SCD 3

Question 1

what is the general implication of dementia

Answer 1

progressive deterioration of cognitive function
(memory, language, orientation etc)

Question 2

what are the 4 different types of dementia

Answer 2

alzheimers
vascular
dementia with lewy bodies
fronto temporal

Question 3

alzheimers dementia

Answer 3

most common
severe size reduction of hippocampus
results in communication difficulties , moodswings, confusion , loss of confidence, memory loss

Question 4

vascular dementia

Answer 4

reduction in blood flow to brain which damages and eventually kills brain cells
can be a result of a stroke or multiple TIAs
sees anxiety, memory problems, delusions, visospatial difficulties

Question 5

dementia with lewy bodies

Answer 5

has similarities to parkinsons
cognitive ability fluctuates, STML, hallucinations, speech and swallowing problems, sleep disorders

Question 6

frontotemporal dementia

Answer 6

jim
younger onset
personality changes, possible aggresion , difficulty with language
STML not always present

Question 7

early symptoms of dementia

Answer 7

STML
confusion , poor judgement, not wanting to make decisions
communication issues
anxiety

Question 8

middle stage symptoms of dementia

Answer 8

increasingly forgetful , may not recognise loved ones
distress, anger and frustration
risk of wandering , leaving oven on etc
reminders needed to eat / wash / dress

Question 9

how is dementia diagnosed

Answer 9

cognitive testing
mini mental state examination is the most common - easy to do and samples a range of cognitive function
however does not test frontal lobe very well and is not sensitive to mild impairment - no time limit between question and recall

Question 10

chronological vs biological old age

Answer 10

chronological = actual age e.g 78
biological = lifestyle age - are they independent , good mobility and have good cognitive function

Question 11

what is frailty

Answer 11

a state of increased vulnerability to stressors due to age related declines in physiological reserves across neuromuscular, metabolic and immune systems

Question 12

what have studies shown increases oral health related quality of life

Answer 12

increased number of teeth
having anterior teeth
increased pairs of occluding teeth

Question 13

what is candidosis/ candidiasis

Answer 13

accumulation of candida albicans fungus in mouth also known as oral thrush
appears as white patches that may bleed upon removal

Question 14

predisposing factors for candidiasis

Answer 14

antibiotic use, smoking, xerostomia, iron deficiency , cushings, diabetes

Question 15

what is miconazole gel and what pts shouldnt be given it

Answer 15

an antifungal that can be used to treat candidiasis
can be put on fitting surface of dentures if denture stomatitis present
contraindicated for warfarinised patients (increased anticoagulating effects) or patients taking statins (increased risk of myopathy)

Question 16

haemangioma

Answer 16

collection/ malformation of bvs creating a pool of blood under mucosa
if traumatised it will bleed
most common oral sites = edges of tongue and inside lip
require hospital removal

Question 17

fibroepithelial polyp

Answer 17

nothing sinister
skin tags whose mucosa looks the same as the mucosa in the rest of the mouth
root cause = trauma with inproper healing
sides of cheeks = most common site

Question 18

black hairy tongue

Answer 18

seen in elderly smokers
due to overgrowth of tongue surface which easily picks up staining
difficult to get rid of
(nothing sinister, but may smell)

Question 19

Geographic tongue
erythema migrans

Answer 19

aread of atrophy (reddish) surrounded by white slightly raised margins
spicy and citrus foods can cause sensitivity

Question 20

atrophic glossitis

Answer 20

really smooth tongue
most common cause = haematinic deficiency , request bloods from GP
can lead to ulceration

Question 21

frictional keratosis

Answer 21

white patch from trauma thats undergone keratinisation
always review for healing
closely monitor if no trauma/ denture cause found

Question 22

sublingual keratosis

Answer 22

leukoplakia in sublingual region
refer to OM could be malignant

Question 23

denture induced hyperplasia

Answer 23

growth of excess mucosa due to denture rubbing

Question 24

denture induced stomatitis

Answer 24

erythema of hard palate due to candida infection
often painless
remind pt to remove and clean denture at night

Question 25

angular chellitis

Answer 25

mixed bacterial/ fungal infection at commisures of mouth
difficult to heal
often due to poor hygiene dentures providing a reservoir for bacteria and fungi
try and deal with problem e.g increasing a reduced OVD before prescribing any meds

Question 26

what two drug tablets may cause burns if pt pouches them

Answer 26

iron and aspirin tablets

Question 27

lichenoid reaction

Answer 27

direct reaction to certain drugs and materials
e.g NSAIDS, diuretics, amalgam

Question 28

action of bisphosphonates and what patients might be taking them

Answer 28

bisphosphonates inhibit osteoclast formation and bone turnover
patients with osteoporosis and bone malignancies may take these

Question 29

MRONJ

Answer 29

exposed bone, for more than 8 weeks, in patients with a history of anti resorptive or anti angiogenic drugs and no history of radiotherapy

Question 30

risk factors for MRONJ

Answer 30

previous MRONJ
on bisphosphonates for more than 5 years
on bisphosphonates in combination with systemic glucosteroids
taking angiogenic and/or anti-resorptive drugs for cancer management