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BDS 2: CHHD > Rheumatology II > Flashcards

Rheumatology II Flashcards

1
Q

Name some inherited non-autoimmune bone disorders (3)

A
  • Osteogenesis Imperfecta
  • Cleidocranial Dysplasia
  • Osteopetrosis
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2
Q

Name some acquired non-autoimmune bone disorders (6)

A
  • Osteomalacia and Rickets
  • Osteoporosis
  • Osteomyelitis
  • Paget’s disease of bone
  • Osteoarthritis
  • Fibrous dysplasia
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3
Q

What type of condition is osteogenesis imperfecta?

A

Autosomal dominant inherited condition

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4
Q

Osteogenesis imperfecta causes defective formation of which type of collagen?

A

Type 1 collagen

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5
Q

What are some clinical features of osteogenesis imperfecta? (3)

A
  • Multiple fractures on minimal impact (less after puberty)
  • Gross deformity and dwarfism due to bone distortion on healing
  • Parietal bossing causing eversion of upper part of ear
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6
Q

What are some potential complications that can arise from osteogenesis imperfecta? (6)

A
  • Cardiac complications
  • Deafness
  • Blue sclera
  • Easy brushing
  • Hernias
  • Weak tendons/ligaments
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7
Q

How could you diagnose osteogenesis imperfecta? (5)

A
  • Positive family history
  • Clinical presentation
  • Radiographs
  • Skin biopsy
  • DNA-based sequencing
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8
Q

How is osteogenesis imperfecta managed? (2)

A
  • Supportive therapy to decrease fractures and deal with disability
  • Bisphosphonates to prevent bone loss
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9
Q

What is the dental relevance of osteogenesis imperfecta? (5)

A
  • Handle patients carefully due to bone fragility
  • Not to be confused with physical abuse
  • Minimal force, support jaws, ensure haemostasis
  • Linked with dentinogenesis imperfecta
  • Bisphosphonates used
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10
Q

What is Cleidocranial dysplasia?

A

Rare autosomal dominant trait on Chromosome 6 causing defect of membrane bone formation

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11
Q

What are some clinical features of Cleidocranial dysplasia? (4)

A
  • Absent or defective clavicle
  • Prognathic mandible due to maxillary hypoplasia
  • Depressed nasal bridge
  • Frontal, parietal and occipital bossing
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12
Q

How could you diagnose Cleidocranial dysplasia? (2)

A
  • Clinical findings

- Radiographic imaging

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13
Q

What is the dental relevance of Cleidocranial dysplasia? (5)

A
  • Facial abnormalities
  • Deciduous teeth retention causing delayed permanent eruption
  • Hyperdontia
  • Twisted roots
  • Dentigerous cyst
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14
Q

What is another name for Osteopetrosis?

A

Marble bone disease

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15
Q

What is Osteopetrosis?

What is it caused by?

A
  • Rare genetic disorder characterised by excessive bone density
  • Defective osteoclastic activity and remodelling
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16
Q

What are some clinical features of Osteopetrosis? (5)

A
  • Bone pain and fractures
  • Osteomyelitis
  • Infections and anaemia
  • Cranial neuropathies
  • Epilepsy
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17
Q

What is the dental relevance of Osteopetrosis? (4)

A
  • Frontal bossing
  • Trigeminal/Facial neuropathies causes issue s
  • Jaw fracture
  • Delayed tooth eruption
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18
Q

What is Osteomalacia?

A

Failure of mineralization of replacement bone in normal bone turnover

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19
Q

What is rickets?

A

Inadequate mineralisation of bone framework

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20
Q

What is the main difference between osteomalacia and rickets?

A

Rickets affects children whereas osteomalacia affects adults

21
Q

What are some risk factors associated with Osteomalacia and Rickets? (6)

A
  • Vitamin D deficiency
  • Pigmented skin
  • Calcium malabsorption
  • Renal diseases
  • Drugs
  • Pregnancy and lactation
22
Q

What are some clinical features of Osteomalacia and Rickets? (6)

A
  • Weak muscles
  • Bone pain
  • Fractures
  • Bone deformity and impaired growth in children
  • Hypocalcemia, tetany and seizures
  • Swellings at costochondral junctions
23
Q

What is Rachitic rosary?

