Influence of Diet & Gastro-intestinal Disease on the Oral Mucosa Flashcards

1
Q

What is the normal epithelial turn over for the buccal mucosa compared to skin?

A

25 days

Much faster than skin which is 50-70 days

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2
Q

In terms of blood levels what may you expect to see in patient with repeated vommiting?

A

Hypokalaemia (reduced potassium levels) observed in FBC

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3
Q

Haematinic deficiencies can lead to sensitivity of filiform papillae, what may a patient complain of orally as a result of this?

A

Soreness
Reduced taste sensation
Ulceration of the tongue
Candidiasis

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4
Q

What oropharyngeal conditions are associated with haematinic deficiencies?

A
  • Glossitis
  • Angular cheilitis + candidosis
  • Recurrent oral ulceration
  • Burning mouth
  • Plummer-Vinson syndrome (web-like growth of membranes in the throat that makes swallowing difficult)
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5
Q

What may result in a patient with Protein energy malnutrition (PEM)?

What may you expect to see in the blood and saliva?

A

Impairment of both nonspecific and specific immunity

Increased blood + saliva levels of free corticosteroids

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6
Q

What is Bulimia Nervosa?

A

Repeated bouts of overeating where patient then purposely vommits or takes laxatives to counteract weight gain

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7
Q

What are some intra-oral features of zinc deficiencies?

A
  • Hypogeusia (reduced taste)
  • Angular cheilitis
  • Superficial aphthous-like ulcers
  • Candidal superinfection
  • Delayed wound healing

Think zn=old people

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8
Q

What are some non-specific lesions of Crohn’s disease?

Non-specific as related to low haematinics

A
  • Recurrent Oral Ulcers / RAS
  • Angular cheilitis
  • Glossitis
  • Persistent submandibular lymphadenopathy
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9
Q

What are zinc dependant enzymes important for? (3)

A

Gene expression
Hormonal function
Cell mediated immunity

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10
Q

What are some specific lesions of Crohn’s disease?

(actually caused by Crohn’s)

A
  • Indurated tag-like mucosal lesions
  • “Cobblestone” mucosa
  • Mucogingivitis
  • Lip swelling
  • Deep linear ulceration
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11
Q

What are some extra-oral features of zinc deficiencies?

A
  • Bullous pemphigoid *
  • Alopecia
  • Diarrhoea
  • Growth retardation
  • Lethargy/depression

*rare skin condition that causes large, fluid-filled blisters

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12
Q

What are some oral features of coeliac disease?

A

Dental Hypoplasia *
Recurrent Oral Ulceration (ROU)
Glossitis
Burning Mouth
Angular Cheilitis
Lichen Planus

*enamel defects

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13
Q

What are oral features of bulimia nervosa?

A
  • Sialodenosis (SG swelling)
  • Dental erosion
  • Ulcers on the soft palate
  • Angular cheilitis (from haematinic deficiencies)
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14
Q

What are some oral features of alcoholism?

A

Sialadenosis (swollen parotid salivary glands)
Dental erosion (palatally, secondary to acid reflux)
Oral Squamous Cell Carcinoma
Signs of liver cirrhosis (e.g. easy bruising or jaundice)

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15
Q

What is glossitis?

What are the two types you may see what deficiences cause these?

A

Inflammation of the tongue

  • Smooth depapillated (iron deficiency)
  • Raw, beefy-red (vitamin B12 and folate deficiencies)
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16
Q

A patient has mild Iron, B12 or Folate deficiency. What may you expect to see orally?

A

Generalised oral epithelial atrophy & depapillation of dorsum of tongue

Atrophy = Tissue wastage

17
Q

A patient presents with a smooth tongue what could be two possible causes of this?

A

Haematinic deficiencies (iron, B12, folate)
Candidiasis

Haematinic deficiences cause depapilation of the tongue

18
Q

What is a Haematinic?

A

Nutrient required for the formation of blood cells
The main hematinics are iron, B12, and folate

The process of hematopoiesis

19
Q

A patient has vitmamin C deficiency what may you initially see extra-orally and later see intra-orally?

A

Initially
Enlargement & keratosis of hair follicles (Cork-screw hairs)

Later (weeks)
Blood vessel proliferation around hair follicles & interdental papillae
Which leads to Gingival hyperplasia & haemorrhage

20
Q

What are some extra-oral clinical features of Coeliac Disease?

A
  • Malabsorption - Fatigue & Anaemia
  • Chronic diarrhoea
  • Weight loss
  • Abdominal distension (swollen abdomen)
21
Q

What is Oro-Facial Granulomatosis

What condition is this oral manifestation linked with?

A

Predominantly labial swelling associated with granulomatous inflammation

May precede GIT manifestation of Crohn’s (early diagnosis)

22
Q

What is Plummer-Vinson syndrome?

A

Rare disease characterised by
- Dysphagia (difficulty swallowing)
- Post-Cricoid web (Mechanical Block of throat)
- Iron-deficiency anaemia
- Glossitis

People with this have an increased chance of esophageal cancer

23
Q

What vitamin is an essential co-factor in collagen synthesis?

A

Vitamin C

24
Q

Integrity of oral mucosa is dependent on complex interplay of what 3 factors?

A

Nutritional
Metabolic
Hormonal

25
Q

What is Crohn’s Disease?

A

Chronic inflammatory bowel disease affecting whole GIT
Discontinuous pattern of transmural inflammation

26
Q

What is the normal epethelial turn over for skin?

A

50-70 days

27
Q

What is the normal epithelial turn over for the buccal mucosa?

A

25 days

Much faster than skin which is 50-70 days