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Systemic Disease in Dentistry > CT Diseases > Flashcards

CT Diseases Flashcards

1
Q

What is osteoarthritis?

A

The most common form of arthritis which can affect both larger and smaller joints of the body

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2
Q

What is inflammatory arthritis?

A

Autoimmune disease in which the body views its own tissue as foreign

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3
Q

Name 2 types of inflammatory arthritis

A
  1. Seropositive

2. Seronegative

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4
Q

What is the key feature of seronegative inflammatory arthritis?

A

Asymmetric joint and axial involvement

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5
Q

Name 4 types of seronegative inflammatory arthritis

A
  1. Ankylosing Spondylitis
  2. Psoriatic Arthritis
  3. Reactive Arthritis
  4. Enteropathic Arthritis
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6
Q

What is anklyosing spondylitis?

A

Fixed and rigid spinal posture with classic presentations of seronegative inflammatory arthritis e.g morning stiffness, cannot fully extend neck

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7
Q

What is reactive arthritis?

A

Secondary to infection which triggers bodily attacks on itself

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8
Q

Name 2 disease which enteropathic seronegative inflammatory arthritis may be associated with

A
  1. Chron’s disease

2. Osteoarthritis

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9
Q

Describe the frequency of RA between men and women

A

Women are 3 times more frequently affected

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10
Q

At what ages does peak incidence of RA occur?

A

40 to 60 years

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11
Q

What is the major example of seropositive inflammatory arthritis?

A

Rheumatoid Arthritis

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12
Q

What is rheumatoid arthritis?

A

Chronic inflammatory disorder which typically affects small and medium sized joints in a symmetrical fashion

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13
Q

Describe the pathogenesis of rheumatoid arthritis

A

Primary lesion is synovitis whereby immune cells invade normally relatively acellular synovium, leading to formation of inflammatory pannus

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14
Q

What is sensitivity of an antibody test?

A

Measured proportion of actual positives which are correctly identified

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15
Q

What is specificity of an antibody test?

A

Measure proportion of negatives which are correctly identified

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16
Q

What is rheumatoid factor?

A

Autoantibodies which target the Fc- part of human IgG

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17
Q

How is rheumatoid factor believed to cause rheumatoid arthritis?

A

Form immune complexes, activating complement in the join, which in turn leads to increased vascular permeability and release of chemotactic factors recruiting immune-competent effectors cells into the joint

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18
Q

What is ACPA?

A

Anti-Citrullinated Peptide Antibody

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19
Q

Name 2 theories on what causes RA

A
  1. Genetics

2. Environment

20
Q

Name 5 possible triggers which may cause RA

A
  1. Infection (bacteria)
  2. Smoking
  3. Obesity
  4. Stress
  5. Female hormones
21
Q

Name 4 potential musculoskeletal effects of RA

A
  1. Tensynovitis and tendon rupture
  2. Bursitis
  3. Myopathy
  4. Fatigue
22
Q

Name 2 important joints for a dentist with regards to RA

A
  1. Atlanto-axial subluxation

2. Temporomandibular Joint

23
Q

What type of arthritis is particularly inflammatory for temporomandibular joint?

A

Seronegative inflammatory arthritis, namely psoriatic arthritis

24
Q

Describe how RA affects the lungs

A

Lung fibrosis

25
Q

Describe how RA affects the heart

A

Pleural effusions

26
Q

Describe how RA affects the brain

A

Peripheral neuropathy

27
Q

Describe how RA affects the kidneys

A

NSAID use to treat arthritis

28
Q

What is Sjorgren’s Syndrome?

A

Dryness of the eyes and mouth, where exocrine function of tear and salivary glands affected

29
Q

How is Sjogren’s Syndrome tested for?

A

Schirmer test performed to test tear production

30
Q

Describe 5 ways Sjogren’s Syndrome may affect an individual

A
  1. Inability to eat dry food
  2. Tongue sticking to roof of mouth
  3. Difficult for speaking for long periods of time
  4. Higher incidence of caries, candida and periodontal disease
  5. Altered sense of taste
31
Q

What is the key message when treating RA

A

Requirement for early recognition and early aggressive intervention

32
Q

What is first line treatment for RA?

A

Methotrexate and prednisone

33
Q

What types of treatment are present for RA if first line treatment with 2 disease modifying treatments (including methotrexate) fail?

A

Biological Therapies in 3 steps (+/- steroid, namely prednisone)

34
Q

Describe methotrexate as the anchor drug in RA treatment

A
  • Resembles folic acid and competitive inhibitor of folate dependent enzymes
  • Depletion of tetrahydrofolates, essential for protein synthesis
  • Combined with folic acid to reduce GI, mucosal and haematological side effects
35
Q

Name 3 common adverse effects of methotrexate

A
  1. Hepatotoxicity
  2. Interstitial pneumonitis
  3. Myelosuppression with low platelets
36
Q

Name 5 common adverse effects associated with biological agents used in treatment of rheumatoid arthritis

A
  1. Antinuclear antibody production
  2. Drug-induced lupus like syndromes
  3. Infections
  4. Bone marrow suppression
  5. Demyelinating disorders
37
Q

Name 5 adverse effects of steroids

A
  1. Increased infection
  2. Easy bruising
  3. Increased appetite and weight gain
  4. Changes in blood sugar levels
  5. Swelling in hands and ankles from water retention
38
Q

What is the main skeletal risk of glucocorticoid therapy?

A

Glucocorticoid induced osteoporosis

39
Q

How is glucocorticoid induced osteoporosis negated in a patient with rheumatoid arthritis?

A

Oral or IV bisphosphonates / Denosumab

40
Q

What is Systemic Lupus Erythematosis (SLE)?

A

Autoimmune disorder characterized by multisystem microvascular inflammation with generation of antibodies

41
Q

Name 4 potential factors associated with development of SLE

A
  1. Genetic
  2. Racial
  3. Hormonal
  4. Environmental
42
Q

Describe 4 presenting symptoms of SLE

A
  1. Oral ulcers with palatal ulcers being most specific
  2. Multiple cytopenias (leukopania, lymphopania, anemia)
  3. Hypocomplementemia may predispose to increased infections
  4. Secondary Sjogren’s Syndrome
43
Q

Name 4 potential treatments for SLE

A
  1. Anti-malarials
  2. Immunosuppressants
  3. Steroids
  4. Bisphosphonates
44
Q

What is scleroderma?

A

A chronic systemic autoimmune disease characterized by fibrosis, vascular alterations and autoantibodies

45
Q

Describe 2 major forms of scleroderma

A

Limited Systemic - Cutaneous manifestations mainly affect hands, arms and face
Diffuse Systemic - Rapidly progressing and affects one large area of skin

Systemic Disease in Dentistry (22 decks)

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