Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

4th yr- CMS- The Oral Cavity > Inflammatory mucosal disease > Flashcards

Inflammatory mucosal disease Flashcards

You may prefer our related Brainscape-certified flashcards:
Introductory Sommelier Exam (CMS) flashcards
1
Q

Name soem inflammatory mucosal diseases

A
  1. Oral lichen Planus
  2. Vesiculobullous disorders
  3. Behçet’s disease
  4. Mucositis
  5. SLE/DLE
  6. Plasma cell mucositis/ gingivitis
  7. Dermatitis herpetiformis
  8. Graft versus Host Disease
  9. Paraneoplastic pemphigus
    10 Erythema Multiforme Minor
  10. Steven Johnson’s Syndrome aka Erythema Multiforme Major
    12, Toxic Epidermal Necrolysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is oral lichen planus

A

An inflammatory mucocutaneous disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How common is oral lichen planus

A

Common it affects 1-1.5% of the population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is oral lichen planus caused by

A

Auto reactive T lymphocytes that attack the skin and mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the trigger for oral lichen planus

A

There is no trigger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is it called if there is a trigger causing oral lichen planus

A

An oral lichenoid reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Name the different subtypes of oral lichen planus

A
  1. Plaque like
  2. Papular
  3. Erosive
  4. Bullous
  5. Ulcerative
  6. Desquamative gingivitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe how oral lichen planus lesions appear clinically

A
  1. Bilateral
  2. Symmetrical
  3. May involve gingivae or skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe how oral lichenoid reaction appear clinically

A
  1. Unilateral
  2. Asymmetrical
  3. Don’t involve gingiva or skin
  4. Closely related to a case eg large amalgam filling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What questions do we need to ask when taking a clinical history of oral lichen planus or oral lichenous reactions

A
  1. Is it symptomatic
  2. Does food or toothpaste irritate
  3. Which sites are affected
  4. Are there any clear trigger eg new medication
  5. Do you smoke
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

List some anti-hypertensive drug that can trigger oral lichenoid reactions

A
  1. Captopril
  2. Labetalol
  3. Methyldopa
  4. Thiazides
  5. Propranolol
  6. Tolbutamide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

List some anti-inflammatories drug that can trigger oral lichenoid reactions

A
  1. Chloroquine
  2. Dapsone
  3. Mepacrine
  4. NSAIDs
  5. Para-aminosalicylate
  6. Penicillamine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

List a anti-coagulants drug that can trigger oral lichenoid reactions

A

Dipyridamole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Give examples of drugs used in diabetes treatment that can trigger oral lichenoid reactions

A
  1. Chloropropamide

2. Metformin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Give examples of Psychoactive drugs that can trigger oral lichenoid reactions

A

Lithium

Phenothiazines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Name some antimicrobials that can trigger oral lichenoid reactions

A

Griseofulvin
Metronidazole
Streptomycin
Tetracycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

List some anti-malarial drug that can trigger oral lichenoid reactions

A

Quinidine

Quinine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When should we be concerned of a oral lichenoid reactions or oral lichen planus

A
  1. It is a high risk site
  2. High risk lifestyle eg smoker, drinker
  3. Has medication or dental material triggered it
  4. Any indicated medical condition
  5. Was there a rapid/ severe pattern to the onset
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Name some sites that can be high risk if affected by ral lichenoid reactions or oral lichen planus

A
  1. Lateral / base of tinge e

2. Floor of the mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Is oral lichen planus chronic or acute

A

Chronic it can last a lifetime

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Does oral lichen planus have the potential to be malignant

A

After a decade of having oral lichen planus the risk or oral cancer is 1 in 100

22
Q

What must we advice a patietn with oral lichen planus

A
  1. Smoking cessation
  2. Alcohol moderation
  3. Help patient self assess and self examine
23
Q

How do we manage symptomatic oral lichen planus

A
  1. Dietary advice to avoid triggering food
  2. Avoid SLS in toothpaste
  3. 0.15% benzydamine hydrochloride (“Difflam”) oromucosal spray or mouthwash - a topical anaesthetic agent
  4. Gelclair or “Gengigel” (coating agent)
  5. Smoking cessation and alcohol reduction advice
  6. Topical corticosteroid prescription
  7. Intralesional steroid injections
  8. Systemic immunomodulatory drugs
24
Q

