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Special care dentistry > older people > Flashcards

older people Flashcards

1
Q

Which of the following oral medicine conditions are considered variations of normal anatomy - 2
A.
Black Hairy Tongue
B.
Lichenoid Tissue Reaction
C.
Geographic Tongue
D.
Fibro-epithelial Polyp
E.
MRONJ

A

A.
Black Hairy Tongue
C.
Geographic Tongue

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2
Q

What is not a cause of xerostomia.
a.
Sjogrens Syndrome
b.
Head and neck radiotherapy
c.
Chemotherapy
d.
Diuretics
e.
Dehydration

A

c.
Chemotherapy

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3
Q

what is the most common cause of death in patients with dysphagia associated with neurological impairment

A

aspiration pneumonia

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4
Q

what is dementia

A

progressive deterioration in cognitive function beyond what is expected for normal ageing

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5
Q

what does dementia affect alongside memory

A

thinking
orientation
learning capacity
language
perception

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6
Q

characteristics of dementia

A

amnesia - difficulty recalling recent events
inability to concentrate
disorientation
intellectual impairment

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7
Q

how to test cognitive function

A

mini mental state exam
delayed word recall
category fluency
clock draw

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8
Q

risk factors of dementia

A

age
gender
genetic background
medical history
lifestyle

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9
Q

early stage symptoms of dementia

A

loss of short term memory
confusion
distress
communication issues

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10
Q

why do you do FBC, U and E, kidney, liver and thyroid function tests for dementia patient

A

to eliminate any treatable cause

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11
Q

what protein makes the plaques and tangles in Alzheimer’s
where are the proteins deposited

A

plaques - beta amyloid - deposited in spaces between nerve cells

tangles - tau protein build up inside cells

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12
Q

associated factors of Alzheimer’s

A

age
women
head injury
lifestyle

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13
Q

abnormalities on which 3 chromosomes are associated with alzheimers

A

1 14 or 21

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14
Q

What are 3 types of dementia

A

alzheimers
vascular
lewy bodies

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15
Q

what causes vascular dementia

A

reduced blood flow to brain - damages and kills brain cells

stroke
blockage of small vessels in brain

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16
Q

underlying health conditions and lifestyle factors linked to vascular dementia

A

high blood pressure
diabetes

obesity
smoking

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17
Q

what is lewy bodies dementia

A

deposits of an abnormal protein called lewybodies inside brain cells

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18
Q

what diseases do you find lewy bodies protein in the brain

A

parkinsons
LB dementia

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19
Q

TDP-43 protein is associated with which type of dementia

A

fronto temporal dementia

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20
Q

dementia type with younger age of onset

A

fronto temporal 45-65

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21
Q

what protein is associated with frontotemporal dementia

A

TDP-43

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22
Q

define frailty

A

increased vulnerability to stressors due to age related decline physiologically

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23
Q

the 4 phenotypes of frailty

A

unintentional weight loss
weakness
slow walking speed
low physical activity

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24
Q

between shortened dental arch and RPD, which improves quality of life at 24 months more

A

SDA - improved quality of life at 24 months

RPD has initial improvement but diminishes

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25
Q

What is the aim of caring for smiles

A

improve OH of older people especially in care homes

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26
Q

what is the name of scotlands national oral health promotion, training and support programme to improve OH of older people

A

Caring for smiles

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27
Q

how do you find out if healthcare is being provided in line with standards, where the service is doing well, and where there could be improvements.

A

clinical audit
meaningful feedback

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28
Q

what did the francis report reveal

A

Poor care of older people at mid Staffordshire hospital - NHS

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29
Q

what is the main source of infection for aspiration pneumonia

A

oral bacteria

30
Q

how to reduce risk of aspiration pneumonia

A

improve oral health - reduces bacteria

31
Q

what is staphylococcal mucositis

A

build up of dead mucosal cells- scab like
Caused by staph aureus

32
Q

what did the francis report highlight needed to change going forward

A

Patients must be protected form avoidable harm
Enhance the education, training and support

