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Human disease-Term 1 > dentist autoimunity > Flashcards

dentist autoimunity Flashcards

1
Q

diabetes - autoimmune oral causes

A

Candida/ dry mouth/ sialosis, glossitis.
Severe periodontitis may upset glycaemic control
Vigorous treatment of oral and facial infections

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2
Q

thyroid issues and there effects on dentistry

A

Analgesics and sedatives incl GAs can precipitate myxoedema coma- which can be serious

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3
Q

carbizomol and its effects orally and what it is used for

A

Carbimazole can cause agranulocytosis ( low neutrophil counts) which can cause oral or oropharyngeal ulceration.

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4
Q

celiac disease dentitry

A

Anaemia (iron or folate)
Aphthous ulcers
Dermatitis herpetiformis- on elbows small raised rash

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5
Q

celiac disease diagnosis

A 
Investigation
Anti-endomysial antibody positive
Anti TTG antibody positive
Biopsy – gold standard
if you want to test if you are 6 weeks 3 pieces of bread
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6
Q

Autoimmune haemolytic anaemia

A

Acute severe or mild chronic anaemia

Associated with thrombocytopenia

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7
Q

Autoimmune neutropenia ( low neutrophils)

A

Oral ulceration
Increased risk of infection
Prophylaxis with antibacterials and anti-fungals

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8
Q

Immune thrombocytopenic purpura

A

Idiopathic or preceded by viral infection
Purpura, bruising and nose bleeds
May need high dose steroids, splenectomy ( not as coonon now) or rituximab( try’s to get rid of bad cells)

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9
Q

Bullous pemphigoid

A

Elderly
Subepidermal blisters
Mucous membranes
Oral prednisolone or azathioprine- immunosuprression

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10
Q

Pemphigus vulgaris

A

Rare blistering disorder
Non-healing erosions of mucous membranes
Flaccid blisters on skin
High dose steroids

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11
Q

kidney disease

A

Can be autoimmune
Non-organ specific – Wegeners granulomatosis, microscopic polyarteritis,SLE and Goodpastures
Goodpastures
anti-GBM antibodies bind to both glomerular and alvelolar basement membrane and these bind in the kidney and also alveolar basement membrane and cause lung disease too
Type II hypersensitivity

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12
Q

renal failure

A 
from kidney disease
Bleeding tendencies
Impaired drug excretion
Steroid treatment
Hypertension
Infections increase
Anaemia
Dysrhythmias in the heart because of elecrolytes distrubence
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13
Q

liver and cns problems

A 
Liver
Autoimmune hepatitis
Primary biliary cirrhosis
Nervous system
Guillain-Barre
CIDP
Myasthenia gravis
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14
Q

rheumatoid arthritis and how to diagnose

A

Associated with extra-articular disease, Sjogren’s syndrome- dry mucous membranes
Diagnosis is clinical
ESR and CRP will be raised- inflammatory mediators
Rheumatoid factor, IgG anti-IgG, anti-CCP autoantibody found in 65

you can also get:
Gastrointestinal problems
Felty’s syndrome
Splenomegaly9 ENLARGED SPLEEN) & neutropenia

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15
Q

sclerderma presentation other than skin

A 
Limited (CREST)
Calcinosis
Raynauds
Oesophageal immotility- difficult to swoolow
Sclerodactyl- sausage fingers
Telangiectasia
Pulmonary hypertension
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16
Q

sclerderma presentation other than skin and the antibodies

A 
Limited (CREST)
Calcinosis
Raynauds
Oesophageal immotility- difficult to swoolow
Sclerodactyl- sausage fingers
Telangiectasia
Pulmonary hypertension

antibodies: Anti-centromere antibodies

17
Q

sclerderma dental aspects

A

Periarticular involvement of temperomandibuliar joint with microstomia
Constriction of oral orifice- skin tightening around mouth
Thickened, stiffened tongue
Oral telangiectasia

Widening of periodontal membrane space without tooth mobility
Potential problems for GA
Dysphagia
Pulmonary, cardiac and renal disease

18
Q

diffuse systemic sclerderma and the antibodies

A

V. evident changes of skin affecting face and mouth
Hands may develop flexion deformities
Intracutaneous and subcutaneous calcification
Renal involvement
Anti-Scl70 andtibodies

19
Q

sjogrens syndrome

A

Triad of :
Dry eyes
Dry mouth
Associated inflammatory arthritis

Lymphocytic infiltrate of lacrimal and salivary glands
Also affects other exocrine glands in pancreas, lungs and vagina
clinal features:
Ocular and oral features
Non-specific fatigue
Dyspareunia
Recurrent chest infection
Dry mouth
Increased cariogenic diet because of impaired sense of taste
Candida infection & angular stomatitis
Ascending parotitis

GA risk

20
Q

sjogrens disease antibodies

A

Anti-nuclear antibodies
Anti-Ro
Anti-La
Rheumatoid factor (esp in arthritis) can. Be detected in this condition
Polyclonal increase in immunoglobulins
But association with lymphoproliferative disease

21
Q

Vasculitis

A 
Granulomatosis with polyangiitis
upper respiratory / sinus involvement
Nasal ulceration
Haemoptysis
Cytoplasmic ANCA ( antibodies)
Rash secondary to the vasculaitus

renal involvement
Cryoglobulinaemia
skin involvement

22
Q

vasculitis diagnosis

A 
Inflammation of blood vessels
Elevated inflammatory markers
ANCA- anti neutrophil cytoplasmic antibodies  
U&Es- as kidney function may be impared 
Urinalysis
Anaemia of chronic disease
Imaging e.g. CXR
23
Q

behcets

A 
Clinical triad of:
Aphthous-type oral ulceration
Genital ulcers
Iritis
Other symptoms
Skin lesions
Pathergy- blistering lesion a couple of days aftert aking blood
Skin lesions:
Papulopustules
Folliculitis
Erythema nodosum
Acne
Venulitis
Large vessel thrombosis
Other manifestations
Neuro-Behcet’s
Gastrointestinal
Ocular involvement
Iritis and retinal vascultits
Arthritis
24
Q

diagnosis

A

No diagnostic tests
Colchicine & thalidomide
Immunosupression
Anti-TNF

25
Q

autoimmune disease treatments

A

Anti-inflammatories

Steroids- steroids not used as much as steroids so use other immunological supperseants

Immunosuppressants/DMARDs

Monoclonal antibodies

26
Q

immunosuppressants risks

A

Consider need for increased dose of steroids with infection, illness, surgery

Poor wound healing, increased risk of infection

Avoid aspirin and NSAIDs as risk of peptic ulceration

Oral candidiasis

Increased risk of infection (e.g. susceptibility to infection, activation of latent viruses (e.g. shingles)

Altered red and white cell counts

Liver function abnormalities

27
Q

anti immune drugs

A

Cytotoxics:
Cyclophosphamide

Antimetabolite drugs:
Methotexate

Antiproliferative drugs:
Azathioprine
Mycophenolate mofetil

Anti-T cell activation:
Ciclosporin- hypertrophy
Tacrolimus

Human disease-Term 1 (14 decks)

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