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Finals > Diseases And Conditions > Flashcards

Diseases And Conditions Flashcards

1
Q

What is anaemia?

A

Low Hb

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2
Q

What is polycythaemia?

A

High Hb

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3
Q

What is leukopenia?

A

Low WCC

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4
Q

What is leukocytosis?

A

High platelets

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5
Q

What is pancytopenia?

A

All cells reduced

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6
Q

What is the origin or red blood cells and platelets?

A

Myeloid origin

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7
Q

What are the normal Hb levels in a male?

A

130-180g/L

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8
Q

What are the normal Hb levels in a female?

A

115-165 g/L

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9
Q

What is the normal RCC in a male?

A

4.5-6.5 x10^12 /L

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10
Q

What is the normal RCC in a female?

A

3.8-5.8 x10^12 /L

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11
Q

What is the normal WCC?

A

4.0-11.0 x10^9/ L

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12
Q

What is the normal MCV?

A

80-100 fL

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13
Q

What is the normal HCT?

A

27-32 pg

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14
Q

What is the normal PLT?

A

150-450 x10^9 /L

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15
Q

What are the three haemantinics?

A

Iron, vitamin b12, folic acid

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16
Q

What are the three haemantinics?

A

Iron, vitamin b12, folic acid

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17
Q

What are the sources and losses of iron?

A

Sources: meat, green leafy veg, supplements
Losses: achlorhydria, IBD, bowel cancer

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18
Q

What are the sources and losses of vitamin b12?

A

Sources: milk, meat
Losses: lack of intake, lack of intrinsic factor, Crohn’s disease

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19
Q

What are the sources and losses of folic acid?

A

Sources: green veg, legumes
Losses: lack of intake, absorption failure

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20
Q

What is the therapeutic INR:

A

2-3

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21
Q

What is a dangerous INR?

A

> 4

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22
Q

What is the definition of lymphoma?

A

Clonal proliferation of lymphocytes

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23
Q

What are the symptoms of lymphoma?

A

Fever
Face/neck swellings
Lump in neck/armpits
Excessive night sweats
Weight loss
Loss of appetite

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24
Q

What is the clinical presentation of Hodgkin lymphoma?

A

Fever
Night sweats
Itching

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25
Q

What is the clinical presentation of Non-Hodgkin Lymphoma?

A

Extra nodal disease
Symptoms of marrow failure

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26
Q

What are the features of Hodgkin Lymphoma?

A

Peak age 15-40 years
2M:1F
Stage I&II: 90% cure
Stage III&IV: 50-70% cure

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27
Q

What are the features of Non-Hodgkin Lymphoma?

A

Peak age: any age
85% affects B cells
15% affects T cells
>50% relapse rate

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28
Q

What are the investigations for lymphoma?

A

Physical exam
Biopsy
Blood tests
Scanning

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29
Q

What is the treatment for lymphoma?

A

Chemotherapy
Radiotherapy
mAbs
Haemopoietic stem cell transplant

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30
Q

What is the definition of multiple myeloma?

A

Malignant proliferation of plasma cells

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31
Q

What is the clinical presentation of multiple myeloma?

A

Monoclonal paraprotein in blood and urine
Lytic bone lesions
Excess plasma cells in bone marrow leading to marrow failure
Anaemia
Hypercalcaemia

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32
Q

What are the symptoms of leukaemia ?

A

Fever/chills
Persistent fatigue
Frequent infections
Weightloss
Swollen nodes

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33
Q

What are the symptoms of multiple myeloma?

A

Bone pain
Fatigue
Weight loss
Repeated infections

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34
Q

What are the investigations for multiple myeloma?

A

CT/MRI scans
Bone marrow biopsy

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35
Q

What is the treatment for multiple myeloma?

A

Anti-myeloma medicines
Chemotherapy
Radiotherapy
mAbs
Haemopoietic stem cell transplant

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36
Q

What is the definition of leukaemia?

A

Group of cancers of the bone marrow which prevents normal manufacture of the blood

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37
Q

What are the clinical features of leukaemia?

A

Anaemia
Neutropenia
Thrombocytopenia
Lymphadenopathy
Splenomegaly
Bone pain

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38
Q

What are the features of Acute lymphoblastic leukaemia (peak age, % cured, prognosis m vs f)

A

Peak age: 4 years
80% children cured
Better prognosis in females

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39
Q

What are the features of acute myeloid leukaemia? (Peak age, cure rate under 60, cure rate over 70)

A

Peak age: elderly
30-40% under 60s cured
10% over 70 cured

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40
Q

What are the features of chronic lymphocytic leukaemia (peak age, M:F, what it is)

A

Peak age: 70 years
2M:1F
B-cell clonal lymphoproliferative disease

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41
Q

What are the features of chronic myeloid leukaemia (peak age, effect on neutrophils, presentation)

A

Peak age: 50-70 years
Increase in neutrophils and their precursors
Fatigue, weightloss and sweating

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42
Q

What chromosome is associated with chronic myeloid leukaemia?

A

Philadelphia chromosome

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43
Q

What are the risk factors of leukaemia?

A

Previous cancer treatment
Genetic disorders
Smoking
Family history

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44
Q

What are the investigations for leukaemia?

A

Blood tests
Bone marrow tests

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45
Q

What is the treatment for leukaemia?

A

Chemotherapy
Radiotherapy
mAbs
Haemopoietic stem cell transplant

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46
Q

What is poryphyria?

A

An abnormality of haem metabolism

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47
Q

What is the presentation of porphyria?

A

Photosensitive rash
Hypertension
Tachycardia
Neuropsychiatric disturbances

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48
Q

What are the signs of anaemia?

A

Pale
Tachycardia
Enlarged liver/spleen

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49
Q

What are the symptoms of anaemia?

A

Tired
Dizzy
Shortness of breath
Palpitations

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50
Q

What are the causes of anaemia?

A

Reduced production: reduced haemantinics
Increased loss: bleeding, autoimmune, thalassaemia, sickle cell)

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51
Q

What are the investigations for anaemia?

A

History
Full blood count
Faecal occult bloods
Endoscopy
Bone marrow examination

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52
Q

What is the treatment for anaemia?

A

Haematinic replacement
Transfusion/eryththropoetin (in production failure)

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53
Q

What is the effect of anaemia on GA?

A

Reduced O2 capacity

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54
Q

What is the effect of anaemia on the oral cavity?

A

Mucosal atrophy
Candidiasis
Recurrent ulceration
Sensory changes

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55
Q

What is the definition of Macrocytic?

A

> 100 fL

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56
Q

What is the definition of Microcytic?

A

<80 fL

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57
Q

What is the definition of normocytic?

A

80-100 fL

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58
Q

What is Macrocytic anaemia associated with?

A

Vit b12 deficiency
Folate deficiency
Drug induced

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59
Q

What is Microcytic anaemia associated with?

A

Iron deficiency
Chronic inflammatory disease
Thalassaemia

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60
Q

What is normocytic anaemia associated with?

A

Haemolytic anaemia
Blood loss
Bone marrow disorders

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61
Q

What are the four stages in the process of haemostasis?

