sjogrens

Question 1

sarcoidosis

Answer 1

over reaction of immune system sees granuloma formation in one or more organs in the body
can affect salivary glands

Question 2

what blood test can be done to assess if a patient is dehydrated

Answer 2

urea and electrolytes

Question 3

name 4 tests that would potentially be used when investigating dry mouth

Answer 3

blood tests - FBC, U & E, glucose
auto antibody screen
MRI of major salivary glands
labial gland biopsy
BBV screen
tear film

Question 4

sicca syndrome

Answer 4

partial sjogrens findings
dry eyes OR dry mouth not both

Question 5

primary sjogrens syndrome

Answer 5

dry eyes AND dry mouth but no other connective tissue disease

Question 6

secondary sjogrens

Answer 6

dry eyes AND dry mouth AND another connective tissue disease

Question 7

does sjogrens affect men or women more

Answer 7

women, 10:1

Question 8

name a theory as to why women experience connective tissue diseases more than men

Answer 8

androgens (male sex hormones) appear to be protective against connective tissue diseases

Question 9

what are the 2 different scoring systems used to diagnose sjogrens

Answer 9

american european consensus group (2002)
ACR- EULAR

Question 10

lymphocytic focus

Answer 10

collection of more than 50 lymphocytes around a duct

Question 11

schirmer test

Answer 11

can be uncomfortable for patient
filter paper placed in lower eye that absorbs tears, measurement taken after 5mins
normal patients will wet more than 5mm in 5 mins

Question 12

fluorescein tear film assessment

Answer 12

fluorescein applied to eye and time is measured until first dark spot appears
dark spot indicates tear film evaporation

Question 13

what are the two main auto anitbodies assosciated with sjogrens

Answer 13

anti ro (main)
anti la

Question 14

why should a MRI be taken if a patient is diagnosed with sjogrens

Answer 14

to be used as a baseline for comparison in future lymphoma screens

Question 15

order of testing for sjogrens

Answer 15

1. look in mouth, is it actually dry ? (not somatoform) (early stage sjogrens wont have a dry mouth or complain of one)
2. least harmful tests first - UWS, autoantibodies, salivary ultrasound
3. labial gland biopsy

Question 16

what clinical effect of porphyria may be seen dentally

Answer 16

incorporation of blood products into tooth structure - discoloured teeth

Question 17

peripheral vs central giant cell granuloma

Answer 17

peripheral - soft tissues
central - jaw bone

Question 18

what can be seen on dental radiographs in hyperparathyroidism patients

Answer 18

loss of lamina dura

Question 19

what is Oro facial granulomatosis

Answer 19

clinical presentation of oedema in oral and facia soft tissues due to blockage of lymphatic drainage due to an immune reaction

Question 20

angioedema

Answer 20

oedema of oral and facial tissues due to an increase in fluid exudate from capillaries
NOT a drainage issue, will both appear and settle quickly, within 24-48 hours
Type I hypersensitivity reaction