A

Swellings at costochondral junctions

24
Q

How could you diagnose Osteomalacia and Rickets?

A

Looking for pseudo fractures through radiology

25
Q

What are some biochemical findings of Osteomalacia and Rickets? (4)

A
  • LOW PO4 & Ca2+
  • RAISED ALP
  • RAISED PTH
  • LOW Vitamin D
26
Q

What can be given to aid Osteomalacia and Rickets?

A

Vitamin D and Calcium supplements

27
Q

What is the dental relevance of Osteomalacia and Rickets? (2)

A
  • Potential delayed eruption

- May cause Vitamin K deficiency and hyperparathyroidism

28
Q

What is osteoporosis?

A

Diminished bone mass leading to fragility and increased risk of fracture

29
Q

What does osteoporosis normally affect? (3)

A
  • Spine
  • Forearm
  • Hips
30
Q

What are some modifiable risk factors of osteoporosis? (7)

A
  • Smoking
  • Alcohol abuse
  • Low dietary calcium intake
  • Vitamin D insufficiency
  • Lack of physical activity
  • Immobility
  • Drugs
31
Q

What are some non-modifiable risk factors of osteoporosis? (4)

A
  • Old age
  • Female
  • Race (Caucasians/Asians)
  • Family history
32
Q

Where are typical fracture sites for osteoporosis patients? (3)

A
  • Thoracic and Lumbar vertebrae
  • Head of femur
  • Distal radius
33
Q

What visible clinical features can potentially be observed from a patient with osteoporosis? (2)

A
  • Kyphosis

- Height shrinkage

34
Q

What can be given to manage osteoporosis?

A
  • Dietary advice (more calcium and vitamin D)

- Bisphosphonates

35
Q

What is the dental relevance of osteoporosis? (3)

A
  • Jaw osteoporosis can cause excessive alveolar loss (especially women)
  • GA may be contraindicated
  • Use of Bisphosphonates
36
Q

How should you approach treatment of someone with osteomyelitis?

A

Delay all elective dental treatments until complete resolution of infection

37
Q

What is Paget disease of bones?

A

Progressive bone enlargement and deformity from osteoclastic and osteoblastic over-activity

38
Q

What are commonly affected sites of paget disease of bones? (6)

A
  • Pelvis
  • Lumbar spine
  • Femur
  • Thoracic spine
  • Skull
  • Tibia
39
Q

Where is pain normally located for patients with Paget disease of bones?

A

Hips and Knees

40
Q

What types of deformities are associated with Paget disease of bones? (2)

A
  • Skull enlargement

- Bowed tibia

41
Q

What is the dental relevance of Paget disease of bones? (4)

A
  • Patients can develop heart failure
  • Avoid GA
  • Hypercementosis may complicate extractions
  • Senses of hearing, sight and smell may deteriorate
42
Q

What is osteoarthritis characterised by?

A
  • Degeneration of the articular cartilage
  • Thickening of the exposed underlying bone
  • Development of peri-articular cysts
  • Joint deformation
43
Q

What are some risk factors of osteoarthritis? (6)

A
  • Age
  • Gender
  • Obesity
  • Fracture through a joint
  • Congenital joint dysplasia
  • Paget’s disease and gout
44
Q

What are some clinical features of osteoarthritis? (5)

A
  • Joint pain (worse on movement relieved by rest)
  • Stiff joint
  • Deformity
  • Loss of function
  • Herberden’s nodes
45
Q

What is the dental relevance of osteoarthritis? (4)

A
  • Dental care access complicated by age and immobility
  • Bleeding tendency due to aspirin
  • Reduced manual dexterity
  • TMJ involvement
46
Q

How can osteoarthritis be managed? (5)

A
  • Regular exercise
  • Weight control
  • Good footwear
  • Use of a walking stick
  • Heat/cold
47
Q

What is fibrous dysplasia?

A

Replacement of an area of bone by fibrous tissues

48
Q

Which type of fibrous dysplasia affects women more?

A

Monostotic fibrous dysplasia

BDS 2: CHHD (28 decks)

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