A

Vasoconstriction
Platelet plug
Coagulation Cascade
Fibrin plug

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62
Q

What are the stages in the process of platelet plug formation?

A

ECM releases cytokines and inflammatory markers
Platelets adhere to each other
Platelet plug forms

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63
Q

What mediators do platelets release?

A

ADP
Serotonin (maintains vasoconstriction)
Prostaglandins and phospholipids (maintain vasoconstriction)

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64
Q

What is the intrinsic pathway in the coagulation cascade?

A

XII -> XIIa
XI -> XIa (via XII)
IX -> IXa (via XIa)

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65
Q

What is the extrinsic pathway in the coagulation cascade?

A

VII -> VIIa (via III)

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66
Q

What is the extrinsic pathway in the coagulation cascade?

A

VII -> VIIa (via III)

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67
Q

What is the common path in the coagulation cascade?

A

Prothrombin -> thrombin (via Va)
Fibrinogen -> fibrin (via thrombin)
Fibrin -> cross-linked fibrin clot (via XIIa)

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68
Q

What is the definition of haemophillia?

A

Rare inherited condition that affects the body’s ability to form clots

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69
Q

What are the clinical features of mild haemophilia?

A

Bleeding occurs after injury, surgery or extraction

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70
Q

What are the clinical features of moderate haemophilia?

A

Bleeding into joints and muscles after mild injury or spontaneously

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71
Q

What are the clinical features of severe haemophilia?

A

Spontaneous bleeding into joints and muscles

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72
Q

What is the cause of haemophilia A?

A

Low clotting factor VIII (8)

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73
Q

What is the cause of haemophilia B?

A

Low clotting factor IX (9)

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74
Q

What are the investigations for haemophilia?

A

Blood test
Clotting screen
Genetic test

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75
Q

What is the treatment of severe and moderate haemophilia A?

A

Recombinant factor VII

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76
Q

What is the treatment of mild haemophilia A and carriers?

A

DDAVP (desmopressin)
Transaeximic acid

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77
Q

What is the treatment for haemophilia B?

A

Recombinant factor IX

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78
Q

What is the definition of Von Willebrand’s disease?

A

Deficiency of Von Willebrand’s factor resulting in reduction of factor VIII

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79
Q

What are the clinical features of Von Willebrand’s disease?

A

Large/easy bruising
Frequent nose bleeds
Bleeding gums
Heavy periods

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80
Q

What kind of mutation causes Von Willebrands disease?

A

Autosomal dominant mutation

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81
Q

What are the investigations for Von Willebrand’s disease?

A

Blood test
Genetic test

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82
Q

What is the treatment for severe and moderate Von willebrands disease?

A

DDAVP

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83
Q

What is the treatment of mild Von Willebrand’s disease and carriers?

A

Transexaemic acid

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84
Q

What is Thrombophilia?

A

Increased risk of blood clot development

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85
Q

What are the causes of Thrombophilia?

A

Protein s/c deficiency
Antithrombin 3 deficiency
Factor V Leiden variant
Cancer
Pregnancy

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86
Q

What is the minimum platelet count for primary care?

A

100 x10 ^9

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87
Q

What is the minimum platelet count for hospital care?

A

50 x10 ^9

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88
Q

What are the irreversible risk factors for CVD?

A

Age
Sex
Family history

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89
Q

What are the reversible risk factors of CVD?

A

Smoking
Obesity
Diet
Exercise
Hypertension
Hyperlipidaemia
Diabetes

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90
Q

What is the primary preventions for CVD?

A

Exercise
Diet
Not smoking

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91
Q

What are the secondary preventions for CVD?

A

Medical treatments to reduce risk

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92
Q

What are the four features of Stable angina?

(Cause, ischaemic/infact, ECG, troponins)

A

Pain due to increased demand due to atherosclerotic plaque
Demand ischaemia, not infarction
Normal ECG
Normal troponins

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93
Q

What are the four features of unstable angina?
(Cause, ischaemic/infact, ECG, troponins)

A

Plaque ruptures, thrombus formation, partial occlusion of vessel, pain at rest
Supply ischaemia, no infarct
ECG: normal, inverted T waves or ST depression
Normal troponins

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94
Q

What are the four features of an NSTEMI?

(Cause, ischaemic/infact, ECG, troponins)

A

Plaque ruptures, thrombus formation, partial occlusion of vessel, subendocardial myocardium infarction
Subendocardial infarct
ECG: normal, inverted T waves or ST depression
Elevated troponins

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95
Q

What are the four features of a STEMI?

(Cause, ischaemic/infact, ECG, troponins)

A

Complete occlusion of blood vessel lumen, transmural injury and infarction to myocardium
Transmural infarct
ECG: hyperacute T waves or ST elevation
Elevated troponin

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96
Q

What is cyanosis?

A

5g/dL or more deoxygenated Hb in blood

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97
Q

What is a cause of central cyanosis?

A

Congenital heart disease

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98
Q

What is a cause of peripheral cyanosis?

A

Cold environment

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99
Q

What is the definition of angina?

A

Reversible ischaemia of the heart muscle

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100
Q

What are the symptoms of angina?

A

Central crushing chest pain
May radiate to arm/back/jaw

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101
Q

What are the investigations of angina?

A

ECG
Angiography
Echocardiogram
Isotope studies

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102
Q

What are the treatment options for angina?

A

Reduce O2 demands
Increase oxygen delivery
Modify risk factors

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103
Q

How can you reduce O2 demands in angina?

A

Reduce hypertension
Reduce heart filling pressure/dilate coronary vessels
Emergency Tx: GTN

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104
Q

What medication can be used to reduce hypertension?

A

Diuretics
Ca Channel agonists
ACE inhibitors
Beta blockers

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105
Q

What medications can be used to reduce heart filling pressure/dilate coronary vessels?

A

Nitrates

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106
Q

What can be done to increase oxygen delivery?

A

Angioplasty
Coronary artery bypass graft (CABG)

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107
Q

What can be done to increase oxygen delivery?

A

Angioplasty
Coronary artery bypass graft (CABG)

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108
Q

What is the definition of peripheral vascular disease?

A

Angina of the tissues

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109
Q

What are the clinical features of peripheral vascular disease?

A

Ateroma in femoral/popilteal vessels
Claudication pain in limbs during exercise
Poor wound healing
Limited function
May lead to necrosis and gangrene

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110
Q

What are the clinical features of peripheral vascular disease?

A

Ateroma in femoral/popilteal vessels
Claudication pain in limbs during exercise
Poor wound healing
Limited function
May lead to necrosis and gangrene

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111
Q

What is the definition of myocardial infarction?

A

Infarction of the coronary artery

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112
Q

What are the clinical features of a myocardial infarction?

A

Pain
Nausea
Sweaty
‘Going to die’

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113
Q

What are the investigations for a myocardial infarction?

A

History
ECG
Biomarkers (troponin)

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114
Q

What are the treatment options for a myocardial infarction?

A

Get patient to hospital
Analgesia
Aspirin
BLS if needed
Open blood flow by angioplasty/ stent (up to 3 hours) Thrombolysis (up to 6 hours)
Bypass obstruction: CABG, fem/pop bypass

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115
Q

Which medications are used for prevention of myocardial infarction?

