older people Flashcards
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.
Black Hairy Tongue
C.
Geographic Tongue
What is not a cause of xerostomia.
a.
Sjogrens Syndrome
b.
Head and neck radiotherapy
c.
Chemotherapy
d.
Diuretics
e.
Dehydration
c.
Chemotherapy
what is the most common cause of death in patients with dysphagia associated with neurological impairment
aspiration pneumonia
what is dementia
progressive deterioration in cognitive function beyond what is expected for normal ageing
what does dementia affect alongside memory
thinking
orientation
learning capacity
language
perception
characteristics of dementia
amnesia - difficulty recalling recent events
inability to concentrate
disorientation
intellectual impairment
how to test cognitive function
mini mental state exam
delayed word recall
category fluency
clock draw
risk factors of dementia
age
gender
genetic background
medical history
lifestyle
early stage symptoms of dementia
loss of short term memory
confusion
distress
communication issues
why do you do FBC, U and E, kidney, liver and thyroid function tests for dementia patient
to eliminate any treatable cause
what protein makes the plaques and tangles in Alzheimer’s
where are the proteins deposited
plaques - beta amyloid - deposited in spaces between nerve cells
tangles - tau protein build up inside cells
associated factors of Alzheimer’s
age
women
head injury
lifestyle
abnormalities on which 3 chromosomes are associated with alzheimers
1 14 or 21
What are 3 types of dementia
alzheimers
vascular
lewy bodies
what causes vascular dementia
reduced blood flow to brain - damages and kills brain cells
stroke
blockage of small vessels in brain
underlying health conditions and lifestyle factors linked to vascular dementia
high blood pressure
diabetes
obesity
smoking
what is lewy bodies dementia
deposits of an abnormal protein called lewybodies inside brain cells
what diseases do you find lewy bodies protein in the brain
parkinsons
LB dementia
TDP-43 protein is associated with which type of dementia
fronto temporal dementia
dementia type with younger age of onset
fronto temporal 45-65
what protein is associated with frontotemporal dementia
TDP-43
define frailty
increased vulnerability to stressors due to age related decline physiologically
the 4 phenotypes of frailty
unintentional weight loss
weakness
slow walking speed
low physical activity
between shortened dental arch and RPD, which improves quality of life at 24 months more
SDA - improved quality of life at 24 months
RPD has initial improvement but diminishes
What is the aim of caring for smiles
improve OH of older people especially in care homes
what is the name of scotlands national oral health promotion, training and support programme to improve OH of older people
Caring for smiles
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.
clinical audit
meaningful feedback
what did the francis report reveal
Poor care of older people at mid Staffordshire hospital - NHS
what is the main source of infection for aspiration pneumonia
oral bacteria
how to reduce risk of aspiration pneumonia
improve oral health - reduces bacteria
what is staphylococcal mucositis
build up of dead mucosal cells- scab like
Caused by staph aureus
what did the francis report highlight needed to change going forward
Patients must be protected form avoidable harm
Enhance the education, training and support
what does the berwick report identify
importance for vigilance
quality of patient care, especially patient safety, above all other aims
treatment of burning mouth syndrome
no cure
Tricyclics
mindfulness
relaxation
all get FBC and haematinics test
causes of burning mouth syndrome
ACE inhibitors
dry mouth
candidosis
haematinic deficiency
parafunction
no cause identified in 50%
what is a haemangioma
malformation of blood vessels
will bleed if trauma
where are haemangiomas often found
inside lip
edge of tongue
under tongue
describe a fibroepithelial polyp
same mucosa as surrounding
nothing to worry but can ulcer due to trauma if get too big so remove
what is black hairy tongue
overgrowth on surface of tongue which picks up stains e.g. tea, smoking
smell
nothing to worry about - variation of normal
who is more susceptible to black hairy tongue
smokers
what is geographic tongue
tongue looks like a map - areas of atrophy surrounded by white raised areas
variation of normal
what is atrophic glossitis
really smooth/shiny tongue
what is the most common cause of atrophic glossitis
low iron or vit b12
what should you do if you see a patient with atropic glossitis
ask GMP for blood test - anaemia
what is frictional keratosis
white patch caused by trauma and keratinisation
what is speckled leukoplakia
hyperplastic candidosis
pre malignant lesion
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
traumatic keratosis
what causes denture induced hyperplasia
ill fitting dentures
treatment of denture induced hyperplasia
surgical removal
new denture
how does denture induced stomatitis present
erythema
what causes denture induced stomatitis
candidal infection
how to avoid denture induced stomatitis
good OH
remove denture at night
denture hygiene
what virus causes heroes zoster (shingles)
varicellar zoster virus
describe the presentation of herpes zoster trigeminal neuralgia
affects any branch of trigeminal
often unilateral
2-3 days later rash in mouth and face
painful
how to treat herpetic trigeminal neuralgia
antidepressants
carbamazepine
cryotherapy
neurectomy
alcohol injection
risk factors for trigeminal neuralgia
female
maxillary and mandibular branch
MRONJ risk factors
concurrent steroids
invasive dental procedure
previous MRONJ
duration of therapy
- OH, smoker, alcohol, perio
what are bisphosphonates used to treat
osteoporosis
paget’s
multiple myeloma
what is angular chelitis
bacterial/fungal infection at corner of mouth
causes of angular chelitis
reduced OVD
denture hygiene
low haematinics
causes of xerostomia
poly pharmacy
sjogrens
radiotherapy
management of xerostomia
change medication
saliva replacement
saliva stimulants - chew gum
two drugs that ill burn mucosa if used topically
aspirin
iron
difference between lichen planus and lichenoid tissue reaction
both mucocutaneous disorders
LP is a dermatology condition
LTR is a reaction to certain drugs e.g. NSAIDS
drugs associated with lichenoid tissue reaction
NSAIDS
beta blockers
diuretics
how do bisphosphonates function
reduce bone resorption by inhibiting osteoclast formation and function
MRONJ requires 3 key characteristics to be present
what are they
current or previous antiresorptive/antiangiogenic treatment
exposed bone for more than 8 weeks
no history of radiation therapy or metastatic disease
who is at low risk of MRONJ while taking bisphosphonates
taking for management to prevention of osteoporosis
high risk of MRONJ
previous diagnosis
concurrent use of corticosteroids
taking for management of malignant condition
What are FOUR cognitive tests for a person with dementia
MMSE: mini mental state examination
MoCA: Montreal cognitive assessment
Clock draw
Delayed word recall
