Brainscape's Knowledge GenomeTM

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


See full index

Past MSAs > Oral Med > Flashcards

Oral Med Flashcards

1
Q

5 epithelium layers from surface down?

A 
stratum corneum 
stratum granulosum 
stratum spinosum
stratum basale
lamina propria

CGSBL
cool girls stand by lush

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

difference between orthokeratinised and parakeratinised epithelium?

A 
orthok = no nuclei
para = has nuclei

partaay keratinised epithelium

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

define keratosis

A

keratin formation in non- keratinised epithelium. called hyperkeratinisation in keratinised epithelium

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

define acanthosis

A

hyperplasia of stratum spinosum

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

define atrophy

A

loss of epithelial layers

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

define erosion

A

partial thickness loss

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

define ulceration

A

loss of epithelial layers with resultant yellow fibrin deposition on surface

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

define dysplasia

A

disordered maturation of cells

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

define atypia

A

changes in individual cells

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

define rete peg elongation

A

hyperplasia of stratum basale

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

diff diag for pt presenting with TMD like symptoms

A

pericoronitis
myofascial pain syndrome

but both do not have clicks from TMJ

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

describe splint fabrication specifics

A 
cover all teeth
hard acrylic
full occlusal coverage
upper and lower alginates
facebow
ground in lab- max intercuspation
wear facets
sloping canine guide plane
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

pt presents with tile like pattern of white patches on roof of mouth, with red dots in the middle of patches. the pt say he did not know it was there. what could this be?

how could you assess whether to is potentially malignant?

A

smoker’s keratosis.
white patches present on palate, red dots represent inflamed salivary glands.
usually painless
result of heat /chemicals of smoke.

mgmt: smoking cessation.
can be pre-cancerous. send for biospy

can access if potentially maligant by looking at:
hyperchromatism and atypia

would be suspicious of malignancy
if:
indurated, raised rolled margins, exophytic growth.

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

indurated?

A

having become firm/hard usually by fibrous deposition

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

pt present with white, lacy patch on buccal mucosa next to amalgam rest..
what could this be?
what causes this?

4 histological features you would see

A

lichenoid tissue reaction
type IV hypersensitivity reaction

keratinisation
hugging band of lymphocytes
basal cell liquefaction
saw tooth rete pegs
apoptosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

types of biospy and why you’d use them

most important to include in biospy?

A

incisional- elliptical shape aids healing. used if diff dx is malignancy

excisional- complete removal of lesion for functional or aesthetic purposes. only used if growth definitely benign. elliptical shape incisions.

punch- incisional or excisional

Laser or electrosurgery biopsy - can distort histological results but good for post op discomfort and haemorrhage control

NEED TO INCLUDE: adjacent intact mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

pt presents with red corners of mouth.
condition?
organisms involved?

sampling method used?
if sampling not available, what would you do?

pt wears denture. advice to give

A

angular cheilitis

staphylococcus aureus, candida albicans.

swab

prescribe miconazole as is both antibiotic and antifungal

advice: denture hygiene, CHX/ Hypochlorite cleansing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

name three diseases assoc/w/ angular cheilitis

A

HIV- pt will have impaired immune function .:. more likely to get angular cheilitis

Coeliac - impaired nutrient intake

Orofacial Granulomatosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

difference in presentation of pempigus vulgaris and bullous pemphigoid

A

vulgaris: mucosal erosions -> erythematous macules -> flaccid blisters -> rupture easily = painful erosions
positive nikolksy sign- skin doesn’t separate when rubbed

bullous: tense fluid filled blisters 1-3cm diameter, unlikely to erode, stable due to being subepidermal - >clear exudate if burst, leave post-inflammatory hyperpigmentation
negative nikolksy sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

diff diag pemphigus vulgaris

what type of condition is it?

A

acute herpetic stomatitis
erythema multiforme - IgM and C3 instead of IgG
apthous ulcers
bullous lichen planus

type II hypersensitivty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

diff diag bullous pemphigoid

A

mucous membrane pemphigoid
Linear IgA disease
Dermatitis herpetiformis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What skin condition is strongly linked to coeliac disease?