A

Aspirin
Beta blockers
ACE inhibitors

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116
Q

What is Bradyarrhythmia?

A

Slowed heart rate

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117
Q

What is the investigation for bradyarrythmia?

A

Prolonged p-q interval on ECG

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118
Q

What is the treatment for Bradyarrythmia?

A

Cardiac pacemakers

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119
Q

What is tachyarrhythmia?

A

Increased heart rate

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120
Q

How does atrial tachycardia present on an ECG?

A

Narrow QRS

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121
Q

How does ventricular tachycardia present on an ECG?

A

Broad QRS

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122
Q

What are the risk factors of infective endocarditis?

A

Prosthetic heart valve
Congenital heart disease
Damaged heart valves
Previous endocarditis

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123
Q

What are the symptoms of infective endocarditis?

A

High temperature
Chills
Headache
Joint and muscle pain

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124
Q

What are the causes of infective endocarditis?

A

Bacteria enters system and adheres to damaged endothelium and microthrombi

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125
Q

What is the duke criteria for infective endocarditis diagnosis?

A

Positive blood cultures (3x over 24 hours)
Evidence of endocardia involvement

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126
Q

What is the treatment for infective endocarditis?

A

Antibiotics

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127
Q

What dental procedures put a patient at risk of bacteraemia?

A

Extractions
Periodontal therapy
Gingival surgery
Implants

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128
Q

What is the definition of heart failure?

A

Output of heart is incapable of meeting demands of tissue

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129
Q

What are the clinical features of left heart failure?

A

Lungs and systolic effects
Dysponea
Tachycardia
Low BP

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130
Q

What are the clinical features of right heart failure?

A

Venous pressure elevation
Swollen ankles
Aceites
Raised jugular vein pressure
Tender enlarged liver
Poor GI absorption
Pitting oedema

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131
Q

What are the causes of high output heart failure?

A

Demands of system increased beyond heart capacity
Anaemia
Thyrotoxicosis

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132
Q

What are the causes of low output heart failure?

A

Heart is failing and not strong enough to force blood around the body
Cardiac defect

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133
Q

What are the investigations for heart failure?

A

Blood test
ECG

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134
Q

What is the treatment for acute heart failure?

A

Emergency hospital management
Oxygen
Morphine
Frusemide (for fluid removal)

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135
Q

What is the treatment of chronic heart failure?

A

Community based management
Improve myocardial function (treat underlying disorders)
Reduce compensation effects

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136
Q

What is hypertension?

A

Increased blood pressure

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137
Q

What are the clinical features of hypertension?

A

Systolic >140mmHg
Diastolic >90mmHg

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138
Q

What are the clinical features of hypertension?

A

Systolic >140mmHg
Diastolic >90mmHg

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139
Q

What are the risk factors of hypertension?

A

Age
Race
Obesity
Stress
Drugs (steroids, oral contraceptives)

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140
Q

What are the causes of hypertension?

A

Environment
Genes
Gene and environment interactions

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141
Q

What are the investigations for hypertension?

A

3 separate measurements: sitting, rested
Urinalysis: serum biochemistry/lipids
ECG

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142
Q

What is the treatment for hypertension?

A

Modify risk factors
Single daily drug dose

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143
Q

What are the causes of valve disease?

A

Congenital abnormality
Rheumatic fever
Myocardial infarction

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144
Q

What is the treatment for valve disease?

A

Valve replacement

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145
Q

What are the features of a mechanical valve?

A

Longer life (up to 30 years)
Ticking noise

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146
Q

What are the features of a porcine valve?

A

Short life <10 years
Silent

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147
Q

What are the two components of respiration?

A

Ventilation
Gas exchange

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148
Q

What are the features of ventilation?

A

Airway patency
Active muscle

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149
Q

What are the features of gas exchange?

A

Adequate alveoli
No alveolar wall fibrosis

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150
Q

What is type1 respiratory failure?

A

Inadequate gas exchange

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151
Q

What is type 1 respiratory failure associated with?

A

Thickening of alveolar walls
Inadequate alveolar number
V-Q mismatch

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152
Q

What is a V-Q mismatch?

A

A mismatch between where air goes into lungs and blood going into lungs

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153
Q

What is type 2 respiratory failure?

A

Inadequate ventilation

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154
Q

What is the definition of asthma?

A

Reversible airflow obstruction
Bronchial hyper reactivity

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155
Q

What are the clinical features of asthma?

A

Cough
Wheeze
Shortness of breath
Diurnal variation
Difficulty breathing out

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156
Q

What are the triggers of asthma?

A

Infections
Environmental stimuli (dust, smoke, chemicals)
Cold air

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157
Q

What is the asthma triad?

A
  1. Bronchial smooth muscle constriction
  2. Bronchial smooth muscle oedema
  3. Excessive mucous secretion into airway lumen
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158
Q

What is the investigation for asthma?

A

Peak expiratory flow rate (PEFR) to track airway resistance

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159
Q

What are the 5 stages of treatment for asthma?

A
  1. Short acting b-agonist
  2. Low dose inhaled corticosteroid
  3. High dose inhaled corticosteroid
  4. Long acting b-agonist
  5. Adjuvant therapy
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160
Q

What are the adjuvant therapy options for asthma?

A

Regular montelukast
Pulsed oral steroid (prednisolone)
Biologic therapy

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161
Q

What is chronic obstructive pulmonary disease (COPD)?

A

Emphysema and chronic bronchitis

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162
Q

What is the risk factor of COPD?

A

Smoking

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163
Q

What are the symptoms of COPD?

A

Increased breathlessness
Persistent productive cough
Frequent chest infections
Persistent wheezing

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164
Q

What does type 1 COPD result in?

A

Hypoxaemia

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165
Q

What does type 2 COPD result in?

A

Hypercapnia
Ventilation failure

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166
Q

What is the PaO2 for type 1 COPD?

A

PaO2 <8.0 kPa

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167
Q

What is the PaCO2 for type 2 COPD?

A

PaCO2 >6.7 kPa

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168
Q

What are the investigations for COPD?

A

Spirometry
Chest x-ray
Blood test

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169
Q

What is the treatment for COPD?

A

Smoking cessation
Long acting bronchodilator
Inhaled steroid
Oxygen support
Pulmonary rehabilitation therapy

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170
Q

What is cystic fibrosis?

A

Inherited defect in cell chloride channels

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171
Q

What are the clinical features of cystic fibrosis?

A

Production of excess sticky mucous

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172
Q

What are the symptoms of cystic fibrosis?

A

Troublesome cough
Repeated chest infections
Prolonged diarrhoea
Poor weight gain

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173
Q

What can cystic fibrosis progress to?

A

Liver dysfunction
Osteoporosis
Diabetes
Reduced fertility

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174
Q

What mutation is associated with cystic fibrosis?

A

CFTR gene mutation

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175
Q

What are the different investigations for cystic fibrosis?

A

Prenatal screening: if sibling +ve
Perinatal testing: blood spot test on day 5 of life
Sweat test: suspected +ve, measures salt content of sweat
CTFR gene testing

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176
Q

What are the treatment options for cystic fibrosis?

A

Physiotherapy (10-60 mins/day: to remove mucous in lungs)
Medication:
Lungs: bronchodilators (open airways), antibiotics (chest infection), steroids (airway inflammation)
Digestive system: pancreatic enzyme replacement, nutritional supplements
CFTR modulators
Stem cell treatment
Exercise (for lung function and physical strength)
Transplantation (heart, lung)

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177
Q

What are the types of lung cancer?

A

Small cell or non-small cell

178
Q

What are the symptoms of lung cancer?

A

Cough
Haemoptysis
Pneumonia
Metastasis (bone, liver brain)
Dysphagia

179
Q

What are the causes of lung cancer?

A

Smoking
Genetics
Air pollution

180
Q

What are the investigations for lung cancer?

A

Radiographs
Biopsy
Biomarkers

181
Q

What are the treatment options for lung cancer?

A

mAbs
Platinum based doublet therapy

182
Q

What is sleep apnoea?

A

Airway obstruction during sleep

183
Q

What are the treatment options for sleep apnoea?

A

Mandíbular advancement appliance
Continuous positive airway pressure
Positional therapy

184
Q

What are the symptoms of bowel cancer?

A

Anaemia
Rectal blood loss

185
Q

What are the A B C D stages of bowel cancer?

A

A- submucosal (80% 5YS)
B- muscularis (65% 5YS)
C- lymph nodes (45% 5YS)
D- liver (5% 5YS)

186
Q

What are the causes of bowel cancer?

A

Genetics- p53 (75%)
Ulcerative colitis
Intestinal polyps
Diet low in fibre and veg and high in fat and meat

187
Q

What are the investigations for bowel cancer?

A

Screening - adults >50 every two years
Endoscopy if +ve screening
CT/MRI
Carcinoembryonic antigen

188
Q

What are the treatment options for bowel cancer?

A

Surgery
Hepatic metastases
Radiotherapy
Chemotherapy

189
Q

What is the definition for coeliac disease?

A

Sensitivity to alpha-gliaden component of gluten

190
Q

What are the clinical features of coeliac disease?

A

Subtotal villus atrophy of the jejunum

191
Q

What are the symptoms of coeliac disease?

A

Weightloss
Lassitude
Weakness
Abdominal swelling
Diarrhoea
Oral aphthae
Malabsorption of iron, folate, vit b12, fat

192
Q

What are the risk factors of coeliac disease?

A

Family history
Environmental factors
Comorbidities

193
Q

What are the investigations for coeliac disease?

A

Autoantibody tests (serum transglutaminase TTG, anti-gliadin/anti-endomyseal antibodies)
Jejunal biopsy
Faecal fat (increased due to malabsorption)
Haemantinics (low b12, folate, ferritin)

194
Q

What are the investigations for coeliac disease?

A

Autoantibody tests (serum transglutaminase TTG, anti-gliadin/anti-endomyseal antibodies)
Jejunal biopsy
Faecal fat (increased due to malabsorption)
Haemantinics (low b12, folate, ferritin)

195
Q

What is the treatment for coeliac disease?

A

Gluten free diet

196
Q

What are the dental aspects of coeliac disease?

A

Oral ulcers and blisters due to malabsorption

197
Q

What is pernicious anaemia?

A

Anaemia caused by vitamin b12 deficiency

198
Q

What are the clinical features of pernicious anaemia?

A

Diarrhoea
Lightheaded
Loss of appetite
Shortness of breath

199
Q

What are the causes of pernicious anaemia?

A

Lack of b12 in diet
Disease of gastric parietal cells (autoimmune)
Crohn’s disease
Bowel cancer

200
Q

What are the investigations for coeliac disease?

A

Blood tests
Schilling test/serological markers
Biopsy

201
Q

What is the treatment for pernicious anaemia?

A

Increase b12 in diet
Supplements
Vitamin b12 injections

202
Q

What are the symptoms of Crohn’s disease?

A

Colonic disease: diarrhoea, abdominal pain, rectal bleeding
Small bowel disease
Orofacial granulamatosis

203
Q

What are the ratios for Crohn’s disease in male/female and white/black

A

M>F
W>B

204
Q

What are the features of Crohn’s disease?

A

Discontinuous
Rectum involved 50%
Anal fissures 75%
Ileum involved 30%
Mucosa cobbled and fissured
Non vascular
Serosa inflammed

205
Q

What is the microscopic appearance of Crohn’s disease?

A

Transmural
Oedematous
Granulomas

206
Q

What is the presentation of necrotising ulcerative gingivitis/periodontitis?

A

Marginal gingival ulceration with loss of interdental papillae
Grey sloughing on surface of ulcers
Halitosis
Pain

207
Q

What are causative factors of NUG/NUP?

A

Anaerobic fusospirochatal bacteria
Smoking
Stress

208
Q

What is used to treat NUG/NUP?

A

Metronidazole

209
Q

What are the functions of the skin?

A

Anatomical barrier
Sensory input
Heat regulation
Stores liquids and water
Drug absorption and waste excretion

210
Q

What is the impact of oily skin?

A

Increased sebaceous gland secretion
Increased bacterial colonisation
Increased spots and pimples
Skin is heavier and thicker
Increased pore blockage

211
Q

What are comedones?

A

Black heads
Buildup of keratin and sebum
The pores oxidise leading to a black colour

212
Q

What are bacterial infections that affect the skin?

A

Furuncles and carbuncles
Acne
Erysipelas
Impetigo

213
Q

What is a group of furuncles called?

A

Carbuncle

214
Q

What is a furuncle?

A

Infection of the skin leading to pus filled pockets
Red, painful and swollen

215
Q

What bacteria causes furuncles?

A

Staphylococcus aureus

216
Q

What does acne consist of?

A

Comedones, papeles, pustules, nodules and inflammatory cysts

217
Q

What age groups are most commonly affected by acne’s?

A

13-18 years
25-40 years

218
Q

What are some causes of acne?

A

Follicular sensitivity to testosterone
Propionibacteruym acne’s overgrowth

219
Q

What five things can worsen acne?

A

Contraceptives
Greasy skin cleansers
Systemic steroid treatment
Anticonvulsants
Squeezing spots

220
Q

What is the local management of acne?

A

Reduce excess skin oil
Antibacterial agents: benzoyl peroxide, retinoids, antibiotic lotions

221
Q

What is the systemic management of acne?

A

Antibiotics; tetracycline based (minocylin)
Retinoids: isotretinoin
Hormone manipulation: anti androgens (cyproterone)

222
Q

What bacteria causes erysipelas?

A

Streptococcus pyogenes

223
Q

What do erysipelas present as?

A

Defined, sharp raised border; may blister and peel
Systemic symptoms: fever, rigors

224
Q

What is the management of erysipelas?

A

Systemic antibiotics

225
Q

What is the progression of erysipelas?

A

Necrotising fasciitis
Septic shock

226
Q

What is impetigo?

A

Highly infectious skin disease
Presents as red, crusty blisters

227
Q

What bacteria is associated with impetigo?

A

Straphlococcal
Streptococcal

228
Q

What is the management of impetigo?

A

Topical antibiotics

229
Q

What are some examples of viral skin infections?

A

Herpes simplex
Shingles (herpes zoster)
Mulluscum contagiosum
Warts
Measles
Rubella
Fifth disease
Hand foot and mouth

230
Q

What is herpes simplex virus activated by?

A

Trauma
Physical
Chemical
UV
Stress

231
Q

What is the management of herpes simplex virus?

A

Aciclovir

232
Q

What is the cause of shingles?

A

Recurrent herpes zoster virus that affects single dermatones

233
Q

What is the management of shingles?

A

High dose aciclovir

234
Q

What is mulluscum contagiosum caused by?

A

Pox virus

235
Q

Who is mostly affected by mulluscum contagiosum?

A

Infants and small children
Children with atopic eczema
Adults with HIV

236
Q

What is the presentation of mulluscum contagiosum?

A

Clusters of small papules

237
Q

What is the presentation of mulluscum contagiosum?

A

Clusters of small papules

238
Q

What conditions are warts associated with?

A

HPV1-3

239
Q

What is the treatment for warts?

A

Keratosis is
Cryosurgery
Excision

240
Q

What are some examples of fungal skin infections?

A

Athletes foot (tines pedis)
Nail infections (oncycholysis)
Ringworm
Intertrigo
Pityriasis versicolour

241
Q

What is the treatment for athletes foot?

A

Keep skin clean, dry and damage free
Antifungal/antibacterial cream: miconazole

242
Q

What is onycholysis?

A

Associated with tinea unguium infection
Nail becomes malformed, thick and crumbly

243
Q

What is ringworm in feet associated with?

A

Tinea cruris

244
Q

What is ringworm in the body associated with?

A

Tinea corporis

245
Q

What is ringworm in the scalp associated with?

A

Tinea capitius

246
Q

What is intertrigo?

A

Fungal infection due to chafing

247
Q

What is the treatment for intertrigo?

A

Topical antifungal
Clotrimazole
Miconazole

248
Q

What is pityriasis versicolor caused by?

A

Pityrosporum orbiculare
Cradle cap

249
Q

What is the presentation of pityriasis versicolor?

A

Patchy skin pigmentation

250
Q

What is the treatment of pityriasis versicolour?

A

Topical or systemic antifungal
Topical ketoconazole (shampoo/wash)
Systemic itraconazole

251
Q

What are two examples of skin infestations?

A

Scabies
Lice

252
Q

What is scabies?

A

Infection with scabies mite (sarcoptes scabiei)
Burrow into skin

253
Q

What is the presentation of scabies?

A

Itching
Rash

254
Q

What is the treatment of scabies?

A

Chemical insectides:
Benzoyl benzoate
Permethrin
Malathion

255
Q

What are the three types of lice and how are they transmitted?

A

Head, pubic, body
Transmitted by close contact and shared items

256
Q

What is the treatment for lice?

A

Personal clothing and hygiene
Chemical insectides: permethrin, malathion, phenothrin

257
Q

What are examples of inflammatory skin disease?

A

Eczema
Occupational dermatitis
Psoriasis

258
Q

What is eczema?

A

Inflammation of skin
Itchy, dry, flaky

259
Q

What are the types of eczema?

A

Atopic
Contact
Seborrhoeic
Discoid
Gravitational

260
Q

What type of surfaces does eczema affect?

A

Flexor

261
Q

What are the features of atopic eczema?

A

Develops in childhood
Improves with age and runs in families
Associated with hay fever and asthma

262
Q

What are the features of contact eczema?

A

Adult onset
Contact with allergen

263
Q

What are the features of seborrhoeic eczema?

A

Affects scalp and eyelashes

264
Q

What are the features of gravitational eczema?

A

Related to poor circulation in legs

265
Q

What are some triggers of eczema?

A

Stress
Menstruation
Illness
Weather

266
Q

What is the management of eczema?

A

Cotton clothing
Emollients: oily and prevent the drying of irritated skin, apply after bath
Soap substitutes
Corticosteroids: remove inflammation and allow skin to return to normal

267
Q

What is occupational dermatitis and how is it treated?

A

Reaction to an environmental agent
Results in a rash, immediately or 72 hours after
Treated with topical steroids and removal of stimuli

268
Q

What is psoriasis?

A

Inflammatory skin disease affecting 2% pop
Dysregulated epidermal proliferation

269
Q

What surfaces are affected by psoriasis?

A

Extensor surfaces

270
Q

What are the treatments for psoriasis?

A

Emollients
Topical steroids
Tar
Dithranol
Vitamin A derivatives
PUVA (psoralen UV light A)

Systemic: methotrexate, cyclosporine, aitretin, inflixamab, etanercept

271
Q

What are examples of blistering immunological skin conditions?

A

Pemphigoid
Pemphigus
Epidermolysis bullosa

272
Q

What are some examples of immunological connective tissue diseases?

A

Scleroderma
Dermatomyositis
Raynaulds

273
Q

How do immunological skin conditions lead to blisters?

A

Auto-antibodies attack skin components causing a loss of cell-cell adhesion
‘Split’ forms in skin which fills with inflammatory exudate, forms vesicle/blister

274
Q

What is pemphigoid?

A

Sub epithelial antibody attack
Leads to thick walled blisters: clear or blood filled
Can have oral and skin lesions

275
Q

What is the treatment of pemphigoid?

A

Steroids or steroid sparing drugs

276
Q

What does pemphigus affect?

A

Affects mucosa and skin

277
Q

What are the signs and symptoms of denture induced stomatitis?

A

Inflammed mucosa
Burning sensation
Discomfort
Bad taset

278
Q

What are the types of dementia?

A

Alzheimers
Vascular
Dementia with Lewy bodies
Fronto temporal
Korsakoff syndtome

279
Q

What are the signs of late stage dementia?

A

Unaware of time and place
Difficulty in recognising faces
Increased need for self care help
Difficulty walking
Behaviour changes

280
Q

What are examples of cognitive tests for dementia?

A

Mini Mental State Exam
Blessed Dementia Scale
Montreal Cognitive Assessment
Single test: clock draw, delayed word recall, category fluency

281
Q

What are the risk factors for head and neck cancer?

A

Smoking
Oral Hygiene
Alcohol
Betel chewing

282
Q

What is a stroke?

A

An acute focal neurological deficit due to cerebrovascular disease

283
Q

What are the risk factors for stroke?

A

Smoking
Alcohol
Hypertension
Hyperlipodemia

284
Q

What are the types of stroke?

A

Haemorrhage
Infarction
Embolic

285
Q

What are the signs/symptoms of stoke?

A

Face drooping
Arm weakness
Speech difficulties

286
Q

What are the methods of stroke prevention?

A

Antiplatelets (aspirin)
Statins (reduce cholesterol)
Stop smoking

287
Q

What are the complications of stroke?

A

Sensory/motor loss
Dysphagia
Dysphonia
Cognitive impairment

288
Q

What is epilepsy?

A

Recurrent seizures associates with reduced GABA levels

289
Q

What are the types of epilepsy?

