Non-neoplastic Salivary Gland Pathology Flashcards
4 causes of non-neoplastic salivary pathology
- Trauma
- Blockae
- Infection
- Autoimmune
Tx for mumps
Palliative - analgesic, soft diet and fluids
Resolves in 2 weeks
Vaccinate!
What usually causes acute sialadenitis
Most result from ductal obstruction/decreased salivary flow, allowing retrograde spread of bacteria
Chronic systemic autoimmune disorder that principally involves the exocrine glands
Sjogrens syndrome
What is secondary Sjogrens (Sicca syndrome)
Sjogresn plus another associated autoimmune disease
What two molecules have been found to be associated with Sjogrens which indicates autoimmune
RF, ANA
What two autoimmune diseases are closely associated with Sjogresn
RA
SLE
List 7 symptoms of Sjogrens Syndrome
- Reduced saliva
- Mouth soreness
- Difficulty chewing/swallowing
- Abnormal taste
- Difficulty in speech
- Difficulty in controlling dentures
- Caries
How is Sjogrens syndrome diagnosed
Labial gland biopsy
Management of Sjogrens Syndrome
- Exclude candida
- Encourage OH
- Fluoride
- Mouthwash
- Salivary stimulants and replacements
Composition of saliva:
- Electrolytes (Calcium, sodium, potassium, fluoride)
- Ig
- Small organic molecules (urea, amino acids, glucose)
What is the pH of the saliva
6-7
Functions of saliva:
- Protection
- Buffering
- Antimicrobial
- Digestion
- Taste
Daily saliva flow rate-
500-600ml/day
If you ordered a blood test for CRP levels, what conditions would you be looking to exclude
Sjogrens
Sarcoidosis
If you ordered a blood test for sACE levels, what condition would you be looking to exclude
Sarcoidosis
Is you ordered a blood test to check for serum calcium and phosphate levels, what would you be looking to exclude?
Hyperparathyroidism (can cause dry mouth)
Systemic conditions which can cause dry mouth:
- Sjogrens Syndrome
- Sarcoidosis
- Diabetes
- Hyperparathyroidism
Example of salivary gland developmental disorder
Hypoplasia
Example of tumour like lesion of the salivary gland:
Sialadenosis
What is this?
Adenomatoid hyperplasia
Rare. Usually males. Usually major glands, usually 6th decade of life.
Systemic condition known to cause Sialolithiasis
Gout
MAnagement of sialolithiasis
- Surgical
- Shock wave
- Milk out
- Endoscopy
- Guided basket retrieval
Acute condition usually secondary to localised or systemic cause of reduced salivary flow.
Acute Ascending Sialadenitis
Management of Acute Ascending Sialadenitis:
Flucloxacillin or Clindamycin
Signs and Symptoms of Acute Ascending Sialadenitits
- Sudden onset
- Reduced salivary flow
- Gland painful, swollen, tender to touch
- Purulent discharge from duct orifice
- Erythematous overlying skin
- Fever
Chronic condition caused by recurrent bacterial infection or non-infectious conditions such as radiotherapy, autoimmune disease or stones. Characterised by low grade tenderness and minor degree swelling.
Chronic Sialadenitis
How does Sarcoidosis present in the salivary glands?
Enlargement and Xerostomia.
Common symptoms of Sarcoidosis
- Dyspnoea
- Dry cough
- Chest pain
- Fever
- Malaise
- Fatigue
- Weight loss
What % of Sarcoidosis have abnormal chest x-ray
90%
List causes of Xerostomia
- Drugs
- Radiation
- Dehydration
- Severe DM
- Sarcoidosis
- Psychogenic
- Graft vs Host Disease
- Hyperparathyroidism
- Amyloidosis
- Sjogrens Disease
- Cholinergic dysfunction
Painless, non-inflammatory, non neoplastic swelling of the salivary glands. Aetiology not well understood but associated with alcohol abuse, cirrhosis, diabetes, anorexia, bulimia and drugs.
Sialosis
Clinical features of Xerostomia
- Halitosis
- Dental caries
- Candidosis
- Ascending sialadentitis
- Difficulty swallowing dry foods
- Poor retention of dentures
Diagnosis of Xerostomia
- Basis of history and exam
- Blood tests
- Salivary flow rate
- Biopsy
- Sialography
Management of dry mouth:
- Fluoride therapies, regular dential check up (preventive)
- Mouthwashes, gels
- Gums, pilocarpine
Overactivity of what cell leads to abnormal apoptosis in Sjogrens
B cells
