oral med - other

Question 1

signs/ features of dry mouth

Answer 1

swallowing difficulty
denture rubbing
altered taste
cervical caries
halitosis
candida
discomfort

Question 2

chronic conditions that may cause dry mouth

Answer 2

renal disease
poorly controlled diabetes
persistent vomiting
addisons
HIV
GVHD

Question 3

treatment of dry mouth

Answer 3

1 - hydration, sugar free gum, frequent water, saliva subsitutes (gum, lozenges, spray)
2 - prevention - duraphat toothpaste, good denture hygiene
3 - pilocarpine , saliva stimulant (radiotherapy adn sjogrens)

contact GP to ask if any drug changes could be considered

Question 4

how to test facial nerve (CN 7)

Answer 4

• wrinkle forehead
• puff cheeks
• raise eyebrows
• pout lips

Question 5

how to test trigeminal nerve (CN 5)

Answer 5

ask pt to close eyes
light touch on forehead cheeks and chin on each side
can patient clench jaw

Question 6

how to test hypoglossal nerve (CN 12)

Answer 6

can patient protrude tongue - is there any deviation

Question 7

what is lichen planus

Answer 7

fairly common immune mediated condition affecting skin and or mucous membranes

CD8 T cells destroy basal keratinocytes

Question 8

4 presentations of lichen planus

Answer 8

reticular
atrophic
papular
bullous
erosive

Question 9

drugs implicated in causing lichenoid reactions

Answer 9

anti hypertensives
NSAIDS
anti malarials

Question 10

3 main culprit drugs for causing dry mouth

Answer 10

amitriptyline
lithium
bendroflumethiazide

Question 11

investigations for dry mouth that may be done

Answer 11

HbA1c
U and E
Autoantibody screen
Ultrasound of glands

Question 12

reasons for swelling/ lumps of salivary glands

Answer 12

blockage
sjogrens
viral infection e.g mumps
tumour - benign or malignant

Question 13

signs of salivary gland obstruction (obstructive sialadenitis)

Answer 13

swelling of gland
pain at meal times/ when eating
unable to express saliva from gland - is there an obvious obstruction