What is Difflam

A

A topical anaesthetic agent

25
Q

Give examples of Topical corticosteroid prescription fro oral lichen planus

A

betamethasone 500 micrograms to be dissolved in 10mls water and held in the mouth 2-3 minutes then spat out QDS (aka “Betnesol”)

26
Q

Why might we use Intralesional steroid injections to manage oral lichen planus

A

solitary erosions or ulcerated patches e.g. triamcinolone acetonide (“Kenalog”)

27
Q

Give examples of systemic immunomodulatory drugs that can be used to manage oral lichen planus

A
  1. Hydroxychloroquine
  2. Azathioprine
    3, Mycophenolate mofetil
28
Q

How can we manage oral lichenoid reaction

A
  1. Remove or treat the underlying cause
  2. Skin patch if dental material is suspected trigger
  3. Remove material under rubber dam
29
Q

What do we aim to achieve if we refer to oral medicine

A
  1. Confirm diagnosis
  2. Take biopsy of tissue diagnosis
  3. Instigate management
  4. Continues prescription and monitoring
30
Q

What are Vesiculobullous disorders

A

Immune driver mucotanous conditions that involve vesicles and bullae formation

31
Q

Name the common Vesiculobullous disorders

A
  1. Mucous Membrane Pemphigoid (MMP)

2. Pemphigus Vulgaris (PV)

32
Q

What type of blistering occurs in Mucous Membrane Pemphigoid

A

Subepithelial blistering

33
Q

What type of blistering occurs in Pemphigus Vulgaris

A

Intra epithelial blistering

34
Q

Describe the cleavage formed in Mucous Membrane Pemphigoid

A

Hemidesmosomal

35
Q

Describe the cleavage formed in Pemphigus Vulgaris

A

Desmosomal

36
Q

What is Mucous Membrane Pemphigoid caused by

A

IgG, C3 +/- IgA all deposited on the basement membrane zone

37
Q

What is Pemphigus Vulgaris caused by

A

IgG, IgM, IgA, Anti-desmogelin protein and C3 deposited throughout the epithelium in a net like distribution

38
Q

Describe the bullae formed in Mucous Membrane Pemphigoid

A

Tense
Resilient
Haemorrhagic

39
Q

Describe the bullae formed in Pemphigus Vulgaris

A

Very friable
Rarely found intact clinically
Lots of ulcerations and sloughing
irregular borders

40
Q

In whom is Mucous Membrane Pemphigoid more common in

A

Older patents (50-80yr olds)

41
Q

In whom is Pemphigus Vulgaris more common in

A

Younger patients (40 yr olds) or young children

42
Q

What areas can Mucous Membrane Pemphigoid Present at

A

May present purely as a desquamative gingivitis with no other oral sites affected

43
Q

What areas can Pemphigus Vulgaris present at

A

Usually presents in a more dramatic fashion and can cover all of the oral mucosa and extend down the throat

44
Q

What do we want to find out when taking a history of a Vesiculobullous disorders

A
  1. Speed of onset
  2. Sites in the mouth affected
  3. Are extra oral sites affected
  4. Is patient able to eat and drink normally
  5. Symptoms and how are they affecting patient
45
Q

What can Paraneoplastic pemphigus be a presentation of

A

Occult malignancy

46
Q

What does Erythema Multiforme affect

A

Various mucosae and cutaneous sites

47
Q

What is Erythema Multiforme triggered by

A

Commonly: Infection or medication

Less commonly: connective tissue disease or foot additives

48
Q

what infection can trigger Erythema Multiforme

A

HSV or mycobacteria

49
Q

what medication can trigger Erythema Multiforme

A

sulphonamide antibiotics,
carbamazepine,
penicillins,
NSAIDs

50
Q

What do we need to consider before managing Erythema Multiforme

A
  1. History
  2. Examination
  3. Patients systemic status
  4. Patients blood
51
Q

How do we treat Erythema Multiforme

A
  1. Supportive measures eg explanations and reassurance
  2. Simple oral hygiene measures
  3. Paracetamol and difflam or pain relief
  4. Chlorhexidene mouthwash
  5. Referral?
    6/ Systemic steroids and maybe antimicrobials
  6. Antiviral medication
  7. Systemic immunosuppression

4th yr- CMS- The Oral Cavity (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions