Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

DMD3 sem 2 > Oncology and Palliative Care > Flashcards

Oncology and Palliative Care Flashcards

1
Q

How is decision made for treatment of cancer in cancer patients?

A

Based on histopathological examination.

Intention is to remove the cancer as much as possible without compromising the anatomy too severely.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How is pathology removed from patient?

A

Margins of the lesion are removed .

Sometimes neck dissection is needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How is anatomy reconstructed following surgical resection?

A

Soft-tissue flaps

Bone-harvesting

Implants intraorally and extraorally

Prosthetics: Obturator or facial prostheses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is an obturator?

A

A prosthesis used to fill in the defect created by oral surgery and has a similar shape to the structures being replaced.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the oral complications post surgery that can arise?

A

Loss of integrily of the oral cavity

Loss of teeth

Changes to soft tissues: Floor of the mouth

Pain

Function

Aesthetics/self esteem

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is chemotherapy?

A

Treatment using cytotoxic drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does chemotherapy do?

A

Kills cells during the process of mitosis

Damages genetic material during DNA replication or at the point of cell division

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is chemotherapy delivered?

A

Can be delivered intravenously or orally.

Usually a combination of medications is used with different actions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the role of chemotherapy?

A

Shrink tumour before surgery/radiotherapy

To try and prevent recurrence after other therapies

Primary treatment for some cancers (lymphoma) can be used for head and neck SCCs

Treat metastatic cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the side effects of chemotherapy?

A

Mucositis

Risk of infection

Thrombocytopaenia

Neutropaenia

Bone marrow suppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is radiotherapy?

A

Use of high energy electromagnetic radiation or particles to disrupt integrity of malignant cells.

Therapeutic application aimed at inducing focal damage to DNA.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How can radiotherapy be used in the treatment of cancer?

A

As a primary therapy for cancer treatment

To shrink a tumour prior to surgery

After surgery to treat lymph nodes

To destroy remaining tumour cells

Palliative therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is IMRT?

A

Using several sources of radiation around the head/body to irradiate the tumour by delivering an adequate dose without damaging the intermediate structures in the process.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the oral complications of radiotherapy?

A

Fibrosis of tissues

Capillary changes and decreased vascularity

Increased tissue fragility

Reduced healing ability

Susceptibility to infection

Mucositis

Telangiectasia

Trismus

Xerostomia

Saliva changes

Oral discomfort

Taste alterations

Dentine hypersensitivity (softening of dentine)

Loss of periodontal attachment

Radiation caries (very unique presentation of caries that is circumferential, browning of teeth caries, yellowing of teeth)

Risk of ORN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How are systemic cancer therapy patients typically treated?

A

Multidisciplinary team involved and special needs dentists + general dentists are important members of this team.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the key roles of dentists in treating patients with systemic cancer therapy?

A

Training other health care professionals

Management of oral problems

Advocating for patient’s needs

Contributing to maintaining wellbeing of the patient

17
Q

What should dentists do prior to cancer therapy?

A

Medical history

Liase with hospital dental clinic

Oral exam + radiographs

Dental treatment: Removal of calculus + plaque, removal of hopeless teeth, stabilise oral condition where possible.

Oral hygiene advice

18
Q

What should dentists do during cancer therapy?

A

Maintain good oral hygiene

Daily topical fluoride application (consider custom trays)

Mouthrinses: saline, bicarb, magic mouthwash (bicarbonate and food colouring), sage tea

Jaw exercises to reduce trismus

Assist with management of oral side effects

19
Q

What is mucositis?

A

Acute erythematous and ulcerative lesions of GI tract

Inflammation and bleeding of oral soft tissues

Pain

20
Q

How is mucositis treated?

A

Lignocaine (topical)

Cannot prevent

Mouthwashes

21
Q

How is mucositis graded?

A

Based on changes:

Grade 0: No changes

Grade 1: Soreness/erythema

Grade 2: Ulceration (solid foods

Grade 3: Liquid diet

Grade 4: No alimentation

22
Q

What are the potential complications of oral mucositis?

A

Risk of septicaemia from oral cavity

Haemorrhage due to low platelets.

23
Q

How is oral mucositis reduced/treated?

A

Pain management topical and systemic

Comfort, nutrition, hydration

Prophylaxis (prevent viral fungal and bacterial infections)

Treat dry mouth

Remove dental prostheses

Soft diet

Removal of oral secretions/debris

Haemorrhage control

Improved oral hygiene

Anti-fungal medications may be required

24
Q

What are mouth swabs?

A

Swabs used to remove debris from tongue/soft tissues

25
Q

How can oral cavity be decontaminated when a patient has mucositis?

A

Anti-fungal medications may be required

Hydrogen peroxide not advisable

Avoid alcohol based mouthwashes (pain)

Avoid juices (destroys oral mucosa and increases risk of infection and caries)

26
Q

What should be avoided when decontaminating the oral cavity when there is mucositis?

A

Hydrogen peroxide not advisable

Avoid alcohol based mouthwashes (pain)

Avoid juices (destroys oral mucosa and increases risk of infection and caries)

27
Q

How can magic mouthwash be made?

A

1 tsp salt and 1 tsp bicarb and 150mL warm water

28
Q

Why is saline used in magic mouthwash?

A

Mucolytic and antibacterial

29
Q

Why is bicarb used in magic mouthwash?

A

Mucolytic and reduces acidity, has antifungal activity, and is a mild analgesic

30
Q

Why is chlorhex used?

A

Anti-biofilm agent

Broad anti-microbial action

Lowers presence of oral infection in presence of significant ulceration and patients inability to maintain oral care

31
Q

How is pain managed in mucositis?

A

Oral cryotherapy

Topical analgesic agents

Anti-inflammatory mouthwashes (NSAID, weak topical anaesthetic and antimicrobial, reduces intensity and duration of mucosal damage, delays need for systemic pain management)

32
Q

What are the functions of saliva?

A

Lubrication

Digestion

Mucosal repair

Buffering capacity

Remineralisation

Anti-microbial

33
Q

How can dry mouth be managed?

A

Water (spray, bottle, ice-chips)

Saliva stimulation (Pilocarpine or sugarfree chewing gum)

Salivary substitutes: Replace or supplement natural saliva, increases comfort, decreases infection risk, can be used as frequent as required, available in various formulations (mouthrinse, gel, spray, gum)

Be careful of pH of the products GC dry mouth gel is pH 7 (biotene has pH4.2)

34
Q

What oral hygiene products should be used for patietns with dry mouth?

A

High fluoride toothpaste (neutrafleur5000)

Biotene products

Recaldent/GC (Tooth mousse plus and tooth mousse)

Lip care

Avoid alcohol-based mouthwashes

35
Q

What conditions besides cancer can require palliative care?

A

End stage HIV/AIDS

Dementia

End-stage motor conditions

Acquired brain injury

Elderly

36
Q

What is palliative dentistry?

A

Management of patients with progressive far advanced disease where oral cavity has been compromised directly or indirectly by disease

37
Q

How should palliative dentistry be done for palliative care patients?

A

Focus on immediate quality of life.

Pain relief and comfort are the priority.

38
Q

What are the most common causes of discomfort in palliative dentistry

A

Xerostomia

Mucositis

Dysphagia

Ulceration

Taste alteration

halitosis

Oral candidiasis

Angular cheilitis

Denture stomatitis

Discomfort

Poor-fitting dentures

DMD3 sem 2 (69 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions