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HUMAN DISEASE MOD 5 > MEDICINE RELEVANT TO DENTISTRY > Flashcards

MEDICINE RELEVANT TO DENTISTRY Flashcards

1
Q

Clinical features of anaemia

A

general fatigue
heart failure
angina
pallor
brittle nails
oral discomfort/ ulceration
glossitis
angular cheillitis

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2
Q

types of anaemia

A

microcytic
normocytic
macrocytic

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3
Q

drugs for iron deficiency

A

ferrous sulfate 200mg

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4
Q

pernicious anaemia

A

deficit in intrinsic factor

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5
Q

macrocytic anaemia causes

A

low vit B12
low folate

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6
Q

causes of vitb12 deficiency

A

alcohol abuse
small gut disease
chronic exposure to nitrous oxide

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7
Q

causes of low folate

A

dietary
coeliac/ skin disease
drugs - phenytoin, methotrexate

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8
Q

normocytic anaemia causes

A

chronic disease
pregnancy
acute blood loss

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9
Q

microcytic anaemia causes

A

iron deficiency through chronic blood loss (menstrual or GI), diet.

thalassaemia

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10
Q

a neoplastic proliferation of white blood cells which account for 50% of childhood malignancy

A

leukaemia

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11
Q

leukaemia oral presentation

A

gingival hypertrophy
bleeding

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12
Q

solid tumours arising in lymphoid tissue

A

lymphomas

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13
Q

lymphoma classifications

A

hodgkins
non hodgkins

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14
Q

what must be avoided, as a dental practitioner, in pts with haematological malignancy, anaemia and bleeding disorders?

A

aspirin
NSAIDs
IM injections

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15
Q

what local measures would you use for a pt with a bleeding disorder post xLA?

A

tranexamic acid
platelet transfusion

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16
Q

causes of coagulation disorders

A

hemophilia’s
anticoagulants
liver disease
von williebrands disease

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17
Q

factor VIII deficiency

A

haemophillia A - clotting disorder

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18
Q

factor IX deficiency

A

haemophilia B - clotting disorder

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19
Q

combined platelet and factor VIII disorder

A

von williebrands disease

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20
Q

common oral symptom of von williebrands disease

A

mucosal purpuras

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21
Q

warfarin

A

oral anticoagulant

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22
Q

what is hypertension

A

a consistently raised BP

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23
Q

hypertensive reading

A

140/90

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24
Q

what is hypertension a risk factor for?

A

ischaemic heart disease
cerebrovascular accidents
renal failure

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25
Q

what is the term used to describe hypertension that doesnt have a definable cause?

A

essential hypertension

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26
Q

what diseases are risk factors for hypertension?

A

renal dysfunction
endocrine disorders

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27
Q

define ischaemic heart disease

A

decrease in blood supply to a part of the heart due to the narrowing of coronary arteries, usually by atheroma

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28
Q

what pain presents with IHD

A

pain of angina pectoris

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29
Q

how does MI progress from ischaemic heart disease

A

if myocardial cells die as a result of iaschaemia

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30
Q

what is the principal sign of left heart failure

A

breathlessness

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31
Q

define a collapse of peripheral circulation due to a sudden decrease in circulating volume

A

hypovolaemic shock

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32
Q

what investigation can differentiate heart murmurs from being functional or significant of structural disorders

A

echocardiography

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33
Q

why are heart murmurs of great relevance to dentists

A

their presence warms of the potential colonisation of damaged valves by blood-borne bacteria - bacteraemia can be caused by dental procedures

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34
Q

are patients with PMH of rheumatic fever at risk of cardiovascular disease?

A

yes - they are likely to have damage to a heart valve, usually mitral

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35
Q

what dental procedures should be avoided for pts with compromised CV systems?

A

avoid GA, especially within 3 months of an MI
use adequate LA with sedation if necessary
avoid excessive adrenaline loads

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36
Q

pts at risk of bacteraemia?

A

heart transplant recipients
prosthetic valves
valvular damage
Hx of IE

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37
Q

what is dyspnoea?

