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Non-neoplastic Disorders Of The Salivary Glandi Flashcards

1
Q

What are the non-neoplastic disorders of the salivary glands?

A
  • mumps (viral parotitis)
  • acute suppurative parotitis
  • chronic recurrent sialadenitis
  • sialectasis
  • salivary calculi
  • sjogren syndrome (sicca syndrome)
  • sialometaplasia
  • sialadenosis
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2
Q

What is the causative agent for mumps?

A

Paramyxovirus

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3
Q

How is paramyxovirus transmitted?

A

By droplet infection & fomites

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4
Q

What is the incubation period for mumps?

A

2-3 weeks

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5
Q

How long is the infective period in mumps?

A

Prior to onset of symptoms & remains 7-10 days post parotid swelling regression

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6
Q

What is the C/F of mumps/viral parotitis?

A
  • fever, malaise, anorexia, muscular pain
  • unilateral parotid swelling (subsides in 1 wk)
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7
Q

How is mumps/viral parotitis diagnosed in the 1st week?

A

Increase in serum & urinary amylase

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8
Q

When is IgM and IgG measured in mumps/viral parotitis?

A

ASAP & 10-14 days of illness

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9
Q

What does presence of IgG indicates in mumps/viral parotitis?

A

Past exposure & immunity

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10
Q

What does >4x raise in IgG indicate in mumps/viral parotitis?

A

Recent infection

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11
Q

What does presence of IgM indicate in mumps/viral parotitis?

A

Recent infection

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12
Q

What is the treatment for mumps?

A

Parotitis - hydration, rest, analgesics, cold/hot compression over parotid

Orchitis - cold compression, support to scrotum, analgesic

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13
Q

How is mumps/viral parotitis prevented?

A

MMR vaccine to be done at 15 month

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14
Q

What are the complications of mumps/viral parotitis?

A
  • ophritis, pancreatitis, myocarditis, nephritis
  • aseptic meningitis, meningoencephalitis
  • unilateral sensorineural hearing loss
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15
Q

Acute suppurative parotitis is seen in which type of people?

A

Elderly
Debilitated
Dehydrated patients

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16
Q

What is the predisposing factor for acute suppurative parotitis?

A

Dry mouth

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17
Q

What are the causative organisms in acute suppurative parotitis?

A

S aureus
Gram +ve, anaerobic bacteria

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18
Q

What is the route of transmission in acute suppurative parotitis?

A

Mouth through stensen’s duct

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19
Q

What are the C/F of acute suppurative parotitis?

A
  • sudden onset with severe pain
  • enlarged gland
  • opening of stensen duct is swollen & erythematous with discharging pus
  • fever
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20
Q

What are the investigation done in acute suppurative parotitis?

A
  • leukocytosis
  • culture of blood/pus
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21
Q

What is the treatment for acute suppurative parotitis?

A

IV antibiotics
Adequate hydration
Oral hygiene
Surgical drainage (if fever not subsided with progressive induration of gland)

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22
Q

Which gland is usually involved in chronic recurrent sialadenitis?

A

Parotid gland with recurrent bacterial infection

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23
Q

What are the C/F of chronic recurrent sialadenitis?

A

Acute exacerbation = enlarged & tender gland, pus from duct

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24
Q

What is the investigations done in chronic recurrent sialadenitis?

