Salivary Glands

Question 1

Features of sialolithiasis

Answer 1

80% submandibular
Classic story: pain and swelling on eating
Red, tender, swollen but uninfected gland

Question 2

Ix for sialolithiasis

Answer 2

Plain XR

Sialography

Question 3

Mx of sialolithiasis

Answer 3

Distal stones are removed via mouth but deeper stones may require excision of gland

Question 4

Sjogren’s syndrome

Answer 4

Chronic inflammatory AI disorder, which may be primary or secondary (associated with CTD e.g. RA, SLE, systemic sclerosis)

Question 5

Histology of Sjogren’s syndrome

Answer 5

Lymphocytic infiltration and fibrosis of exocrine glands (esp lacrimal and salivary)

Question 6

Features of Sjogren’s syndrome

Answer 6

Decreased tear production
Decreased salivation
Parotid swelling
Vaginal dryness and dyspareunia
Dry cough
Dysphagia
Systemic signs: polyarthritis, Raynaud's, lymphadenopathy, vasculitis, lung/liver/kidney involvement

Question 7

Associations of Sjogren’s syndrome

Answer 7

Other AI diseases: thyroid disease, AIH, PBC

Question 8

Ix for Sjogren’s syndrome

Answer 8

Schirmer’s test: conjunctival dryness

Anti-Ro, anti-La Abs, ANA, RhF

Question 9

Mx of Sjogren’s syndrome

Answer 9

Artificial tears
Frequent drinks, sugar-free pastilles/gums
NSAIDs for arthralgia
Immunosuppressants may be indicated in systemic disease

Question 10

Causes of parotiditis

Answer 10

Infectious: bacterial (usually Staph aureus, TB), viral (e.g. mumps, HIV)
AI: Sjogren’s
Sialolithiasis