A

breathlessness

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38
Q

what is haemoptysis?

A

coughing of blood

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39
Q

what respiratory symptom mandates that malignancy be excluded?

A

haemoptysis

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40
Q

drug of choice for streptococcal sore throat?

A

penicillin

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41
Q

what antibiotics must be avoided when treating a sore throat?

A

amoxicillin and ampicillin

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42
Q

what upper respiratory tract infection is an emergency?

A

epiglottitis

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43
Q

give examples of upper respiratory tract infections?

A

common cold
sinusitis
pharyngitis/ tonsilitis
laryngotracheitis
acute epiglossitis

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44
Q

the cause of COPD?

A

a combination of bronchitis and emphysema

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45
Q

what is the prime risk factor of COPD?

A

smoking

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46
Q

term for reversible bronchocontriction?

A

asthma

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47
Q

what drug may precipitate asthma?

A

NSAIDS
allergy to penicillin and aspirin

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48
Q

an inherited disorder in which viscosity of mucus is increased

A

cystic fibrosis

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49
Q

what do pts with CF experience?

A

pancreatic exocrine insufficiency
recurrent chest infections

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50
Q

an industrial disease caused by asbestos exposure?

A

mesothelioma

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51
Q

what dental procedures must be avoided in the presence of respiratory disease?

A

GA
sedatives and analgesics (opiods) decrease resp drive
NSAIDs exacerbate asthma

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52
Q

how is dysphagia investigated?

A

CXR
barium swallow
endoscopy

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53
Q

what is a common cause of dyspepsia, sore throat, cough and bad taste?

A

reflux oesophagitis

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54
Q

what bacteria cause PUD?

A

helicobacter pylori

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55
Q

other than H.pylori, what are other causes of PUD?

A

stress ulceration in critically ill or major surgical pts
elderly pts on NSAIDs

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56
Q

what is dyspepsia

A

indigestion

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57
Q

what drug is used to clear non malignant PUD? and what drug is used to maintain?

A

1 month of omeprazole 10-20mg (PPI)
ranitidine or cimetidine (H2 antagonist)

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58
Q

name 2 diseases of the small bowel?

A

coeliac
Crohn’s

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59
Q

what is coeliac disease?

A

hypersensitivity to gluten

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60
Q

oral symptoms of coeliac disease?

A

cobblestone mucosa

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61
Q

what area of the GI tract has crohns disease got a preference for?

A

ileo-caecal area

62
Q

a chronic granulomatous disease affecting the full thickness of the mucosa?

A

Crohn’s disease

63
Q

where does ulcerative colitis affect?

A

colorectum only

64
Q

treatment for small bowel disease i.e., Crohn’s

A

systemic steroids
immunosuppressants

65
Q

how may colonic cancer present?

A

rectal bleeding
change in bowel habit
intestinal obstruction
abdominal pain
anaemia

66
Q

what bacteria is associated with gardener syndrome (large bowel disease)?

A

familial polyposis coli

67
Q

cause of antibiotic induced colitis?

A

overgrowth of toxigenic C.difficile after use of ampicillin and clindamycin

68
Q

what organ has the worst prognosis when malignant?

A

pancreas

69
Q

what is the main cause of acute pancreatitis?

A

alcohol abuse

70
Q

main problems presented by liver disease

A

increase risk of bleeding
inability to metabolise and excrete drugs
Hep B.C.D transmission

71
Q

the prime symptom of liver disease?

A

jaundice

72
Q

jaundice cause?

A

inability of liver to process bilirubin (the breakdown product of haemoglibin) which occurs by either:
1. haemolytic anaemia
2. cholestatic jaundice

73
Q

dental implications for pt with liver diease?

A

do not administer GA
caution with LA and drug prescribing
additional local bleeding precautions

74
Q

a syndrome of proteinuria, hypoalbuminaemia, and generalised oedema?

A

nephrotic syndrome

75
Q

what symptom is prominent in nephrotic syndrome?

A

facial oedema

76
Q

what is the major precipitant of nephrotic syndrome?

A

glomerulonephritis

77
Q

a medical emergency causing a rapid rise in creatinine, urea, and potassium?

A

acute renal failure/ kidney injury

78
Q

marker of acute renal failure?

A

inability to pass urine

79
Q

treatment of chronic renal failure?

A

peritoneal dialysis
haemodialysis
transplants

80
Q

main problems relevant to dentistry for a pt with renal disease

A

increase risk of infection
increase bleeding tendancy
decrease ability to excrete drugs
potential carriage of hep B HIV

81
Q

in a pt with renal disease, what causes bone lesions of the jaws

A

hyperparathyroidism

82
Q

addisons disease aetiology

A

atrophy of adrenal cortices = failure of cortisol and aldosterone secretion

83
Q

Conn syndrome aetiology

A

hyperaldosteronism
*causing hypertension

84
Q

cushings syndrome aetiology

A

excess cortisol (corticosteroid) production and adrenal hyperplasia due to increase ACTH

85
Q

classical features of cushings syndrome?

A

obesity (moon face and buffalo bump)
osteoporosis
skin thinning
hypertension

86
Q

define diabetes insipidus

A

production of too much dilute urine due to a decrease in diuretic hormone secretion

87
Q

define diabetes mellitus

A

persistent hyperglycaemia due insulin deficiency

88
Q

acromegaly aetiology

A

excess production of growth hormone

89
Q

what is a goitre?

A

a large thyroid gland

90
Q

symptoms and signs of hyperthyroidism?

A

symptoms:
heat intolerance
weight loss
sweating
signs:
tachycardia
lid lag
tremor

91
Q

commonest cause of hyperthyroidism

A

graves disease

92
Q

causes of hypothyroidism?

A

thyroid disease
hypothalamic/ pituitary dysfunction

93
Q

signs and symptoms of hypothyroidism?

A

symptoms:
poor tolerance to cold
hair loss
weight gain
loss of appetite
poor memory

signs:
bradycardia
hoarse voice

94
Q

a rare tumour of the adrenal medulla, secreting adrenaline and noradrenaline?

A

phaeochromocytoma

95
Q

phaeochromocytoma symptoms?

A

palpitations
headache with sweating
simultaneous hypertension

96
Q

main symptom of pituitary tumours? and why

A

blindness as they may erode the pituitary fossa and cause optic chiasma compression

97
Q

when is it best to treat a pregnant woman?

A

2nd trimester

98
Q

what is MEN 2b?

A

medullary thyroid cancer
phaeochromocytoma
oral mucosal neuromas

99
Q

what type of disorder is osteogenensis imperfecta?

A

autosomal dominant type 1 collagen defect

100
Q

osteogenesis imperfecta symptoms?

A

blue sclera
deafness
dentinogenesis imperfecta

101
Q

failure of bone mineralisation?

A

rickets/ osteomalacia

102
Q

causes of rickets/ osteomalacia?

A

vitD deficiency

103
Q

a lack of bone matrix and mineralisation?

A

osteoporosis

104
Q

causes of osteoporosis?

A

steroid therapy
post-menopausal hormone changes
immobilisation
endocrine abnormalities

105
Q

treatment to prevent osteoporosis in post menopausal women?

A

HRT

106
Q

osteoporosis treatment drugs

A

bisphosphonates

107
Q

what is Pagets disease of bone?

A

common disorder of the elderly, where normal bone is replaced by chaotic structure of new bone, causing enlargement and deformity

108
Q

Pagets disease treatment?

A

bisphosphonates

109
Q

What is polymyalgia rheumatica?

A

vasculitis affecting proximal axial muscles - shoulders, neck and hips

110
Q

polymyalgia rheumatica tx

A

steroids

111
Q

degeneration of articular cartilage?

A

osteoarthritis

112
Q

commonly affected joints with osteoarthritis?

A

knees, hips and lumbar spine

113
Q

immunologically mediated disease where joint pain and damage are symptoms?