A
  • pus culture = staphylococci/streptococci
  • sialography = normal duct system
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25
What is the treatment for chronic recurrent sialadenitis?
- maintain good oral hygiene - avoid drugs which dry oral mucosa - sialogogue to promote salivation
26
What are the drugs that dry the oral mucosa?
1. Anticholinergic = atropine, hyoscine, ipratropium 2. Antihistamine
27
What is the pathogenesis of sialoectasis?
Dilatation of duct system -> stasis of secretion -> infection
28
What’s the significance of sialography in sialoectasis?
- to differentiate from chronic recurrent sialadenitis - shows different degree of dilatation = punctuate, globular, cavitary
29
What conditions are associated with sialectasis?
- granulomatous disease - autoimmune disease (sjogren’s syndrome)
30
What are the different stages of sialectasis?
1. Punctate is < 1mm in size 2. Globular is 1-2 mm in size, uniform in shape 3. Cavitary is > 2mm in size, irregular in shape
31
What glands are involved in TB infection?
Parotid & submandibular glands (children & adult)
32
What is the mode of transmission in TB infection of glands?
Via parotid duct from oral cavity Spreads from primary lesion into lungs
33
What is the C/F of TB infection of glands?
- acute parotid sialadenitis/long standing parotid mass (mimics tumor) - skin changes or fistulae seen
34
What is the diagnosis for TB infection of glands?
PPD skin test FNAC/biopsy Culture +ve for acid fast bacilli Chest X-ray
35
What is the C/F of actinomycosis of glands?
- parotid swelling/fistulae of skin - sulphur granules discharge
36
What is the investigation done for actinomycosis of glands?
Gram staining = non-acid fast gram +ve organism
37
What is the treatment for actinomycosis of glands?
Penicillin Erythromycin Tetracycline
38
What is the C/F of toxoplasmosis of gland?
Isolated lymphadenopathy
39
What is the investigation done for toxoplasmosis of gland?
- Serology of acute & convalescent phase sera - lymph node biopsy
40
What is the treatment for toxoplasmosis of gland?
Self-limiting - required in immunocompromised & pregnant women with Pyrimethamine
41
Sarcoidosis of parotid is characterized by?
- fever - enlargement of parotid & lacrimal glands - chorioretinitis - cranial nerves palsies
42
What is sialolithiasis?
Formation of calculi in ducts of submandibular (90%) or parotid glands (10%) due to deposition of calcium phosphate on organic matrix of mucin/cellular debris
43
What is the C/F of sialolithiasis?
- intermittent swelling of glands - pain due to obstruction of glands - stone visible at duct opening/palpated intraorally
44
What are the investigations done for sialolithiasis?
- x-ray of face (as 80% stones are radio-opaque) - sialography - contrast sialography, USG, magnetic resonance sialography - sialoendoscopy (diagnostic & therapeutic)
45
What is the treatment for sialolithiasis?
If at peripherally = removed intraorally If in hilum/parenchyma = excision of gland
46
Primary sjogren syndrome is also called as?
- benign lymphoepithelial lesion - mikulicz’s disease
47
What is the C/F of primary sjogren syndrome?
- xerostomia (salivary gland involved) - xerophthalmia (lacrimal gland involved)
48
What are the 3 major components of secondary sjogren syndrome?
1. Keratoconjunctivitis sicca 2. Xerostomia 3. Autoimmmune connective tissue disorder (SLE, RA)
49
What is the histopathological findings in secondary sjogren syndrome?
Destruction of acini Lymphocytic infiltration
50
Which areas are mostly involved in sialometaplasia?
Minor salivary glands in the palate
51
What are the C/F of sialometaplasia?
- swelling - ulcerated lesion
52
What is the histopathological findings in sialometaplasia?
Destruction of acini with squamous metaplasia (pseudoepitheliomatous hyperplasia)
53
What are the investigation done for sialometaplasia?
Biopsy to differentiate it from squamous cell or mucoepidermoid carcinoma
54
What is the treatment for sialometaplasia?
Lesion of sialometaplasia heal spontaneously in 5-6 wks
55
What is are the C/F of sialadenosis?
- bilateral enlargement of parotid glands
56
What is the histological findings in sialadenosis?
Hypertrophy of acinar cells 2x or 3x the normal size
57
What are the predisposing factors of sialadenosis?
- DM, alcoholism, malnutrition, obesity, prolonged intake of anticholinergic drugs
58
What are the investigations done for sialadenosis?
- fine needle aspiration - biopsy of gland
59
What is the chronic condition of sialadenosis?
Acini undergoes degeneration & replacement with fatty tissues -> xerostomia
60
What is the treatment for sialadenosis?
- artificial saliva - sialogogues

ENT (18 decks)

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