Describe its main features

A

Dermatitis herpetiformis

raised red patches with small blisters that burst when rubbed
severe itching and stinging

commonly affects elbows, knees and buttocks
usually appears both sides of body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Neon green diagnostic test. What is it

What you expect to see for…

pemphigus vulg, bullous pemphigoid and dermatitis herpetiformis

A

direct immunofluorescence

pemphigus vulgaris: epidermal INTERcellular IgG in fishnet pattern

bullous pemphigoid: linear deposition of IgG and c3 along epidermal basement membrane
(uninterupted bright green line running course of basement membrane)

dermatitis herpetiformis: granular deposition of IgA along basement membrane and dermal papilla
(look like bumpy interupted line)

IgG and IgA antibodies will be targeting antigens. direct immunfluorescence shows where the antigens and antibodies are- aiding diagnosis.s
check onenote for pics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Describe how to stage cancer

A

TNM staging

T- size or direct extent of primary tumour

N - degree of spread to regional lymph nodes

M- metastasis

Tx-cannot be assessed
Tis- Carcinoma in situ
T0- no evidence of tumour
T1-4 size

Nx- cannot be assessed
N0- no evidence
N1- spread to closest/small number of nodes
N2- spread to areas between closest and furthest
N3- spread to distant/ large number of nodes

M0 - no mestasis
M1- spread to distant organs - beyond regional lymph nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

how to grade cancer?

A

description of how abnormal cancer is to surrounding tissue

GX- cannot be determined

G1 - low grade
well-differentiated- when cells are similar to normal surrounding tissue

G2 - intermediate
moderately differentiated-

G3 - high
poorly-differentiated- when the cells are very different to surrounding cells

G4- high
un-differentiated- severely abnormal looking cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How to grade dysplasia

A

basal cell hyperplasia - > mild, mod, severe, - > carcinoma in situ
CIS= full thickness

mild- low 1/3 - slight nuclear abnormalities, most marked in basal third, a few abnormal mitoses, usually acompanied by keratosis and chronic inflammation. upper layers show maturation and stratification

mod - abnormalities marked in basal 2/3

severe - loss of upper layer maturation
some abnormal mitoses in upper layers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

how would you restore function to the tongue after removal of lesion

A

soft tissue grafting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Features of an aphthous ulcer

Types of Recurrent aphthous stomatitis

A

well demarcated, shallow, ovoid or round, have a necrotic centre w/ yellow pseudomembrane

minor
- less than 5mm diameter, heals in 1-2 weeks
major
- often >10mm, takes weeks/months to heal, often leaves a scar
herpetiform
- multiple pinpoint ulcers, heal within a month. most common on tongue.

diagnosed based on exclusion and appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

diff diag recurrent aphthous stomatitis

A

Herpes simplex
Herpangina
Erythema multiforme
Fixed drug eruption.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How to tell difference between aphthous ulcer and herpes simplex ulcer?

A

culture or PCR of viral swab from fresh vesicles of ulcer-

if positive if HSV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

differences between minor and major recurrent aphthous?

A 
minor / major
1-20 ulcers / usually singular
<10mm / >10mm
heals without scar / heals with scar
heals in 1-2 weeks / heals in 6-8 weeks
non keratinised mucosa / any mucosa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

causes of recurrent aphthous stomatitis

A 
haematinic deficiency (iron, B12, folate)
stress
anxiety
diet
trauma
sls toothpaste
systemic disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Treatment recurrent aphthous stomatitis

A 
CHX 0.2% 10ml / 2x daily
dietary avoidance - chocolate, cinnamon-aldehyde, benzoates
toothpaste change
blood tests + then correct deficiency
betamethasone MW 0.5% 2xdaily

first line- corticosteroids -beclamethasone inhaler
betamethasone tablets

topical anaesthetics- lidocaine,
topical analgesics- benzydamine
topical antimicrobials - CHX or doxycycline

if severe, short course of systemic- prednisolone
consider: b12 supplementation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

risks of recurrent aphthous ulcers

A

dehydration

infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what would a pt describe the pain of trigeminal neuralgia like?

A

worst pain ever
electric shock like -lasts a few seconds
unilateral

severe paroxysmal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

2 most common causes of trigeminal neuralgia

test to determine cause

A

focal demyelination of peripheral nerves causing ischaemia
OR
trigeminal nerve compression from aberrant artery

MRI, FBC tests
can do IDB to check if it is not just TMD pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

If pt has trigeminal neuralgia due to MS or brain tumour what symptoms may they experience?

A

MS: intention tremor

Brain tumour: diplopia/ memory loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

mgmt trigeminal neuralgia?

A

carbamazepine - anti-epileptic
100mg 2x daily

if pt not reacting to medication or having adverse effects:

Microvascular decompression
Balloon compression
cryosurgery
Gamma Knife radiosurgery
long acting bupivicaine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

investigations needed before giving medical mgmt of trigeminal neuralgia

A

blood tests- FBC
LFT liver function test
U&E

liver tests as function may be reduced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

3 side effects of carbamazepine

A 
GI disturbances
headache
drowsiness
visual disturbance
folate  deficiency
hypertension
facial dyskinesia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

2 intraoral manisfestations of herpes

- symptoms of both

A

herpes labialis - cold sores
burning pain followed by small blisters. first attack accompanied by fever, sore throat and enlarged lymph nodes.

primary herpetic gingivostomatitis- intraoral presentation of primary herpes simplex virus - inflammation of both the gingiva and oral mucosa
- fever, anorexia, irritability, malaise occur before numerous pinhead vesicles appear
these burst to form irregular ulcerations covered by yellow membranes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

three vesicle forming conditions/

A

erythema multiforme
pemphigus vulgaris
bullous pemphigoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

2 groups that cause ulceration

A

herpes simplex
ebv - HHV4, ebstein barr virus - glandular fever, hairy leukoplakia, burkitt’s lymphoma.
coxsackie virus - hand foot and mouth
varicella zoster - HHV3, chicken pox

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

virus causing hand foot and mouth? how does it present orally?

symptoms
how does it differ to gingivostomatitis?

A

herpangina- aka mouth blisters

typically found posterior oropharynx
- .:. differ to herpetic gingivostomatitis which are anterior oro or mouth

usually present in children, in summer
symptoms: sore throat, headache, loss of apetite, neck pain

self limiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

process by which herpes labialis progresses?

A
  • primary infection
  • latency
  • reactivation
  • secondary infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

5 types of candidiasis & presentation & tx

A

pseudomembranous - thick white plaque, scrapped off easily to leave erythematous bleeding surface.

  • systemic: fluconazole tabs 50mg/ 1 x daily/ 14 days
  • topical: nystatin lozenges, qid

erythematous- diffuse erythema, soreness. aka atrophic

  • systemic: same^
  • topical: nystatin ^

angular cheilitis - cracking and inflammation of corners of mouth, soreness, burning

  • systemic: same^
  • topical: miconazole gel qid

hyperplastic - chronic form - firm white non-scrapeable leathery plaque

  • systemic: same^
  • topical: miconzaole ^

medial rhomboid glossitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

2 med conditions assoc/w/candidiasis

A

HIV

diabetes - poorly controlled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

pros and cons swabs and rinse

A

swab

pros: site specific
cons: uncomfortable for pt, can be contaminated

rinse

pros: quantifiable amount, can record whole mouth
cons: more difficult to standardise as not site specific. some pt may find difficult.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

what to ask path for when sending sample

A

culture, sensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

2 drug interactions with fluconazole and effect caused

A

warfarin (increased bleeding)

statins (hepatotoxicity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

pt contraindicated to fluconazole, what could you prescribe for candidiasis

A

fluconazole systemic

could use
itraconazole 50mg capsules / 1 x daily / 15 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

tx aphthous ulcers

A

first line- corticosteroids -beclamethasone inhaler
betamethasone tablets

topical anaesthetics- lidocaine,
topical analgesics- benzydamine
topical antimicrobials - CHX or doxycycline

if severe, short course of systemic- prednisolone
consider: b12 supplementation

CHX 0.2% 10ml / 2x daily
dietary avoidance - chocolate, cinnamon-aldehyde, benzoates
toothpaste change
blood tests + then correct deficiency
betamethasone MW 0.5% 2xdaily
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

pt presents with headache surrounding one eye, comes in sharp attaches

A

chronic paroxysmal hemicrania

nose dripping
worse when shaking head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

pt presents with severe head pain, scalp tenderness, jaw pain, and fever. what could this be?

A

temporal arteritis

inflammation of temporal arteries are inflammed and constricted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

name some systemic and some local causes of pigmented tongue

A

systemic:
- racial
- karposi’s sarcoma
- haemochromatism
- addison’s
- lead poisoning

local:

  • smoking
  • hydroxychloroquine - malaria meds
  • chromogenic bacteria - black hairy tongue
  • melanoma
  • melanotic macule
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Histological features of lichen planus

A 
hugging band of t lymphocytes
basal cell liquefaction - > colloid bodies
apoptosis
keratosis
lymphocytes
acanthosis
saw tooth rete pegs
atrophy / hyperplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Types of lichen planus

A 
bullous
reticular
atrophic
papular
plaque
erosive
desquamative
58
Q

Causes lichen planus

A 
stress
automimmune
bowel disease
food allergies
dental materials
drugs- NSAIDs, beta blockers, ACE inhibitors, antimalarials
Diabetes
Hypertension
Betel Nut CHewing
Toothpaste flavourings- cinnamates
59
Q

SI lichen planus

A

would biopsy lichen planus if:
smoker, high risk area or symptomatic
send for DI direct immunfluorescence

60
Q

Tx lichen planus

A

assymptomatic & reticular: monitor and reduce risk factor

if symptomatic and other types: remove cause if known, topical steroids, systemic steroids, difflam MW and CHX MW

61
Q

histology of pempigus

A

H&E staining:
tzank cells
suprabasal split
acantholysis

direct immunofluorescene- basket wire appearance intercellular IgG

62
Q

salivary gland tumours in order of incidence?

A 
pleomorphic adenoma
warthin's tumour
adenoid cystic carcinoma
mucoepidermoid carcinoma
acinic cell carcinoma
63
Q

histological features of pleomorphic adenoma

which sign related to recurrence?

A

patterns: duct like structures, trabeculae
tissue: myxoid and chrondroid
cells: plasmacytoid, fusiform, cuboidal

encapsulation - if no capsule or poorly encapsulated likely to recur
invasive nature .:. likely to recur
pseudopodia - finger- like structures extend beyond pseudocapsule or capsule

64
Q

histological features of Warthin’s tumour

A

cystic
distinct epithelium
lymphoid tissue

65
Q

clinical features of growth that was lead to suspicion of malignancy

A

firm
attached to underlying structures
rapid growth

66
Q

histology of adenoid cystic carcinoma

A

presents as mixed tumour

consists of tubular, cribriform +/- solid growth patterns

67
Q

68 y/o male attends with now ill fitting denture
what could be causing this? He says he is taking medication for a bone disorder.
dental implications

A

paget’s disease
increases bone turnover- increased osteoclast and osteoblast activity, altering shape of ridge

implications:
- pt may be taking bisphosphonates- care with XLA

  • hypercementosis- opacities periradicular on rads
  • high caries rate - polypharmacy and xerostomia- aging pt, reduced OH due to reduced manual dexterity, poorly fitting denture- plaque trap, increased sugar intake
68
Q

two types of hemangioma

differences histologically

A

hemangioma- birth mark, rubbery, bright red nodule of extra blood vessels

capillary - groups of smaller vessels
cavernous - large dilated vascular spaces

69
Q

what nerve supplies temporomandibular?

A

auriculotemporal nerve

70
Q

Give 3 management techniques for TMD

A 
athrocentesis
arthroscopy
condylectomy
total joint replacement
high condylar shave
71
Q

common triggers for reactivation of herpes

A

Sunlight
stress
run down/unwell
immunosuppression

72
Q

nerve assoc w herpes

A

trigeminal

73
Q

what is anaemia?

A

reduction in oxygen carrying capacity of the blood due to reduction in red blood cells or haemoglobin

74
Q

general signs and symptoms of anaemia?

general oral signs?

A

fatigue, malaise, pallor, weakness, dizziness

recurrent oral ulceration, candidiasis, glossitis (-iron), beefy (-vit b12, folate), oral dysaesthesia, mucosal pallor

75
Q

MCVs for types of anaemia

A

microcytic <80fL - iron deficiency, thalassaemia

normocytic 80-95fL - pregnancy, bleeding, sickle cell

macrocytic >96fL - vit B12, folate

76
Q

Give two local, four systemic causes of xerostomia

A

local -

  • sialolith
  • salivary gland tumour
  • developmental defects of salivary gland
  • radiotherapy problems in area
  • mouth breathing

systemic

  • medications - diuretics, cytotoxics, antidepressants
  • anxiety
  • diabetes
  • HIV
  • sjogren’s
  • dehydration
77
Q

how to assess xerostomia intraorally (3)

A

visual check of saliva pooling FoM
mirror sticking to buccal mucosa
saliva flow rate test

78
Q

signs and symptoms xerostomia

A 
frothy saliva 
increased cervical caries rate
increased perio
halitosis
difficulty eating
difficulty swallowing
difficulty speaking
candidiasis
79
Q

mgmt xerostomia

A 
hydration
modify drugs
control diabetes
control somatoform disorder
prevent candida infection
salivary substitute- saliva orthana
saliva stimulants- pilocarpine
80
Q

name 3 saliva substitutes

A

saliva orthana,
glandosane,
biotene

81
Q

name 3 saliva proteins

A

histatin
IgA
PRP
mucins

82
Q

name 3 saliva enzymes

A

lipase
amylase
lysozyme - antimicrobial

83
Q

Indications for antibiotic use in dentistry

A
  1. temporary treatment of acute infection where drainage or XLA not possible
  2. in cases of spreading infection e.g cellulitis
  3. as an adjunct to surgery e.g in aggressive periodontitis
  4. in immunocompromised pt s
84
Q

5 ways in which antibiotics work

A

CPDDC

cell wall destruction
protein synthesis inhibition
DNA synthesis inhibition
DNA replication inhibition
cell membrane inhibition
85
Q

3 cons ABs

A

GI disturbance
drug interactions
resistance
hypersensitivity

86
Q

mechanisms of antibiotic resistance

A

drug inactivation
altered target site
reduced accumulation
altered metabolism

87
Q

How can you differentiate between upper and lower motor neuron disease?

A

everything above eyebrows still functions in upper -
“upper spares upper”

  • as upper part of facial motor nucleus receives innervation from both crossed and uncrossed fibres so frontalis and obicularis oculi are spared.
88
Q

classification of motor neuron diseases

give 4 mnds

A

classified as to whether they are inherited or sporadic
and whether they affect upper, lower motor neurons or both.

Most common
- ALS - amyotrophic lateral sclerosis, affects both U and L, has inherited and sporadic forms

  • Primary lateral sclerosis – upper only affected
    - Progressive muscular atophy – lower only affected
    - Progressive bulbar palsy - lowest motor neurones of brain stem affected .:. difficulty eating, swallowing and speaking.
89
Q

what is geographic tongue?
incidence
implications

A

intraoral psoriasis of dorsum of tongue
affects 1-2%

no implications barr appearance- not related to any pathology!

90
Q

what is geographic tongue?
incidence
implications
mgmt

A

intraoral psoriasis of dorsum of tongue
affects 1-2%

no implications barr appearance- not related to any pathology!

reassure and monitor

91
Q

what is coxsackie virus?

name 4 conditions it causes

A

RNA virus

hand foot and mouth
herpangina
haemorrhagic conjunctivitis
aseptic meningitis

92
Q

What is epstein barr virus?

name 3 conditions it causes

A

human herpes virus 4

hairy leukoplakia
burkitt’s lymphoma
infectious mononucleosis - glandular fever

93
Q

two types of inhaler for asthma what are they

A

blue- salbutamol- beta 2 agonist

brown - beclomethasone - corticosteroid

94
Q

What is asthma?

A 
Reversible airflow obstruction.
characterised by:
1. smooth muscle contraction.
2. inflamed mucosa - causing swelling
3.  increased mucous secretion
95
Q

dental effects of inhalers and advice to give

A

increased candida - due to steroid effects
increased erosion - due to acidity
increased xerostomia - exacerbates erosion and candida

drink water after taking inhaler, use inhaler correctly as advised, use a spacer if poss.
+ follow good OH

96
Q

pt presents with asthma. you want to give fluoride therapy. what considerations should you make?

A

pt may be allergic to colophony and .:. fluoride varnish.

consideration to med emergencies.

97
Q

% in scotland treated for asthma

A

7%

98
Q

List 10 histological signs of epithelial dysplasia

A
  1. hyperchromatism
  2. pleomorphism
  3. basal cell hyperplasia
  4. drop shaped rete pegs
  5. altered basal cell polarity
  6. increase/ abnormal mitoses
  7. enlarged nuclei
  8. abnormal stratification
  9. abnormal keratisation
  10. loss of intercellular adhesion
99
Q

most common sufferers of oral dysaesthesia

common symptoms

A

50 y/o menopausal women

xerostomia
burning mouth
parasthesia

mucosa appears clinically normal

100
Q

SI oral dysaesthesia

A 
salivary flow rate
FBC 
haematinics
Hba1c
parafunction assessment
denture assessment
psychiatric assesment
101
Q

diff diag oral dysaesthesia

A 
lichen planus
diabetes
denture problems
dental effect
Recurrent oral ulceration
102
Q

mgmt oral dysaesthesia

A 
reassure
correct any deficiencies
treat possible causes- diabetes
correct parafunction or denture fault
difflam MW
CBT
gabapentin - antineuropathic/ antidepressant
103
Q

pt presents with swelling of the lips and surrounding tissues, lips are slightly crusted. what could you ask the patient to help diagnose?
what could this most likely be?