A

rheumatoid arthritis

114
Q

rheumatoid arthritis symptoms

A

symmetrical morning pain and stiffness in hands and feet
may be systemic upset and anaemia
ulnar deviation of fingers

115
Q

RA treatment?

A

NSAIDS
steroids
physiotherapy
DMARDS (at expense of unwanted effects)

116
Q

what disease is an outcome of RA?

A

secondary sjogrens syndrome

117
Q

define gout

A

urates deposited in joints, causing sudden severe joint pain often in the great toe

118
Q

what causes gout?

A

drug abuse
radiotherapy
haematological disease

119
Q

what joint disease affects the spine and is usually seen in young men?

A

ankylosing spondylitis

120
Q

what gene is ank spond associated with?

A

HLA-B27

121
Q

What is Reiters syndrome?

A

seronegative arthritis, urethritis, and conjunctivitis in response to an infection

122
Q

an indolent skin cancer which very rarely metastasises?

A

basal cell carcinoma

123
Q

basal cell carcinoma aetiology? and appearance

A

sun exposure
ulcerated nodule with raised pearly margins and a telangiectatic surface

124
Q

most aggressive site for SCC

A

external ear

125
Q

SCC of skin presentation

A

ulcerated lesion with raised edges, keratin horns

may present in areas of previous sun exposure or in gravitational leg ulcers

126
Q

what is the prognosis of a malignant melanoma dependant of?

A

thickness of lesion

127
Q

malignant melanoma aetiology?

A

sun exposure

128
Q

what is bowens disease and presentation?

A

carcinoma in situ which presents as scaly, red plaque

bascially a SCC which hasnt penetrated the basal layer

129
Q

actinic keratosis

A

persistently sun damaged areas of skin in which cancer may arise

130
Q

kaposi sarcoma presentation

A

purple, vascular, malignant tumour seen in AIDS

131
Q

a common relapsing proliferative inflammatory skin disease

A

psoriasis

132
Q

psoriasis presentation

A

red plaque with silvery scale, on knees and elbows

133
Q

psoriasis tx

A

topical steroids

134
Q

what is also known as dermatitis

A

eczema

135
Q

when does atopic eczema show and what is its presentation?

A

first year of life
red symmetrical scaly rash

136
Q

what triggers exogenous eczema? where does it present and what does it look like?

A

irritants
presents on the hands
blistering, erythema, crackling of skin

137
Q

what causes allergic contact eczema?

A

genuine allergic response

137
Q

what is seborrhoeic eczema?

A

fungal infection mainly affecting the scalp (‘cradle cap’) in babies

138
Q

what is erysipelas?

A

streptococcal cellulitis

139
Q

list skin infections caused by viruses

A

herpes zoster
herpes simplex
molluscum contagiosum
warts

140
Q

what characterises acne vulgaris? and what is it?

A

blackhead (comedone)
inflammatory condition caused by increased sebum secretion due to hormones

tends to scar

141
Q

what does dermatitis herpetiformis present as and what is it associated with?

A

vesicular rash of knees, elbows and scalp
associated with coeliac disease

142
Q

what is the condition with the highest profile among immunocompromised pts?

A

AIDS

143
Q

List drugs that suppress the immune system

A

corticosteroids
ciclosporin
azathioprine
cytotoxics

144
Q

common congenital immunodeficiency state

A

IgA deficiency

145
Q

what levels control AIDS development?

A

CD4 levels

146
Q

AIDS tx

A

HAART

147
Q

list oral manifestations of AIDS

A

candidiasis
hairy leukoplakia
HIV gingivitis
NUG
HIV periodontitis
Kaposi sarcoma

148
Q

hairy leukoplakia presentation and tx

A

bilateral, white non removable, corrugated lesions of the tongue

tx - aciclovir or valaciclovir

149
Q

hairy leukoplakia associations and indications

A

associated with EBV and HIV
indicated development of lymphoma

150
Q

what is the name of lesions caused by septic emboli?

A

janeway lesions

151
Q

what are septic emboli?

A

little infective clots from the infected endocardium that work towards periphery and lodge themselves

HUMAN DISEASE MOD 5 (54 decks)

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