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Systemic Disease in Dentistry > Oral Manifestations (1) > Flashcards

Oral Manifestations (1) Flashcards

1
Q

Name 4 neurological conditions

A
  1. Multiple sclerosis
  2. Trigeminal Neuralgia
  3. Hypoglossal Nerve Palsy
  4. Facial Nerve Palsy
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2
Q

Describe multiple sclerosis

A
  • Chronic inflammatory disease of the CNS
  • Thought to be idiopathic (autoimmune)
  • F > M
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3
Q

Describe 4 classifications of multiple sclerosis

A
  1. Acute
  2. Subacute
  3. Relapse
  4. Progressive
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4
Q

Describe the aetiology and pathogenesis of multiple sclerosis

A
  • Plaques and demyelination of axons

- Variable symptomology including dysesthesia, balance coordination, vertigo and optic disturbances

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5
Q

Describe trigeminal neuralgia

A
  • Episodic neuropathic pain
  • Sudden unilateral, severe, brief stabbing, recurrent episodes of pain in distribution of one or more branches of trigeminal nerve
  • F > M
  • 45-59 years
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6
Q

Describe the aetiology and pathogenesis of trigeminal neuralgia

A
  • Areas of demyelination or vascular compression, but unsure on cause
  • Pathology related to HIV, vascular aneurysm or neoplasm
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7
Q

Describe hypoglossal nerve palsy

A
  • Rare
  • Deviation to affected side
  • Fasciculation of affected side
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8
Q

Name 5 causes of hypoglossal nerve palsy

A
  1. Idiopathic
  2. Metastatic disease at base of skull
  3. Medical causes
  4. Trauma
  5. Meningioma
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9
Q

Describe facial nerve palsy

A
  • Swelling of facial nerve due to virus aetiology
  • May be caused by Herpes Simplex
  • Upper or lower motor neurone lesion can be cause
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10
Q

Name 4 classifications of respiratory disease

A
  1. Obstructive
  2. Restrictive
  3. Perfusion
  4. Lung Cancers
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11
Q

Name 4 oral manifestations of respiratory disease

A
  1. Dental caries
  2. Dental erosion
  3. Periodontal disease
  4. Oral candidiasis
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12
Q

Describe the clinical features of pseudomembranous candidiasis

A
  • Creamy plaques
  • Large areas of the oral mucosa
  • May be wiped off
  • Erythematous mucosa
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13
Q

Describe the clinical features of erythematous candidiasis

A
  • Red areas of the tongue and palate

- Can be painful

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14
Q

Describe tuberculosis

A
  • Chronic infectious disease caused by mycobacterium tuberculosis
  • Nine million people affected
  • Lung main organ affected but may have extra pulmonary involvement
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15
Q

Describe the oral implications of tuberculosis

A
  • Oral TB is uncommon (0.1% to 5.0%)
  • Primary or secondary in occurrence
  • Any oral site affected
  • Men > Women
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16
Q

What is sarcoidosis?

A
  • Multi-systemic chronic granulomatous condition
  • Cause unknown but thought to be immune response to bacterial infection
  • 3,000 new cases diagnosed yearly
  • Young adults aged 20-40 years
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17
Q

Describe the common sites affected by sarcoidosis

A
  • All organ system

- Lungs and lymph nodes affected

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18
Q

Describe 5 symptoms of sarcoidosis

A
  1. Flu-like sypmtoms
  2. Lupus pernio
  3. Blue-ish/purple plaque like lesions
  4. Pathognomonic
  5. Uveitis
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19
Q

Describe the oral implications of sarcoidosis

A
  • Oral involvement rare
  • Swellings may be present
  • Salivary gland swelling
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20
Q

Name 4 common issues with cardiovascular system

A
  1. Ischaemic heart disease
  2. Heart failure
  3. Congenital heart failure
  4. Valvular defects
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21
Q

Describe 4 common oral manifestations of cardiovascular disease

A
  1. Pain in orofacial region can occur during MI
  2. Colour changed
  3. Pathological changes
  4. Medication
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22
Q

Describe oral varices

A
  • Most commonly seen on ventral surface of tongue and floor of mouth
  • Abnormally dilated veins
  • Tend to become more prominent with age
  • Asymptomatic and blanch on diascopy
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23
Q

Name 6 common drug reactions from common cardiovascular drugs

A
  1. Burning mucosa (ACE inhibitors e.g ramipril)
  2. Swellings
  3. Dry mouth (Diuretics e.g furosemide)
  4. Ulceration (GTN spray)
  5. Gingival hyperplasia (Calcium channel blockers e.g amlodipine)
  6. Haemorrhagic lesions
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24
Q

Name 3 types of haemorrhagic lesions caused by cardiovascular drugs

A
  1. Petechiae
  2. Purpura
  3. Ecchymosis
25
Q

Describe coeliac disease

A
  • Immune mediated condition
  • Ingestion in wheat in genetically susceptible individual
  • Any age with 2 peaks
  • Increased incidence of autoimmune disease and atopy
26
Q

Name 5 typical presentations of coeliac disease

A
  1. Abdominal pain
  2. Chronic diarrhoea
  3. Vomiting
  4. Weight loss
  5. Abdominal distension
27
Q

Name 3 atypical presentations of coeliac disease

A
  1. Fatigue
  2. Iron deficiency anaemia
  3. Dermatitis herpetiformis
28
Q

Describe 4 tooth related oral manifestations of coeliac disease

A
  1. Dental enamel hyperplasia
  2. Pitting or grooving of enamel
  3. Partial loss of enamel
  4. Delayed tooth eruption
29
Q

Describe 5 soft tissue related oral manifestations of coeliac disease

A
  1. Aphthous ulceration
  2. Oral lichen planus
  3. Angular cheilitis
  4. Atrophic glossitis
  5. Bleeding tendency
30
Q

What is inflammatory bowel disease?

