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Fourth year > Oral Medicine > Flashcards

Oral Medicine Flashcards

1
Q

what is a licenced medication

A

A medicine that has been proven in evidence to the MHRA to have efficiency and safety at defined doses in a child and/or adult population when treating specified medical conditions

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2
Q

what is an unlicenced medicine

A

medicines that have not had evidence of efficacy submitted for the condition under treatment
- used at the discretion of the treating physician
- patients should be informed medicine being used is ‘off liscence’
- must be supplied with a PIL

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3
Q

What is aciclovir used to treat

A
  • primary herpetic gingivostomatitis
  • recurrent herpetic lesions
  • recurrent herpes zoster
  • herpes simplex in immunocompromised or severe infections in non immunocompromised
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4
Q

Give an appropriate regimen of drug to prescribe for a patient who is immunocompromised and has herpes simplex infection

A
  • Aciclovir tablets 200mg
  • 25 tablets, 1 to be taken 5 times a day for 5 days
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5
Q

Give an appropriate regimen of drug to prescribe for a patient who is not immunocompromised and does not have a severe herpes simplex infection

A
  • Aciclovir cream 5%
  • give 2g, and apply to lesion every 4 hours for 5 days
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6
Q

Give an appropriate regimen of drug to prescribe for a patient who has varicella zoster infection (shingles)

A
  • aciclovir 800mg
  • give 35 tablets, 1 tablet to be taken 5 times per day for 7 days
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7
Q

name the three antifungal medications used to treat pseudomembranous candidiasis and erythmatous candidiasis

A
  • fluconazole
  • miconazole
  • nystatin
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8
Q

what patient groups are predisposed to pseudomembranous candidiasis and erythematous candidiasis

A
  • Patients taking inhaled corticosteroids, cytotoxics or broad-spectrum antibacterials
  • diabetic patients
  • patients with nutritional deficiencies
  • immunocompromsied > HIV, leukemia/other cancers
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9
Q

give a 7 day regimen for fluconazole (antifugnal)

A
  • fluconazole 50mg capsules
  • send 7 capsules, 1 taken daily
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10
Q

When should you not prescribe fluconazole

A
  • if a patient takes warfarin or statins
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11
Q

give a 7 day regimen for miconazole to treat candidiasis

A
  • miconazole gel 20mg/g
  • send 80g tube and apply pea-sized amount after food four times per day
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12
Q

when should you not prescribe miconazole

A
  • when a patient is on warfarin or statins
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13
Q

what is an appropriate regimen of beclomethasone diproprionate inhaler for mucosal ulceration condition

A
  • 50micrograms/metered dose
  • send 200 dose unit and label 1-2 puffs directed onto ulcers twice daily
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14
Q

what is an appropriate regimen of betamethasone for mucosal ulceration lesions

A

0.5mg (1mg with 10mls water) rinse for two minutes twice daily

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15
Q

what is an appropriate regimen of hydrocortisone oromusocsal tablets for oral ulcer lesions

A
  • 2.5mg tablets
  • send 20 tablets
  • label 1 tablet dissolved next to lesion four times daily
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16
Q

Wha must be included in a prescription

A
  • Patients name, address and age if under 18
  • Patients identifier (DoB and CHI number)
  • Number of days of treatment
  • Drug to be prescribed
  • Drug formulation and dosage
  • Instructions on quantity to be dispensed
  • Instructions to be given to the patient
  • Signed, identifier of prescriber
17
Q

how long is a prescription valid for

A

six months from the date of issue

18
Q

what are the risks of systemic steroid use over a prolonged time

A
  • adrenal suppression
  • cushingoid features
  • osteoporosis
  • peptic ulcer risk
  • mania/depression
19
Q

what is hydroxychloroquine mainly used for in oral medicine

A

lichen planus

20
Q

what special instructions would you give when prescribing betamethasone mouthwash

A
  • oral candida risk
  • must spit out to avoid systemic steroid effects
  • do not rinse after use
21
Q

When prescribing beclomethasoe what should you inform patient

A
  • small candida risk
  • dont rinse mouth after use or effect will be lost
22
Q

why are white lesions white

A
  • a thickening of the mucosa or keratin causes the blood vessels in the connective tissue to be less visible
  • similarly, a decrease in blood flow through the connective tissues will cause a decrease in the pink colour seen in the mucosa (an example is blanching when LA is injected into mucosa)
23
Q

what is leukoplakia

A

a white patch which cannot be scrapped off or attributed to any other cause

(it is a clinical description)

24
Q

what are Fordyce’s Spots

A

Ectopic sebaceous glands that should be in the skin
benign and normal structures
not a disease with malignant potential

25
Q

Describe white sponge naevus

A

a keratosis not from traumatic origin. It is hereditary. Fluid accumulates between the epithelial cells, making it difficult to see through the epithelium

26
Q

when should you refer a white lesion

A
  • if lesion is becoming more raised and thickened
  • if it has an inflammatory margin
  • if lesion is without cause on the lateral tongue, anterior floor of mouth or soft palate area
27
Q

why are red lesions res

A
  • the blood flow has increased due to inflammation or dysplasia
  • there is a reduced thickness of the epithelium
28
Q

what is erythroplakia

A

a red patch which cannot be attributed to any other cause

29
Q

what is keratosis

A

thickening of the epithelial layer with keratinocytes in a nonkeratinised site (parakeratosis)

30
Q

what is atrophy

A

reduction in visible layers

31
Q

what is erosion

A

partial thickness loss of epithelium

32
Q

what is ulceration

A

complete loss of epithelium

33
Q

what can cause smooth change in tongue

A

nutritional deficiencies (iron or b vitamin)

34
Q

what gives geographic tongue its characteristic appearance

A

halting of epithelial replication - the loss of cells from surface of tongue continues but there is no replacement which results in thinning of the epithelial layer. This thinner layer can appear red as there is less of a barrier to the CT and blood vessels underneath

Fourth year (12 decks)

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