A

Generalised tonic-clonic seizures
Partial/Focal seizures
Myoclonic seizures
Tonic seizures
Atonic seizures

290
Q

What is an aura?

A

Abnormal sensation that a seizure may occur

291
Q

What is tonic associated with?

A

Muscle tensing

292
Q

What is clonic associated with?

A

Muscle jerking

293
Q

What is a post-ictal period?

A

Post seizure
Person is confused, tired, irritable and low

294
Q

How does a partial/focal seizure present?

A

Occurs in isolated areas
Affects hearing, speech, memory and emotions
Awake during simple, Unconscious during complex
Symptoms: deja vu, strange smell/tastes, unusual emotions/behaviours

295
Q

What is an acute febrile convulsion?

A

A fit or seizure occurring in children 6 months - 6 years when they have a high fever

296
Q

What are the causes of epilepsy?

A

Idiopathic
CNS disease
Trauma

297
Q

What are the precipitators of epilepsy?

A

Illness
Stress
Fatigue

298
Q

What is the treatment for epilepsy?

A

Anti-convulsants
Anti-epileptics

299
Q

What is the emergency treatment for epilepsy?

A

Protect head, clear area
Give O2
>5minutes: buccal midazolam
Post-seizure reassurance

300
Q

What information should you gather in a fit history?

A

Last 3 fits
Medications and compliance
When fits are most likely

301
Q

What is status epilepticus?

A

Single epileptic seizures lasting more than 5 minutes or 2 or more within a 5 minute period

302
Q

What is multiple sclerosis?

A

Progressive demyelination of axons leading to reduced nerve conductivity

303
Q

How does multiple sclerosis present?

A

Intention tremor
Muscle weakness
Paraesthesia
Visual disturbance

304
Q

What is motor neurone disease?

A

Degeneration of spinal cord affecting bulbar motor nuclei

305
Q

What are the tests for bleeding disorders?

A

Prothrombin test
Platelet count
Activated partial prothrombin time
Thrombin time

306
Q

What drugs are associated with xerostomia?

A

Benzodiazepines
Antidiuretics
Antidepressants
Anticholinergics

307
Q

What is the definition of delusion?

A

False, fixed beliefs which dominate the person’s mind and are contrary to education and culture

308
Q

What are the dental implications of alcohol use disorder?

A

Xerostomia
Poor oral hygiene
Erosion and toothier
Increased caries risk

309
Q

What is schizophrenia?

A

Encompasses a number of symptoms associated with significant alterations to a person’s perception, thoughts, moods and behaviour

310
Q

What are the dental implications of schizophrenia?

A

Hypersalivation
Tardive Dyskinesia
Xerostomia
Increased oral cancer risk

311
Q

What is tardive dyskinesia most commonly caused by?

A

Typical antipsychotics

312
Q

What are the side effects of atypical antipsychotic clozapine?

A

Agranulocytosis
Neutropenia
Hypersalivation
Plasma levels can be influenced by tobacco withdrawal

313
Q

What are the dental implications of cannabis use?

A

Increased dietary carbohydrates
Can induce tachycardia and widespread vasodilation
Use can be a contraindication to dentist led sedation
Xerostomia

314
Q

What is the safest LA to use on patients with advanced liver disease?

A

Articaine

315
Q

What analgesia is best used for patients with liver cirrhosis?

A

Paracetamol

316
Q

What is the liver responsible for producing?

A

Clotting factors 1,2,7,9,10,11
Thrombopoietin

317
Q

What is the minimum UKLED score for a transplant?

A

49

318
Q

What is cirrhosis?

A

Liver cell necrosis and inflammation followed by replacement with fibrotic tissue and regenerating nodules of hepatocytes and vascular derangement

319
Q

What type of RNA does hepatitis D have?

A

Circular

320
Q

What is the main route of hepatitis A transmission?

A

Faeco-oral

321
Q

What is used for the treatment of hepatitis A

A

Sofosbuvir

322
Q

What are the cardinal signs of Parkinson’s?

A

Postural instability
Muscle rigidity
Resting tremor
Bradykinesia

323
Q

What are the oral health implications of Parkinsons?

A

Oral hygiene deteriorates
Poor access
Dry mouth
Lack of muscle control

324
Q

What are the signs of dental pain in a non-verbal patient?

A

Pulling at face and mouth
Refusal to eat
Disturbed sleep
Increased restlessness

325
Q

What is Parkinsons?

A

Degenerative brain disease: loss of dopaminergic neurone in the substantial Niagara

326
Q

What is xerostomia?

A

Dry mouth
1/2 the amount of normal unstimulated flow rate
Clinically <3ml/min

327
Q

What medications are associated with xerostomia?

A

Tricyclic antidepressants
Anticholinergics
Antipsychotics
Beta blockers
Antihistamines
Diuretics
Benzodiazepines

328
Q

What are the causes of xerostomia?

A

Sjögren’s syndrome
Anxiety
Surgical removal
Head and neck radiotherapy
Dehydration
Stress

329
Q

What is the peak age for Acute Lymphoblastic Leukaemia?

A

0-4 years

330
Q

What medications are associated with gingival hyperplasia?

A

Calcium channel blockers (nifedipine)
Immunosuppressants (cyclosporine)
Anticonvulsants (phenytoin)

331
Q

How many cases of Acute Lymphoblastic Leukaemia occur annually?

A

440

332
Q

What are the symptoms of Acute Lymphoblastic Leukaemia?

A

Breathlessness
Pale
Fatigue
Easy bleeding/bruising
Increased temperature
Increased infections
Swollen lymph nodes
Irritable
Bone pain
Decreased appetite
Fullness in stomach
Swollen testicles

333
Q

Examples of MDT for Acute lymphoblastic leukaemia:

A

Paeds Oncologist
Paeds Haematologist
Paeds Dentist
GP
Paeds Cancer Nurse
Play Specialist
Psychologist
Social Worker

334
Q

What are the management options for Acute Lymphoblastic Leukaemia?

A

Chemotherapy
Stem cell or bone marrow transplant

335
Q

What oral problems are associated with Acute Lymphoblastic Leukaemia?

A

Increased infection during treatment
Oral and pharyngeal mucositis
Xerostomia
Increased caries
Gingival hyperplasia
ORN, MRONJ
Trismus

336
Q

What are the dental considerations to be made for an Acute Lymphoblastic Leukaemia patient?

A

Prevention
Timing of appointments
Immunosuppressant and bleeding risk
Anxiety
Fatigue
Wider social and family circumstances

337
Q

What is the presentation of diabetes?

A

Polyuria (Toilet)
Excessive Thirst
Lethargy (Tired)
Weight Loss (Thinner)

338
Q

What is the MDT associated with diabetes in Paeds?

A

Paediatric Endocrinologist
Paeds diabetes specialist nurse
Paeds dietician
Clinical psychologist

339
Q

What is the diagnostic value for diabetes in mmol/litre glucose?

A

11.1

340
Q

What is type 1 diabetes managed with?

A

Insulin

341
Q

What dental problems are associated with type 1 diabetes?

A

Increased perio risk
Decreased saliva flow
Increased caries
Candidiosis
Increased infection

342
Q

What considerations should be made for the treatment of type 1 diabetes patients?

A

Prioritise prevention (high risk)
Timing of appointment (early/mid morning)
GA (liase with endocrinologist, may need overnight monitoring due to fasting)
Anxiety
Fatigue with care: fed up of tx

343
Q

What is the ratio of autism M:F

A

3M:1F

344
Q

What are the four cardinal signs of Parkinson’s disease?

A

Postural instability (impaired gait and falls, impaired use of upper limbs)
Resting tremor
Bradykinesia (slow movement and slow initiation of movement)
Rigidity (Increased muscle tone)

345
Q
A
346
Q

How may a Parkinson’s patient present?

A

Mask-like face
Slow speech
Difficulty swallowing
Abnormal posture
Difficulty walking
Memory problems

347
Q

What are the dental issues associated with a Parkinson’s patient?

A

Difficulty accepting treatment
Tremor at rest
Lack of control of muscles of mastication
Dry mouth

348
Q

What is xerostomia in Parkinson’s patients associated with?

A

Anticholinergic effect of drugs (benzotropine)
Increased drug interactions

349
Q

How may pain display in a Parkinson’s patient?

A

Fighting
Pacing
Repetitive motions
Refusal to eat
Crying
Groaning and refusal to co-operate

350
Q

What are the facial signs in a Parkinson’s patient in pain?

A

Frowning
Grimacing
Teeth clenching
Biting
Rubbing area

351
Q

What are the behavioural signs of a Parkinson’s patient in pain?

A

Aggression
Depression
Isolation
Sleep disturbance
Withdrawal

352
Q

What is the difference in tremors in Parkinson’s and Cerebral Palsy?

A

Parkinsons is a resting tremor
Cerebral palsy is an intention tremor

353
Q

What are some management techniques for xerostomia?

A

Sucking on ice cubes
Frequent sips of water
Avoiding alcohol containing mouthwashes
Avoiding dry foods and caffeine

354
Q
A
355
Q

What is Alzheimer’s?

A

Reduction in the cortex size, severe in the hippocampus
Presence of plaques which are deposits of protein fragments of beta-amyloid that builds up in the space between the nerve cells and the tangles (twisted fibres of tau protein build up in cell)

356
Q

What is vascular dementia caused by?

A

Reduced blood flow to the brain which damages and eventually kills brain cells

357
Q

What is dementia with Lewy bodies?

A

Deposits of abnormal protein- Lewy bodies inside of brain cells

358
Q

What is fronto-temporal dementia?

A

The frontal lobe has an associated ubiquitous associated protein linked with TDP-43

359
Q

What are examples of rarer types of dementia?

A

HIV-related
Corticobasal degenerative
Parkinson’s
Multiple Sclerosis
Niemann-Pick disease
Creutz-feld Jacob

360
Q

What is the presentation of early stage dementia?

A

Short term memory loss
Confusion
Poor judgement/decisions
Anxiety, agitation or distress over changes
Inability to manage everyday tasks
Communication problems
Declines in talking, reading and writing

361
Q

What is early stage dementia often attributed to?

A

Stress
Bereavement
Ageing

362
Q

What is early stage dementia often attributed to?

A

Stress
Bereavement
Ageing

363
Q

What is the presentation of mid stage dementia?

A

More support required to eat, wash, dress
Increasingly forgetful, may fail to recognise people
Distress, aggression, anger, mood changes
Wandering and getting lost
May behave inappropriately
May experience hallucinations/throwback memories

364
Q

What is the presentation of late stage dementia?

A

Inability to recognise familiar objects, surroundings or people
Increased physical frailty
Difficulty eating and swallowing, weight loss
Associated incontinence
Loss of speech
Symptoms are progressive and irreversible

365
Q

What are the three types of Von Willebrand disease?

A

Hereditary
Acquired
Psuedo/platelet type

366
Q

What are the three types of Von Willebrand disease?

A

Hereditary
Acquired
Psuedo/platelet type

367
Q

What are some examples of rarer blood disorders?

A

Haemophilia carriers
Factor XIII deficiency
Factor X deficiency
Factor V deficiency
Glandsman Disease

368
Q

What is thrombocytopenia?

A

Abnormally low levels of thrombocytes

369
Q

What is the reference value for thrombocytopenia?

A

<150x10^9/L

370
Q

What is the reference value for thrombocytopenia?

A

<150x10^9/L

371
Q

What are examples of blood tests?

A

Full blood count
Coagulation screen
Prothrombin time
Partial thromboplastin time
Activated partial thromboplastin time (APTT)
APTT ratio
INR
D-dimer
Fibrogen

372
Q

What does the INR determine?

A

How long it takes for blood to clot

373
Q

What is INR=1

A

Equal to a person not on warfarin

374
Q

What is INR>1

A

Longer clotting time

375
Q

What is INR <4?

A

Allows treatment without interruption

376
Q

What are the risk factors of oral cancer?

A

Tobacco use
Increased sun exposure
Gender (M>F)
Poor OH
Weakened immune system
Alcohol use
Human papilloma virus (HPV)
Increased age
Poor diet and nutrition

377
Q

What are the physical features of Down’s Syndrome?

A

Macroglossia
Class II occlusion
Hypodontia
Short neck

378
Q

What are the physical features of Down’s Syndrome?

A

Macroglossia
Class II occlusion
Hypodontia
Short neck

379
Q

Why are Down’s syndrome patients at increased Perio risk?

A

Immunocompromisation
Poor OH

380
Q

Why are Down’s syndrome patients at increased Perio risk?

A

Immunocompromisation
Poor OH

381
Q

What is the definition of NUG/NUP?

A

Painful ulceration and blunting of interdental papilla
Associated with grey/yellow necrotic slough

382
Q

What are the signs/symptoms of NUG/NUP?

A

Malodour/halitosis
Interproximal necrosis
Gingivitis
Pain, swelling, bleeding
Metallic taste
Bleeding

383
Q

What are the risk factors for NUG/NUP?

A

Poor OH
Immunocompromised
Stress
Smoking

384
Q

What is an abscess?

A

Localised collection of dead and dying neutrophils

385
Q

What are the signs/symptoms of a dental abscess?

A

TTP in lateral direction
Pain
Swelling
Redness
Pus drainage
Bleeding

386
Q

What are the types of abscess?

A

Gingival
Periodontal
Pericoronal
Periapical
Perio-endo

387
Q

What is atrial fibrillation (AF)?

A

Electrical impulses in atria fire irregularly and chaotically

388
Q

What are the symptoms of atrial fibrillation?

A

Irregular and fast heartbeat

389
Q

What are the risks associated with atrial fibrillation?

A

Risk of blood clot formation- stroke

390
Q

What are the three types of diabetes?

A

Type 1
Type 2
Gestational

391
Q

What are the associated side effects of diabetes?

A

Hypoglycaemic episodes
Increased periodontal disease risk
Xerostomia
Oral dysaesthesia (burning mouth syndrome)
Decreased wound healing
Increased infection risk
Parotid gland enlargement

392
Q

What is hypertension>

A

Increased blood pressure

393
Q

What are the risks associated with hypertension?