A

any systemic inflammatory conditions e.g sarcoidosis or Crohn’s disease
OFG can precede these conditions for years!

orofacial granulomatosis - swelling of lips and surrounding tissues secondary to an underlying granulomatous inflammatory process.

  • Type IV hypersensitivity reaction
  • lymphomatous swelling due to blockage of lymph channels

sarcoidosis - groups of inflammatory cells form lumps- in lungs, skin or lymphs

104
Q

aetiology of OFG

A

autoimmune
hypersensitivity to SLS, cinnamon, benzoates
non- caseating giant cell granulomas

105
Q

histological appearance OFG

A

non- caseating giant cell
oedema
dilated lymph

106
Q

Signs and symptoms OFG

A 
lip swelling and crusting
angular cheilitis
stag horned sublingual folds
buccal cobblestoning
ulceration of buccal sulcus
107
Q

Mgmt OFG

A 
dietary advice - re: avoidance allergens
antibiotics: erythromycin
tacrolimus on lips
oral steroids
no surgery!!

benzoates: e210-e219
preservative in processed foods, drinks and occur naturally in fruit, tea, chocolate

108
Q

risks of radiotherapy

A 
mucositis
xerostomia
increased infection
poor wound healing
osteoradionecrosis
109
Q

grades of mucositis

A
  1. sore and erythematous
  2. erythematous and ulcers - can eat
  3. ulcers - liquids only
  4. cannot take anything orally
110
Q

mgmt mucositis

A 
prevention
good oh
analgesics
topical lidocaine
sls- free toothpaste
ice chips
CHX
tea tree oil
111
Q

histological difference between pemphigus and pemphigoid

A

Pemphigoid - Sub-basal split, autoantibodies attack hemidesmosomes

Pemphigus - Supra-basal split, autoantibodies attack desmosomes, Tzank cells, acantholysis

112
Q

risk factors oral cancer

A

Multifactorial → Smoking, alcohol (combo x35), poor OH, diet, viral e.g. HPV 16&18, age, betel quid

113
Q

signs and symptoms oral cancer

A

> 3 months unexplained ulcer, white patch, red patch, welling
hoarseness
unexplained mobility
dysphagia

ulcer –» rolled border, indurated, bleeding, numbness, late presentation pain, exophytic

114
Q

metastatic cascade

A 
primary tumour formation ->
local invasion ->
intravasation ->
survival in circulation ->
arrest at distant organ site -> 
extravasation -> 
initial proliferation ->
metastasis colonisation
115
Q

high risk areas oral cancer

A

lateral border of tongue
FoM
Soft palate

116
Q

pt presents with 2cm ulcerated lesion on palate. diff diag?

how would you aid diagnosis

A

necrotising sialometaplasia
squamous cell carcinoma
mucoepidermoid carcinoma

biospy for histology
if decide NS (benign) then rebiopsy in 3 months if still present

117
Q

what is necrotising sialometaplasia?
aetiology?
SI?
Mgmt?

A

benign, self-limiting inflammatory reaction of salivary gland tissue
appears v similar to SCC.

aetiology:ischaemia of salivary gland tissue, due to smoking, trauma or LA

SI: biopsy for histology - would be expecting to see
Surface slough necrotic tissue, hyperplasia, metaplasia of the ducts, necrosis of salivary acini & inflammatory exudate,

would expect to heal in <3 months - spontaneous healing. no mgmt bar reassure pt.

118
Q

pt presents with swollen lower lip. diff diag?

A

mucocele
OFG
SCC
trauma

119
Q

What is a mucocele
Histological appearance?
mgmt

A

recurrent lip swelling due to damaged salivary gland- recurrent

macrophage lined cavity w/ saliva and granulation tissue - foam cells

mgmt: excision of mucocele and gland.

120
Q

Name for mucocele on FoM

A

RANULA

121
Q

Where does median rhomboid glossitis occur?

3 histological features?