A

Group of chronic inflammatory conditions primarily affecting the digestive tract

31
Q

Describe the pathogenesis of inflammatory bowel disease

A
  • Pathogenesis is unclear
  • Multi-factorial with immune system, genetics and environmental factors
  • One third develop extra-intestinal manifestations
32
Q

Describe 4 extra oral manifestations of inflammatory bowel disease

A
  1. Liver (5%)
  2. Joints (20%)
  3. Eye (5%)
  4. Skin (5%)
33
Q

Describe the demographics of ulcerative colitis

A
  • Inflammatory condition of the GI tracts (colorectal)
  • Second to fourth decade (M=F)
  • Smoking is protective
  • Eight times more likely to occur if first degree relative affected
34
Q

Name 4 common presenting symptoms of ulcerative colitis

A
  1. Rectal bleeding
  2. Urgency
  3. Tenesmus
  4. Diarrhoea
35
Q

What are 2 common oral signs of ulcerative colitis?

A
  1. Oral ulceration

2. Pyostomatitis vegetans

36
Q

Describe the clinical signs of oral ulceration during ulcerative colitis

A
  • Most common sign of ulcerative colitis
  • Coincides with flair up
  • Resemble aphthous ulceration
  • Painful for patient
37
Q

Describe the clinical signs of pyostomatitis vegetans during ulcerative colitis

A
  • Pustules
  • Labial attached gingiva
  • Males > Females
  • Variable sypmtoms
38
Q

Describe Crohn’s disease

A
  • Chronic granulomatous inflammation to the intestinal wall
  • Inappropriate response to intestinal microbes and other environmental factors in genetically susceptible host
  • Oral cavity to anal cavity
  • Exacerbations followed by periods of remission
39
Q

Name 5 clinical symptoms of Crohn’s disease

A
  1. Abdominal pain
  2. Diarrhoea
  3. Rectal blood loss
  4. Weight loss
  5. Growth failure in children
40
Q

Describe the oral manifestation prevalence in Crohn’s disease

A
  • 0.5-37%
  • More common in children or patients with perianal involvement
  • May be more severe during flair up
41
Q

Name 6 specific lesions to Crohn’s disease

A
  1. Diffuse labial and buccal swelling
  2. Cobble stoning
  3. Mucosal tags
  4. Stag horning
  5. Deep linear ulcerations
  6. Mucogingivitis
42
Q

Describe lip swelling in Crohn’s disease

A
  • Can be diffuse and symmetrical or localised
  • May affect both lips
  • Can be persistent
  • Often chronic fissuring and associated angular cheilitis
43
Q

Describe cobble stoning in Crohn’s disease

A
  • Fissured and swollen mucosa
  • Posterior buccal mucosa and palate
  • May be painful
44
Q

Describe mucosal tags in Crohn’s disease

A
  • Small localised swellings
  • Labial and buccal vestibules and retro molar pads
  • Asymptomatic
  • 75% will show non-caseating granuloma
45
Q

Describe stag horning in Crohn’s disease

A

Elevation and prominence of most distal and superficial section of submandibular ducts, terminating in the duct orifices at the midline

46
Q

Describe linear ulcers in Crohn’s disease

A
  • Deep linear ulceration
  • Hyperplastic margins
  • Labial and buccal vestibules
47
Q

Describe mucogingivitis in Crohn’s disease

A
  • Full width gingivitis
  • Granular and oedematous appearance
  • May be associated ulceration
48
Q

Name 4 non specific lesions to Crohn’s disease

A
  1. Aphthous like ulcers
  2. Pyostomatitis vegatens
  3. Angular cheilitis
  4. Persistent submandibular lymphadenopathy
49
Q

Describe diabetes mellitus

A
  • Group of metabolic disorders
  • Chronic hyperglycaemia
  • Insulin resistance, deficiency or both
50
Q

Name 3 types of diabetes mellitus

A
  1. Primary (Type I or Type II)
  2. Secondary (usually pancreatic injury)
  3. Drug induced
51
Q

Name 4 acute presentations of diabetes mellitus

A
  1. Thirst
  2. Polyuria
  3. Weight loss
  4. Ketoacidosis
52
Q

Name 5 subacute presentations of diabetes mellitus

A
  1. Older patients
  2. Delayed healing
  3. Lack of energy
  4. Balanitis
  5. Asymptomatic
53
Q

Name 6 common oral manifestations of diabetes mellitus

A
  1. Sialosis
  2. Xerostomia
  3. Caries
  4. Periodontal disease
  5. Oral candidosis
  6. Oral dyaesthesia
54
Q

Describe the prevalence of hypothyroidism

A
  • Underactivity of thyroid gland
  • Common infection
  • Primary or secondary
  • Increased TSH and reduced T4
  • F > M
  • Incidence increases with age
55
Q

Name 4 symptoms of hypothyroidism

A
  1. Goitre
  2. Dysgeusia
  3. Macroglossia
  4. Periodontal disease
56
Q

Describe hyperthyroidism

A
  • Thyroid over activity
  • Common
  • Many causes
  • Increase in T4 and decrease in TSH
57
Q

Describe the pathogenesis of Addison’s disease

A
  • Primary adrenal insufficiency
  • Adrenal glands are damaged
  • Cortisol and aldosterone production are affected
58
Q

Describe 6 common symptoms of Addison’s disease

A
  1. Lethargy / Depression
  2. Anorexia / Weight loss
  3. Pale brown pigmentation of oral mucosa
  4. Pressure points
  5. Skin creases
  6. Recent scars

Systemic Disease in Dentistry (22 decks)

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