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Dentistry Year 2 Term 2 > Geraldine Gardiner > Flashcards

Geraldine Gardiner Flashcards

1
Q

Define neoplasia

Define tumour

Define metaplasia

Define metastasis

A

Neoplasia- the formation of abnormal cells due to genetic change

Tumour- an abnormal growth of tissues which may be either benign or malignant

Metaplasia- a stable change from one to another normal differentiated cell type within a tissue

Metastasis- spread of cancer cells to new areas via lymphatic system or blood stream

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2
Q

Define hyperplasia

Define hypertrophy

Define atrophy

Define involution

Define dysplasia

A

Hyperplasia- increased number of cells in tissue

Hypertrophy-increased size of cells in a tissue

Atrophy - decrease in number of cells in a tissue

Involution - reduction in size of cells in a tissue

Dysplasia - abnormal development in tissues which may imply potential malignancy in some tissues but not others

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3
Q

What are the characteristics of benign tumour (6)

What are the characteristics of a malignant tumour (6)

A

Well differentiated,slow growth, mitotic figures rare and normal, well demarcated within own fibrous capsule, expansive growth within capsule, do not metastasise

Spectrum of differentiation from well to poorly differentiated, variable growth rate, mitotic figures numerous and atypical, poorly demarcated, locally invasive, regional and distant metastasis

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4
Q 
What is lymphoma
What is melanoma
What is leukaemia
What is teratoma
What is hermatoma
What is ameloblastoma
A

Tumours of the lymphoid system all of which are malignant
Highly malignant tumours derived from melanocytes in skin
Tumours of lymphoid bone marrow cells
A tumour which differentiates to resemble the three embryonic germ layers
A developmental abnormality
A tumour of the odontogenic epithelium characterised histologically by columnar cells resembling preameloblasts, and the stellate reticulum in islands or strands most commonly at angle of mandible, appears radiographicly as soap bubble and treated by surgical excision

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5
Q

Hodgkins lymphoma

Burrkitts lymphoma

Pindborg lymphoma

Kaposis sarcoma

Ewing sarcoma

A

A type of lymphoma in which cancer origionates from the lymphocytes

A cancer of the lymphatic system particularly in B lymphocytes found in germinal centre

A calcifying epithelial odontogenic tumour

A cancer that can form masses in skin, lymph nosdes and organs caused by human herpes virus 8- skin lesions often purple

A cancer of bone and the surrounding tissues that mainly effects children and young people

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6
Q

What are potential harmful consequences of benign tumours

2

A

Cellular over activity

Pressure

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7
Q

Where can analgesics act

Where can anti inflammatories act

Where can anti pyretics act

A

Analgesics- centrally and peripherally

Anti inflammatories- peripherally

Anti pyretics- centrally

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8
Q

What are the NSAIDs

5

A 
Asprin
Ibuprophen
Diclofenac
Naproxen
Celecoxib
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9
Q

Outline the cox pathway
4

What are the consequences of inhibiting cox 1
(3)

What are the consequences of inhibiting Cox 2
(3)

A
  1. Phospholipid is broken down into arachidonic acid
  2. COX1 (present all times) breaks down AA into TXA2, PGI2, PGE2
  3. COX2 (produced during inflammation) breaks down AA into PGI2 and PGE2
  4. 5-LOX breaks down AA into LTB4, LTC4 and LTD4

Inhibition of COX1= gastric ulcers, bleeding, acute renal failure

Inhibition of COX2= reduces inflammation, reduces pain, reduces fever

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10
Q

What is the role of TXA2 in the COX pathway (1)

What is the role of prostoglandins in the COX pathway (4)

What is the role of leukotrienes in the COX pathway (2)

A

TXA2:
Platelet activity

Prostaglandins:
Protection of GI mucosa
Pain
Fever
Inflammation

Leukotrienes:
Inflammation
Gastric lesion formation

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11
Q

What is the chemical name for paracetamol

What is its mechanism of action

What are its properties

What are its indications

What are its contraindications

Dose

A

Acetaminophen

Non selective weak inhibitor of COX1 and COX2, inhibits prostaglandins, penetrates blood brain barrier to block COX3 to give anti pyretic effect

Good bioavailability, metabolised in liver by conjugation with glucaronic acid and sulphuric acid, has hepatoxic metabolites, no anti platelet action, safe with NSAIDs

OTC drug for mild pain up to 5 days, anti pyretic, safe for children and pregnant women

Can lead to dependance

1-2 500mg tablets taken at 4 hr intervals max 4g daily

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12
Q

What is the chemical name for ibuprofen

What is its mechanism of action

What are its properties

What are its indications

What are its contraindications

Dose

A

Propionic acid

Non selective reversable cox1 and cox2 inhibitor

Peripheral and central effects

OTC drug for mild moderate pain up to 5 days, anti pyretic, safe for children over 3 months

Can cause GI bleeding, not recommended for pregnant or breastfeeding women or asthmatics, can cause peptic ulcers

1 400mg tablet 4 times a day after food maximum 2.4g daily

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13
Q

What is the chemical name for aspirin

What is its mechanism of action

What are its properties

What are its indications

What are its contraindications

Dose

A

Acetylsalicylic acid

Irreversible non selective COX inhibitor, it is a prodrug that is converted to salicylate in the stomach