33
Q

what does the berwick report identify

A

importance for vigilance

quality of patient care, especially patient safety, above all other aims

34
Q

treatment of burning mouth syndrome

A

no cure
Tricyclics
mindfulness
relaxation
all get FBC and haematinics test

35
Q

causes of burning mouth syndrome

A

ACE inhibitors
dry mouth
candidosis
haematinic deficiency
parafunction

no cause identified in 50%

36
Q

what is a haemangioma

A

malformation of blood vessels
will bleed if trauma

37
Q

where are haemangiomas often found

A

inside lip
edge of tongue
under tongue

38
Q

describe a fibroepithelial polyp

A

same mucosa as surrounding
nothing to worry but can ulcer due to trauma if get too big so remove

39
Q

what is black hairy tongue

A

overgrowth on surface of tongue which picks up stains e.g. tea, smoking
smell
nothing to worry about - variation of normal

40
Q

who is more susceptible to black hairy tongue

A

smokers

41
Q

what is geographic tongue

A

tongue looks like a map - areas of atrophy surrounded by white raised areas
variation of normal

42
Q

what is atrophic glossitis

A

really smooth/shiny tongue

43
Q

what is the most common cause of atrophic glossitis

A

low iron or vit b12

44
Q

what should you do if you see a patient with atropic glossitis

A

ask GMP for blood test - anaemia

45
Q

what is frictional keratosis

A

white patch caused by trauma and keratinisation

46
Q

what is speckled leukoplakia

A

hyperplastic candidosis
pre malignant lesion

47
Q

pt complains of pain in upper right gum and thinks her new denture is rubbing

on examination you see a white lesion in the buccal sulcus and the denture does appear to be snug in that area. what is the white lesion likely to be

A

traumatic keratosis

48
Q

what causes denture induced hyperplasia

A

ill fitting dentures

49
Q

treatment of denture induced hyperplasia

A

surgical removal
new denture

50
Q

how does denture induced stomatitis present

A

erythema

51
Q

what causes denture induced stomatitis

A

candidal infection

52
Q

how to avoid denture induced stomatitis

A

good OH
remove denture at night
denture hygiene

53
Q

what virus causes heroes zoster (shingles)

A

varicellar zoster virus

54
Q

describe the presentation of herpes zoster trigeminal neuralgia

A

affects any branch of trigeminal
often unilateral
2-3 days later rash in mouth and face
painful

55
Q

how to treat herpetic trigeminal neuralgia

A

antidepressants
carbamazepine
cryotherapy
neurectomy
alcohol injection

56
Q

risk factors for trigeminal neuralgia

A

female
maxillary and mandibular branch

57
Q

MRONJ risk factors

A

concurrent steroids
invasive dental procedure
previous MRONJ
duration of therapy

  • OH, smoker, alcohol, perio
58
Q

what are bisphosphonates used to treat

A

osteoporosis
paget’s
multiple myeloma

59
Q

what is angular chelitis

A

bacterial/fungal infection at corner of mouth

60
Q

causes of angular chelitis

A

reduced OVD
denture hygiene
low haematinics

61
Q

causes of xerostomia

A

poly pharmacy
sjogrens
radiotherapy

62
Q

management of xerostomia

A

change medication
saliva replacement
saliva stimulants - chew gum

63
Q

two drugs that ill burn mucosa if used topically

A

aspirin
iron

64
Q

difference between lichen planus and lichenoid tissue reaction

A

both mucocutaneous disorders

LP is a dermatology condition

LTR is a reaction to certain drugs e.g. NSAIDS

65
Q

drugs associated with lichenoid tissue reaction

A

NSAIDS
beta blockers
diuretics

66
Q

how do bisphosphonates function

A

reduce bone resorption by inhibiting osteoclast formation and function

67
Q

MRONJ requires 3 key characteristics to be present
what are they

A

current or previous antiresorptive/antiangiogenic treatment
exposed bone for more than 8 weeks
no history of radiation therapy or metastatic disease

68
Q

who is at low risk of MRONJ while taking bisphosphonates

A

taking for management to prevention of osteoporosis

69
Q

high risk of MRONJ

A

previous diagnosis
concurrent use of corticosteroids
taking for management of malignant condition

70
Q

What are FOUR cognitive tests for a person with dementia

A

MMSE: mini mental state examination

MoCA: Montreal cognitive assessment

Clock draw

Delayed word recall

Special care dentistry (15 decks)

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