Painless bilateral enlargment of the jaws
- Rounded face and swollen cheeks
- Dental malocclusion
What are the radiographic signs of cherubism?
- Multilocular radiolucencies in posterior quadrants of mandible
- Mandible/maxilla replaced by fibrous tissue
- Facial sinuses appear obliterated