A

dorsum of tongue anterior to sulcus terminalis.
(where tongue divides into post 1/3, from ant 2/3)

candida hyphae infiltration
PMNL infiltration
elongated/hyperplastic rete ridges

122
Q

Name 5 antifungal agents

A 
miconazole
fluconazole
CHX
nystatin
Itraconazole
123
Q

5 virulence factors of candida

A 
germ tube formation
phenotype switching 
extracellular enzymes
adhesion
acidic metabolites
124
Q

what hormones would adrenal insufficiency affect?

how would this affect the body

signs

A

steroids e.g cortisol
mineralcorticoids e.g aldosterone

.:. stress response - mood, motivation fear
+
sodium conservation, potassium secretion,water retention

signs: oral pigmentation, hair loss, weakness, anorexia, postural hypertension, lethargy

adrenal crisis!

125
Q

What information should be written on a prescription

A 
patient name, address
pt age if <12
date
number of days of treatment
generic drug name
SEND 
LABEL
score out extra space
GDP name
Signature
GDP stamp
126
Q

Common dosages for two antibiotics used for dental abscessed

A

amoxycillin 500mg SEND: 15 capsules LABEL: 1 capsule 3 times daily

metronidazole 400mg SEND: 15 capsules
LABEL: 1 tablet 3 times daily

127
Q

Rate of infection of

HIV
HEP B
HEP C

on exposure

A

HIV: 0.3%

HEP B: 30%

HEP C: 3%

128
Q

6 oral lesions assoc/w/ HIV

A
  1. candidiasis esp. pseudomembranous and erythematous
  2. karposi’s sarcoma
  3. hairy leukoplakia
  4. non hodgkins lympoma
  5. Periodontal disease - NUG
  6. herpetic like ulcers
129
Q

how is HIV diagnosed and treated?

A

ELISA
enzyme linked immunosorbent assay

HAART
highly active anti-retroviral therapy

130
Q

What is a fibrous epulis?
aetiology?

histological appearance?

A

a localised fibrous enlargement of gingival tissues
- called a fibroepithelial polyp elsewhere

caused by low grade chronic irritation

ulceration, granulation, metaplastic bone

131
Q

3 GI diseases that may cause microcytic anaemia?

A

crohns
ulcerative colitis
coeliac disease

132
Q

What to write on lab sheet for sample

A

pt name, address, contact
GDP name and details

clinical description and provisional diagnosis

specimen type and site
drawing if applicable

tests- done previously and to be tested now - culture, viral
ABs- current, today, resistance

MH
DRUG HISTORY
DH

signature
date
time of sample

133
Q

what is sjogren’s

A

autoimmune condition with lymphocytic infiltration of exocrine glands, causing glandular dysfunction
characterised by dry eyes, dry mouth

134
Q

what conditions are commonly associated with sjogren’s

A

rheumatoid arthritis
SLE
scleroderma

135
Q

6 investigations used to diagnose sjogren’s

A

subjective/objective for dry eyes, mouth

subjective dry eyes: >3months gravel/sand feeling, using tear sub 3xdaily
objective dry eyes: schirmer test - <5mm in 5 mins

subjective dry mouth: >3 months needing liquid for swallowing/ gland swelling
objective dry mouth: <1.5ml in 15 minutes unstimulated salivary flow

autoantibody findings: anti-Ro and anti-La
histology: biopsy of labial gland @premolar region of inner lip w/ >5 minor glands

136
Q

what are the histological findings - minor and major

sjogrens

A

minor: acinar loss, fibrosis, focal lymphocytic sialadenitis
major: acinar loss, lymphocytic infiltration, myoepithelial islands, epithelial hyperplasia,

137
Q

4 oral complications of sjogrens

A 
increased caries rate
increased perio
increased infection e.g candida
denture retention difficulty 
salivary lymphoma
138
Q

systemic drug to manage sjogrens

A

prilocarpine

139
Q

name a hereditary white patch

how does it appear histologically

A

white sponge naevus

140
Q

how does smokers keratosis appear histologically

A

oedema in prickle layer

PARAkeratosis

141
Q

pt presents with tumour like, fibrous growth around where denture sits. diff diag?

A

denture induced hypoplasia
leaf fibroma
SCC
pyogenic granuloma

142
Q

factors that cause denture induced hypoplasia

histological features

mgmt

A

ill fitting denture causing trauma,
fibrous reaction of gingiva

pseudoepithelial hyperplasia
candida often present

mgmt: LA, excise hyperplastic area,
short term tissue conditioner on denture
then remake denture

Past MSAs (23 decks)

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