Works centrally and peripherally

OTC drug for acute mild moderate pain, anti thrombotic drug

More potent effect on platelet aggregation, can cause gastric irritation and bleeding, cannot be used under 12, disrupts electrolyte balance, can cause peptic ulcers, not recommended for asthmatics, cant be used with warfarin/heparin/antihypertensive drugs/alcohol

High dose (anti inflammatory and anti pyretic)- 2 300mg tablets 4 times a day after food with 4 hour intervals
Low dose (anti thrombotic)- 75-300mg daily
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14
Q

What is the chemical name for naproxen

What is its mechanism of action

What are its properties

What are its indications

What are its contraindications

Dose

A

Tiaprofenic acid

Non selective reversible COX1 and COX2 inhibitor

Works centrally and peripherally

Prescription only drug for short term moderate acute pain, rheamatic disease, gout

Liver toxicity, GIT irritation

Initially 500mg then 250mg every 6-8hrs maximum dose 1.25g daily

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15
Q

What is the chemical name for diclofenac

What is its mechanism of action

What are its properties

What are its indications

What are its contraindications

Dose

A

Phenylacetic acid

Non selective COX 1 and COX 2 inhibitor

Works centrally and peripherally

Prescription only drug for short term moderate acute pain, prescribes if patient already taking low dose aspirin

Cannot be used for those with heart disease, cerebrovascular disease, peripheral arterial disease, heart failure. Avoid for pregnant or breastfeeding women, children, patients on oral anticoagulants and those with history of peptic ulcers

One 50mg tablet three times daily maximum 150g day

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16
Q

What is the chemical name for celecoxib

What is its mechanism of action

What are its properties

What are its contraindications

A

Coxib

Selective COX2 inhibitor

Analgesic, anti inflammatory (acts peripherally), fewer GI side effects than NSAIDs

Withdrawn from market due to hypertension, MI and stroke

17
Q

What is the physiology of opioids

What is the reversal agent to opioid overdose

A

Prevent release of substance p by blocking opiote receptors- Mu

They also act on kappa receptors to produce euphoria which can lead to dependence

Naloxone- competitively antagonises Mu (most), Kappa and Delta to displace opioid

18
Q

What is the recommended analgesics for dental pain

A

For mild pain
1000g paracetamol 4 times daily or 400mg ibuprofen 3 times daily

For moderate to severe pain
400-600mg ibuprofen 3-4 times daily and 1000mg paracetamol four times daily

19
Q

What are some of the causes of IBS

A 
Muscle contractions in intestine
Abnormalities in nerves to digestive system
Severe infection or bacterial overgrowth
Stress
Changes in gut microbes
20
Q

What are some oral symptoms of IBS
5

What are the risk factors of IBS
4

A 
Pain dysfunction syndrome
Sore tongue
Atypical facial pain
Bad taste in mouth
Dry mouth - loperamide, dicyclomide

Under 50
Females
Family history
Mental health- anxiety, depression

21
Q

What are the oral manifestations of kidney disease

7

A

Uremic stomatitis- white plaques on buccal mucosa, FOM, tongue causing pain burning and unpleasant taste
Dry mouth
Taste changes
Renal osteodystrophy- increase risk of fracture during dental treatments
Candidiasis
Mucosal lesions
PD disease

22
Q

What happens during phase 1 and 2 reactions of drug metabolism in liver

How can use of drugs affect this system
2

What action does grapefruit juice have on the oxygen p450 system

A

Phase 1: addition of molecule to increase/decrease/leave unchanged the action of a drug- oxidation, reduction, hydrolysis
Phase 2: conjugation of drug usually leaving it inactive- glucaronidation, glycosidation, methylation, sulphation, acetylation, conjugation with AA, glutathione conjugation

The repeated use of some drugs can increase activity of system through up regulation, this reduces effect of drugs
Other drugs inhibit the system so limit breakdown of other drugs, this increases there effect

Grapefruit juice inhibits cytochrome p450 , this increases bioavailability of some drugs

23
Q

What are the mechanisms of drug excretion in the kidneys

3

A

Glomerular filtration: small molecules less than 300 molecular weight pass freely through glomerular membranes- eg insulin, creatine

Active tubular secretion: carrier mediated transport system within proximal renal tubule in which drug is moved against its conc gradient- eg penicillin, morphine, diuretics

Tubular reabsorption: passive process occurring along entire nephron but mostly in distal renal tubule- drugs with high lipid solubility more readily absorbed

24
Q

What are the main hepatic changes with age in relation to drug metabolism
3

What are the pharmacological implications of these
3

A

Reduced function with age
Reduced amount of p450 enzymes
Decreased hepatic blood flow

Potential for prolonged half lives of drugs leading to enhanced effects
Potential for adverse effects of drug drug interactions when patients on multiple medications processed by p450
Potential decrease in speed of phase 1 metabolism

25
Q

What are the main renal changes with age in relation to drug metabolism
2

What are the pharmacological implications of these
2

A

Reduction in mass and blood flow
Lower renal clearance and glomerular filtration rate

Potential accumulation of metabolites of drugs leading to toxic side effects
Decreased creatine clearance

Dentistry Year 2 Term 2 (4 decks)

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