A

Heart attack
Stroke
Kidney failure
Sight problems
Vascular dementia

394
Q

What are the primary risk factors for hypertension?

A

Genetics
Black
Smoking
Lack of exercise
SIMD
Increased alcohol
Increased weight
Increased salt intake

395
Q

What are the secondary causes of hypertension?

A

Increased adrenal hormone
Kidney disease
Diabetes
Medications

396
Q

What is neurosis?

A

Contact with reality maintained

397
Q

What are two examples of neurosis?

A

Anxiety
Phobias

398
Q

What is psychosis?

A

Contact with reality lost

399
Q

What are examples of anxiety disorders?

A

Generalised Anxiety Disorder
Phobic Anxiety
Panic Disorders

400
Q

What is generalised anxiety disorder?

A

Free-floating anxiety in many/all situations

401
Q

What is phobic anxiety?

A

Intense anxiety/panic in specific situations

402
Q

What is panic anxiety?

A

Unpredictable extreme anxiety

403
Q

What is somatosomal disorder?

A

Repeated presentation of physical symptoms and persistent requests for medical investigations in spite of negative findings and reassurance that the symptoms have no physical basis

404
Q

What are psychological treatments for mental disorders?

A

Psycho-education
Anxiety management techniques
Cognitive behaviour therapy

405
Q

What are examples of anxiolytic drugs?

A

Alcohol
Benzodiazepines (diazepam, midazolam, temazepam)
Antidepressants (tricyclics, mirtazepione, SSRIs)

406
Q

What is the dental presentation of anxiety?

A

TMD and parafunction
Oral dysaethesia
Denture intolerance

407
Q

What are adjustment disorders?

A

Maladaptive responses to severe past or continuing stress/trauma

408
Q

How are adjustment disorders managed?

A

Psychological intervention

409
Q

What is the dental presentation of mood disorders?

A

Face pain
Dysaethesias

410
Q

What is the occurrence of mood disorders based on gender?

A

3F1M

411
Q

What are examples of depressive mood disorders?

A

Major depressive disorder
Persistent depressive disorder
Bipolar depression
Post-partum depression
Pre-menstrual dysphoria
Seasonal affective disorder
Atypical depression

412
Q

What are the symptoms of depression?

A

Low mood
Lethargy
Appetite disturbance
Loss of confidence/ self esteem
Unreasonable self reproach and guilt
Anxiety
Reduced interest/motivation
Sleep disturbance
Poor concentration
Recurrent thoughts of suicide

413
Q

What are the two types of bipolar?

A

Mania
Cyclothermia and Hypomania

414
Q

What are the symptoms of cyclomania and hypomania?

A

Increased productivity and feeling of wellbeing
Reduced need for sleep
Gradual reduction in social/occupational function
Increase in reckless behaviour, followed by period of depression

415
Q

How does an euphoric mood disorder present?

A

Upbeat
Talkative
Inflated self esteem
Feels that anything is possible

416
Q

How does a dysphoric mood disorder present?

A

Irritable
Agitated
Aggressive
Restless
Rage

417
Q

What are the treatment options for mood disorders?

A

Psychological: cognitive therapy, interpersonal psychotherapies
Physical: exercise, phototherapy, ect
Drugs: antidepressants, mood stabilising

418
Q

What are examples of acute phase antidepressants?

A

Selective Serotonin Reuptake Inhibitors (SSRIs)
Venalfaxine/Mirtazepine
Tricylic Antidepressants (TCA)
Monoamine Oxidase Inhibitor (MAOI)

419
Q

What are examples of mood stabilising drugs?

A

Lithium
Carbamazepine
Valproate
Lamotrigine

420
Q

What are uses of antidepressants?

A

Treating depression/anxiety
Pain relief
Helps psychological treatments

421
Q

What are examples of conditions with perceptual abnormalities?

A

Manic depression
Schizophrenia
Korsakoff’s Psychosis
Alcohol induced brain degeneration

422
Q

What is schizophrenia?

A

Fundamental and characteristic distortions of thinking and perception
Various types of delusions
Auditory hallucinations
Relapsing and remitting periods of acute psychosis

423
Q

What causes schizophrenia?

A

Multifactorial abnormality of dopaminergic neurotransmission

424
Q

What is schizophrenia associated with?

A

Genetic susceptibility
Environmental: perinatal risk factors
Drug abuse; cocaine, amphetamines, ecstasy, opiates

425
Q

What is the prevalence of schizophrenia?

A

1-2%

426
Q

How is schizophrenia managed?

A

Psychological therapy: CBT, cognitive remediation, family intervention
Drug therapy: dopamine antagonist drugs (extrapyramidal effects), atypical antipsychotics

427
Q

How are the extrapyramidal effects of antipsychotics treated?

A

Use an atypical antipsychotic
Beta-adrenergic blockers
Antichlolinergics

428
Q

What is borderline personality disorder?

A

Instability in interpersonal relationships, self image, marked impulsivity

429
Q

What is antisocial personality disorder?

A

Disregard for and violation of rights of others

430
Q

What is histrionic personality disorder?

A

Excessive emotionality and attention seeking

431
Q

What is narcissistic personality disorder?

A

Grandiosity, need for admiration, lack of empathy

432
Q

What is avoidant personality disorder?

A

Social inhibition, feelings of inadequacy, hypersensitivity to negative evaluations

433
Q

What is a dependent personality disorder?

A

Submissive and clinging behaviour

434
Q

What is shizoid personality disorder?

A

Detachment from social relationships and restricted range of emotional expression

435
Q

What is the presentation of necrotising stomatitis?

A

Bone denudation
Osteitis and bone sequestrum

436
Q

What is the management of orofacial granulomatosis?

A

Oral hygiene support
Symptomatic relief as per ulceration
Dietary exclusion
Topical steroids
Topical tacrolimus
Short courses of oral steroids
Intralesional corticosteriods
Surgical intervention

437
Q

What is the management of orofacial granulomatosis?

A

Oral hygiene support
Symptomatic relief as per ulceration
Dietary exclusion
Topical steroids
Topical tacrolimus
Short courses of oral steroids
Intralesional corticosteriods
Surgical intervention

438
Q

What is the treatment of necrotising periodontal disease?

A

Debridement and chlorhexidine mouthwash rinse 0.2% twice daily
If systemic effects use metronidazole 400mg

439
Q

What are the signs and symptoms of primary herpetic gingivostomatitis?

A

Fluid filled vesicles: rupture to painful, ragged ulcers on gingival, tongue, lips, buccal and palatal mucosa
Severe oedematous marginal gingivitis
Fever
Malaise
Headache
Cervical lymphadenopathy

440
Q

What is the NICE recommendation for patients with acute sinusitis that do not respond to first line treatments within 48 hours?

A

Referral to ENT specialist

441
Q

What factors increase the risk of complications from acute sinusitis?

A

People with pre-existing co-morbidites: cystic fibrosis, immunosuppression, significant heart, liver, lung or renal disease

People with acute cough >65 years with two of the following RF or >80 with one: hospitalisation in the previous year, type 1/2 diabetes, congestive heart failure, current use of oral corticosteroids

Finals (20 decks)

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