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Oral Medicine > Salivary gland diseases > Flashcards

Salivary gland diseases Flashcards

1
Q

inflammation of salivary glands aka

A

sialadenitis

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2
Q

sialadenitis breakdown

A

viral infection

  • mumps
  • HIV

bacterial infection

sarcoid sialenditits

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3
Q

mumps cause

A

paramyxovirus

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4
Q

incubation of mumps

A

14-21 day incubation

acute onset - within 2 weeks

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5
Q

mumps onset, location and prediclition to

A

usually in children
- bilateral or unilaeal parotid gland enlargment

low grade fever

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6
Q

high grade fevers with mumps

A

suggestive of metastatic orchitis - in 25 % of males or meningitis

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7
Q

diagnosis of mumps

A

enlargmentof parotid

isolate in saliva

uses RT- PCR

paired serum IgG IgA / IgM – acute vs convalescent serum
- 4 fold rise in mumps antibody titers

IgM raised in early stage

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8
Q

histopathology of mumps

A

biopsy is not customarily to diagnose

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9
Q

treatment of chldren in mumps

A

self limiting in 1-2 weeks
- hydration, rest, isolation

nno specific therapy is given other than bed rest, analgesic and hydration

rare deaths occur from meningitis progressing to encephalitis

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10
Q

mumps vaccine when

A

15 months second to 4-6 years

with the MMR – mumps-measles-rubella

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11
Q

dont give vaccination of mumps to who

A

immunocompromised or those allergic to eggs or neomycin

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12
Q

HIV infection manifestations

A

salivary gland enlargment of unknown etiolgy – but viruses are the suspected cause

parotid is involved 98% of the time and disease is bilateral in 60% of the cases

more common in children than adults

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13
Q

HIV parotitis

A

fluid filled cysts of all sizes together with a diffuse inflammation,

thin epithelial lining with sever inflammation

CD 8 lymphocytes
NOT CD4

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14
Q

cytomegalovirus associated with

A

human herpes 5 – with the HIV parotitis

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15
Q

tx of the HIV parotitis

A

remove cyst and the surrounding gland tissue

can supplement

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16
Q

bacterial infection lovation

A

usually UNILATERAL

- VS viral = bilateral

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17
Q

bacterial infection in salivary glands?

A

actinomycosis - sulfur granules

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18
Q

actinomycosis ?

A

if occurs in the salivary glands – accompanied by SULFUR granules in the purulent discharge

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19
Q

tx in acute suppurative sialadenitis

A

must be treated aggresssively

surgical drainage more imp than medications

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20
Q

sarcoid sialadenitis

A

sarcoidosis is a multisystem granulomatous disease with lympho- proliferation

systemic disease

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21
Q

cause of sarcoidosis

A

atypical mycobacterial infection or an altered reaction to mycobacterial tuberculosis

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22
Q

clinical features of sarcoid sialadenitis

A

BILATERAL DIFFUSE ENLARGMENT OF THE PAROTID GLANDS – indicates an early involvment in sarcoidosis

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23
Q

diagnosis of sarcoidosis

A

ESR elevated

CBC – leucopenia and or eosinophilia

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24
Q

diagnosis of sarcoidosis

A

ESR elevated

CBC – leucopenia and or eosinophilia

hypercalcemia – in advanced stages of disease he range of 50-80 mmHg

arterial hypoxema PaO2 in t

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25
Q

biopsy of sarcoid

A

incisional parotid gland biopsy

but if it has all 4 clinical signs – do not need to biopsy - then just follow

26
Q

tx for sarcoidosis

A

those with certain organ involvments or disease manifestations require corticosteroid therapy –like prednisone

27
Q

sialoliths form around..**

A

a nidus in CONCENTRIC layers – suggesting that some event

  • inflammation
  • bacterial colonization
  • foreign body
  • sloughed cells

precedes their formation *

the presence of tumors can initiate stone formation

28
Q

name for submandibular and parotid glands

A

sialocele

29
Q

ranula

A

sublingual

30
Q

mucocele

A

minor salivary gland

31
Q

tx of mucocele

A

remove completely

32
Q

ranula results of

A

from extravasation of saliva from any one of the 20 ducts that arise from t he sublingual gland, initiated by ductal injury or inflammation created by sialoliths of the whartons ducts

large 3-6 cm and form a blue, tense vesicle in the floor of the mouth

treated by excision of the fibrous capsule and the entire sublingual gland from which it arises

