Systemic Diseases Part 2 Flashcards
rheumatic diseases
large groups of disorders that affects bones, joints, and muscles
autoimmune and inflammatory diseases that cause your immune system to
attack itself
examples of rheumatic diseases (5)
psoriatic arthritis systematic lupus erythematous scleroderma sjogren sydrome gout
types of rheumatic diseases (3)
osteoarthritis (OA)
rheumatoid (RA)
sjogren syndrome (SS)
almost everyone older than 60 years of age develops — to some degree. most are minimally —
osteoarthritis
symptomatic
OA is the leading cause of — within the elderly population
disability
what does osteoarthritis affect? (5)
often used joints such as hips, knees, feet, spine, and hands
what may also be affected?
TMJ
OA is more common that –
RA
who does OA affect?
women 2x men
however men are affected at an earlier age
when do you develop OA?
usually after 40
OA is normal (2)
wear and tear
where does OA affect?
distal joints of hands
OA is —
asymmetrical
RA is more
serious
RA
autoimmune disease of unknown origin
where does RA affect
symmetric inflammation of joints, especially hands, feet, and knees
onset of RA
35-50 years of age
who does RA affect?
women to men ratio 3:1
RA (4)
Multiple symmetric joint involvement
Significant joint inflammation
Morning stiffness lasting longer than 1 hour
Systemic manifestations (fatigue, weakness, malaise)
OA (5)
Usually, 1-2 joints involved Pain usually without inflammation Morning stiffness lasting less than 15 mins. No systemic involvement Heberden nodes of DIP joints
sjodrens syndrome
Autoimmune disease complex that
causes exocrinopathy and affects the
salivary and lacrimal glands
who does sjogrens syndrome predominately involve? ratio?
women,
with female to male ratios over 10:1
Primary Sjogren syndrome (SS-1)
dry eyes and dry mouth are seen in the absence of a connective tissue disease.
Not as common.
Secondary Sjogren syndrome (SS-2) is
more common:
dry eyes and dry mouth
are seen together with other
autoimmune diseases like RA, systemic
lupus erythematous, scleroderma.
Sjogren’s syndrome is characterized by (3)
eye dryness, hyposalivation, and
enlargement of the parotid glands
secondary outcomes of persistent oral dryness (5)
angular cheilitis dysgeusia (taste dysfunction) burning mouth syndrome secondary infections increase in caries rate
due to increased caries rate: (3)
Topical daily fluoride
Increase production of saliva-drugs such as pilocarpine
Increased prophylaxis
phazix pill swallowing aid
dry mouth, Lubricates the
mouth and throat.
Pill swallowing gel
16.9oz for $41.00
DENTIST MUST BE AWARE OF THE TYPE
AND EXTENT OF THE CANCER AND
PREPARE FOR COMPLICATIONS SUCH AS
(3)
ADVERSE BLEEDING,
SIDE EFFECTS OF
DRUGS,
AND INFECTION
INCREASED SURVIVAL RATES- DENTIST
WILL BE TREATING PATIENT WHILE
UNDERGOING
VARIOUS PHASES OF
TREATMENT. (CHEMOTHERAPHY,
RADIATION)
cancer is 1/3 due to
tobacco
cancer is also 1/3 due to (3)
poor nutrition, obesity, physical inactivity
cancer precautions (3)
Chemotherapy: immunocompromised
Head and neck radiation therapy
Med consult
Head and neck radiation therapy (3)
Xerostomia
Mucosal irritation
Cervical caries
epilepsy IS NOT A SPECFIC DIAGNOSIS BUT RATHER A TERM THAT REFERS
TO A GROUP OF DISORDERS: CHARACTERIZED BY (5)
CHRONIC AND
RECURRENT, PAROXYSMAL CHANGES IN NEUROLOGICAL
FUNCTION(SEIZURES), ALTERED CONSCIOUSNESS, OR
INVOLUNTARY MOVEMENTS CAUSED BY ABNORMAL AND
SPONTANEOUS ELECTRICAL ACTIVITY IN THE BRAIN.
