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Human Diseases > Musculoskeletal disorders dentally related questions > Flashcards

Musculoskeletal disorders dentally related questions Flashcards

1
Q

What is osteoarthritis? and what joints are affected?

A

Inflammation causing joint pain, wearing cartilage that covers and cushions joint
Affecting distal inter-proximal pharyngeal joints

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2
Q

What radiographic changes are seen in osteoarthritis?

A

Scerlosis - whitening
Subchondral bone cysts
Joint space narrowing
Osteophytes - benign outgrowths of bone

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3
Q

How is osteoarthritis managed?

A

Analgesics, NSAID, coxibs with omeprazole, steroid/hyaluronan injections
Quad exercises, <25 BMI, aids/supports
Surgical replacement of knee/hip

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4
Q

What is the ARA criteria for rheumatoid arthritis?

A 
Symmetrical arthritis (every joint except distal inter-pharyngeal joints)
Hand joints 
At least 3 area 
Morning stiffness >60 minutes 
Rheumatoid nodules
Xray changes
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5
Q

What does rheumatoid arthritis look like on a radiograph?

A

Early: Thin black bone, peri-articular erosions
Late: Joint space narrowing, subluxation/dislocation, ankylosis

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6
Q

What extra-articular manifestations are there of rheumatoid arthritis?

A 
Lymphadenopathy
Lung = pleurisy, effusion, fibrosis 
Heart = pericarditis
Muscle atrophy
Vasculitis 
Osteoporosis of the bone
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7
Q

What drugs can be offered for rheumatoid arthritis management?

A

DMARDs –> disease modifying anti-rheumatic drugs, slowing progression not curing, slow action which needs monitoring

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8
Q

What are the triple therapy conventional DMARDs used for rheumatoid arthritis management?

A

Methotrexate
Sulphasalazine
Hydroxychloroquine

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9
Q

In dentistry when a patient is taking biologic therapy drugs, what should you be aware of?

A

Less likely to notice disease symptoms of disease - ‘abscess’

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10
Q

What other systems are affected in ankylosing sponylitis?

A

Iritis and conjunctivitis
Pulmonary fibrosis
Fatigue
Aortic valve disease

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11
Q

What drug treatments can be used in ankylosing spondylitis?

A

NSAIDs/ coxibs
DMARDs - for peripheral arthritis
Anti-TNF drugs for peripheral and spinal disease

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12
Q

What is the moll and wright classification?

A
  1. Distointerpharyngeal joints
  2. Arthritis mutilans
  3. Clinically indistingushable from rheumatoid arthritis
  4. Asymmetrical oligoarthritis
  5. Ankylosing spondylitis
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13
Q

What drug treatment is involved for psoriatic arthritis treatment?

A

Analgesics

DMARDs: arthritis - sulfasalazine, arthritis and psoriasis -methotrexate/anti-TNF

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14
Q

Who is affected by reactive arthritis?

A

Commonly affecting young people

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15
Q

How does reactive arthritis occur?

A

10-14 days after infection:

  • GI: campylobacter, salmonella
  • Urogential - chlamydia
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16
Q

What is reiter’s syndrome?

A

Reactive arthritis + conjuctivitis/urethritis

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17
Q

What is the recurrence rate of reactive arthritis?

A

50%

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18
Q

What is the F:M of sjogrens syndrome?

A

9:1

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19
Q

What are the oral features of sjogrens syndrome? and what can be given to overcome this?

A

Xerostomia

Oral sprays/gels/lozanges

20
Q

What are the 3 LeFort fractures?

A

I –> Palate
II –> Through nasal bridge
III –> Passes through zygomatic bone

21
Q

What is ORIF?

A

Open reduction internal fixation

22
Q

What are the 5P’s of compartment syndrome?

A

Pale, Pulse, Paraesthesia, Pain, Paralysis

23
Q

How much calcium is in the body?

A

1kg

24
Q

What happen in chronic high PTH?

A

Bones deteriorate and release calcium

25
Q

How is calcium transported around the body?

A

1/2 bound to albumin in the blood

1/2 ionised in the blood

26
Q

What scan is used to diagnose osteoporosis

A

DEXA

27
Q

What does a vitamin D deficiency in 1.adults and 2.kids cause?

A
  1. osteomalacia

2. rickets

28
Q

What is paget’s disease?

A

Uncoordinated bony remodelling and disorganised bone turnover in localised areas

29
Q

What treatment is used for paget’s disease and how does it work? give an example.

A

Bisphosphonates by inhibiting osteoclast activity and prevent bone resorption
E.g. alendronate/risedronate orally weekly, can also get other injective treatment quarterly/annually

Can also treated with monoclonal –> Denosumab

30
Q

How does phossy jaw occur?

A

Exposed to phosphorus

31
Q

What is myeloma?

A

Malignancy of plasma cells in bone marrow

32
Q

When a patient presents with blue sclera, what could this be?

A

Impact on collagen formation

33
Q

What to do for an extraction if patient is on 1.IV or 2. oral bisphosphonates?

A
  1. Refer to a specialist

2. Can treat in primary care if bone is stable

34
Q

What is osteopetrosis?

A

Spongy bone not there, all compact bone

Marrow absent, less haematopoiesis = anaemia

35
Q

What is pagets disease of the bone?

A

Periods of bone deposition/resorption - mosaic appearance

36
Q

What do patients complain of to the dentist when they have pagets disease of the bone?

A

Dentures don’t fit due to bone deposition

37
Q

Why do people need to be dentally fit before starting cytokine inhibitor treatment?

A

Affects immune response

38
Q

How long should extractions be avoided for after radiotherapy? and why?

A

6 months to 1 year

Osteoradionecrosis

39
Q

What should be considered when doing an extraction on a patient post radiotherapy?

A

Minimal trauma - small flap for increased blood perfusion
No vasoconstrictor used
Trim sharp bone edges
Prophylaxis 1month/until socket heals

40
Q

What does a marfan’s syndrome palate look like?

A

High arched palate is typical

41
Q

What are the dental abnormalities of cleidocranial dysostosis?

A

Delay/non-eruption or supernumerary teeth

42
Q

How do NSAIDs protect against periodontal disease?

A

Prostaglandin synthesis interference

43
Q

What oral side effects can arise from cox 2 inhibitors?

A

Stomatitis and taste disturbances

44
Q

What oral side effects can arise from the anti-rheumatic drug, penicillamine?

A

Lichenoid reactions

Oral ulceration

45
Q

What oral side effect occurs from allopurinol and what does it treat?

A

Gout treatment

Taste disturbances

46
Q

What is baclofen used for and what oral side effect does it have?

A

Antispasmodic agent

Causing xerostomia

Human Diseases (17 decks)

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