33
Q

superficial mucocele where

A

formed after a duct rupture in the subepithelial location of the palate and retromolar areas as small yellow or gray vesicles

difficult to find entire gland

34
Q

treatment for ranula

A

excision of the fibrous capsule and the ENTIRE sublingual gland from which it arises

35
Q

dry mouth causes

A 
drug induced 
radiation
plummer inson syndrome
diabetes 
HIV
subjective dry mouth - exclude any other possible causes
36
Q

normal daily secretion of saliva

A

1 and 1.5 L

37
Q

1 drug that causes dry mouth

A

2 = azathioprine

antidepressant medication
trcyclic antidepressants cause morme of these side-efffects than the newer biocyclic and tetracyclic agents

38
Q

azathioprine

A

immunosuppressive medication commonly used for renal transplantaion and RA may cause dry mouth during the t

39
Q

radiation induced dry mouth

A

2 years after

local side effect
only with radation that is covering the gland area

can get severe mucositis and xerostmia

40
Q

plummer vinsom syndrome

A

manifestation of iron-deficiency anemia

particulary in females

estimated that between 5 and 30 ercent of woman in US are iron deficient – while in some parts of the world is 50%

41
Q

clinical features of plummer vincon syndrome

A

dry mouth

cracks and fissures at the corners of the mouth

smooth red and painful tongue

atrophy of the upper alimentary tract – high risk of gastric cancer – atrophic change of gastric mucosa – can go to cancer

lab
low serum iron
low red blood cell count
no megaloblasts typical of pernicious anemia

lower hemociderin

42
Q

sjogren syndrome

A

autoimmune destruction of salivary and lacrimal glands that produces the clinical manifestations of dry mouth and dry ees and in more than 50% of cases - parotid enlargment

43
Q

insulin dependent diabetes

A

dry mouth and candidiasis can be common

44
Q

HIV patient and dry mouth?

A

yes + erythmatous candidiasis
1. side effect of anti viral medication
+ there is involvment of the parotid

erythema – because immunocompromised

45
Q

infiltration of what in sjorgren

A

lymphocytes

46
Q

hallmark of sjorgens

A

lymphocytic infiltratino of glands is the hallmark of sjorgens histopathology

47
Q

punctate sialectasis

A

think sjorgen’s

48
Q

tear test

A

schirmer tear function test

49
Q

asymptomatic mass

A

salivary gland neoplasm is on your dx

50
Q

largest number of salivary gland tumor is located

A

parotid gland

benign and malignant

51
Q

% of tumors in parotid that are benign

A

80%

52
Q

if mass found in ___ more likely to be malignant

A

sublingual gland – as it is an uncoomon site for neoplasms so majority are malignant

53
Q

most common tumore in both major and minor

A

pleomorphic adenoma

54
Q

which tumors have strong prediliction for warthin tumor

A

warthin tumor, basal cell adenomas, onocytomas, acinic cell carcinoma, and sebaceous tumor

55
Q

prediliction for minor salivary glands

A

pleomorphic low grade adenocarcinoma

56
Q

most intraoral salivary gland tumors favor what

A

favor the palate

57
Q

benign malignant ratio is minor salivary gland tumors is

A

1:1

58
Q

palate with normal epitheium mass nodular - no symptoms

A

ddx

- minor salivary gland tumor should be on

59
Q

free margin of surgical removal

A

adequate resection of pleomorphic adenoma

extracapsular stuff could be left behind

if do not have enough margin – will come back

60
Q

clinical margins

A

1-1.5 cm including the full palatal thicckness of muscosa and periosteum

61
Q

granulation of palate will occur in

A

after 2 weeks – can remove the splint

2 months

Oral Medicine (11 decks)

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