epilepsy symptoms (5)
Aura Irritability Epileptic cry-just before Loss of consciousness Muscle rigidity
aura (2)
Momentary sensory alteration
Unusual smell or vision
Epileptic cry-just before
Diaphragm spasm
Epilepsy treatment (3)
Long term drug therapy-Dilantin,
Tegretol
60-80% achieve complete control
Gingival hyperplasia
Gingival hyperplasia tx
Dilantin
uncontrolled epilepsy (3)
- > 1-2 seizures / month
- Med consult
- Avoid triggers
well controlled epilepsy (2)
- <1-2 seizures / month
* Med consult
epilepsy (dental) (4)
Complete health history- type, age of onset, cause(if known), frequency, meds, date of last seizure. Ask if they feel unusually tired Ask them to communicate if they sense seizure coming Don’t shine light in pt eyes
Don’t shine light in pt eyes bc
May stimulate seizure
epilepsy management (6)
PRIMARY-PROTECT THE PATIENT AND TRY TO PREVENT INJURY
DO NOT MOVE PT. TO THE FLOOR, PLACE CHAIR IN SUPINE POSITION
INSTRUMENTS REMOVED FROM THE AREA
NO ATTEMPT TO RESTRAIN/HOLD PT.
O2 IF NECESSARY
4444
GERD
Gastroesophageal Reflux
Disease
(= acid reflux)
Stomach liquids regurgitate (6)
Pregnancy Bad sphincter Obesity Alcohol Smoking Can increase with age
GERD (dental) (3)
Halitosis
Enamel erosion
Don’t give meds that upset stomach
Don’t give
meds that
upset stomach (2)
Codeine
erythromycin
skin lesion examples (4)
rash
mole
patch
melanoma
Danger Signs: Pigmented Skin
Lesions (4)
Asymmetry (MAIN)
Border irregular
Color varied
Diameter > 6mm (pencil eraser)
Border irregular (2)
Scalloped or
fuzzy
steroid uses (4)
Rheumatoid arthritis
Lupus
Asthma
Psoriasis
Cushing syndrome refers to a conditions
caused by
excessive cortisol in the body.
The most common cause is the use of
steroid drugs
Cushing syndrome can
also result in (3)
high blood pressure
bone loss
Type 2 diabetes
When Cushing syndrome is caused by a — process (e.g., tumor ofthe pituitary gland or tumor of the adrenal gland), it is called — —
pathophysiologic
Cushing disease
BOTH (2) PRODUCE
SIMILAR CLILNICAL
FEATURES.
Cushing DISEASE AND
SYNDROME
symptoms of Cushing syndrome
WEIGHT GAIN AND FATTY TISSUE DEPOSITS, PARTICULARLY AROUND THE MIDSECTION AND UPPER BACK, IN THE FACE (MOON FACE) AND BETWEEN THE SHOULDERS (BUFFALO HUMP)
what does Cushing syndrome result in (4)
thinning, fragile skin that bruises easily
abdominal striae
decreased healing
acne
Addison’s
not enough steroid
Gingival lesions
Trigeminal Neuralgia=
Tic douloureux
Trigeminal Neuralgia
sudden, severe,
electric or stabbing
pain in the side of jaw or cheek
what triggers Trigeminal Neuralgia
physical
stimulus
Trigeminal Neuralgia results in —
attacks
Intermittent
intermittent attacks last
several seconds
who does Trigeminal Neuralgia affect?
mostly women over 50
Trigeminal Neuralgia may — sporadically
disappear
SKIPPED
sample reasons for bed consults
Rheumatic fever, unsure of heart condition MI in last 6 mos. Hypertension >160 / >100 Unsure how well controlled diabetes is Congenital heart defects > 5 significant meds Chemo or radiation treatment Elevated glucose levels
Congenital Heart Disease patients is at high risk to develop
Infective Endocarditis (IE)
Request med consult for the type of — —-, and
the treatment performed to correct the defect
heart defect
follow physician’s recommendation for antimicrobial
prophylaxis on the basis of — guidelines
AHA
Medication history includes all (4)
Rx OTC Herbal, natural, alternative Have pt bring a list or all their pill bottles (Brown paper bag)
true allergy symptoms (5)
Itching Hives Rash Swelling Wheezing
drug intolerance (3)
Nausea
Vomiting
Palpitations
drug intolerance is not a true
allergy
with drug intolerance, avoid using
drug