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Oral Disease > Therapeutics and effects management > Flashcards

Therapeutics and effects management Flashcards

0
Q

What is a good system for taking a history?

A
  1. PCO
  2. HPC - chronology is important
  3. PMH - systems; pt often tertiary referral; prev. XLA; bleeding
  4. DH
  5. SH - often overlooked; includes drugs, alcohol, smoking; liver function
  6. FH
  7. NKDA?
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1
Q

What are the first few steps when history taking: before the actual history?

A
  1. Introduce yourself
  2. Ask permission!
  3. Explain what you propose to do
  4. Acquire consent for action
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2
Q

What are the important chronological points for the HPC (history of presenting complaint)?

A
  • Described in patient’s own words
  • Get timeline
  • Other clinicians
  • Previous investigations
  • Patient’s own thoughts and disposition!
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3
Q

What are the seven important questions to ask for the history of lesion?

A
  • When did you notice it?
  • Were there any predisposing events?
  • Why did these events occur?
  • Has it changed?
  • How does it bother you?
  • Are there any other lumps?
  • What investigations/treatments have you had in the past for this lesion?
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4
Q

What are some questions to gain the history of an ulcer?

A
  • Is this part of a recurrent pattern of ulceration?

- Is this an isolated ulcer?

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5
Q

What are some important questions necessary to obtain a drug history?

A
  • List all the medication the pt is currently taking
  • List important drugs that have previously been taken
  • Doses and durations of tx
  • Over-the-counter medications
  • Drug allergies (also state if none)
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6
Q

When you are inspecting a pt where should you look?

A

The entire head and neck region

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7
Q

How should you palpate a pt?

A
  • Palpate from behind
  • Are their any painful areas?
  • Use bimanual palpation
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8
Q

Give some examples of variations in normal oral anatomy.

A
  • Fordyce spots

- Tori

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9
Q

What characteristics of an ulcer should you examine?

A
  • Base
  • Firmness
  • Edge
  • Painful response
  • Local tissues
  • Regional lymph nodes
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10
Q

What are two examples of histopathological investigations?

A
  • Histopathology

- Direct immunofluorescence

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11
Q

What information does a full blood count provide?

A

Haemoglobin (Hb); mean cell volume (MCV); lymphocyte count; neutrophil count; platelet count

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12
Q

What are the oral manifestations of anaemia?

A
  • Atrophic glossitis
  • Angular cheilitis
  • Apthous-like ulceration
  • Dysaesthesia
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13
Q

What is atrophic glossitis and give an example of when it can manifest?

A

AKA Bald tongue, smooth tongue: a condition characterised by a smooth glossy tongue that is often tender/painful caused by complete atrophy of the lingual papillae (depapillation). Dorsal surface can be affected totally or in patches and may be associated with a burning sensation.

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14
Q

What is angular cheilitis?

A

Inflammation of one or both corners of the mouth - cheilitis is inflammation of the lips.

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15
Q

What is aphthous-like ulceration?

A

Idiopathic ulcers that cannot be defined as present due to an underlying cause - their definition can change if systemic disease is found.

16
Q

What is dysaesthesia?

A

Abnormal sensation.

17
Q

What information does a prothrombin time (PT) coagulation blood test provide?

A
  • Warfarin Rx (receipt)

- Liver disease

18
Q

What information does an activated partial thromboplastin time (APTT) coagulation blood test provide?

A

It is used to test for defects of the clotting system e.g. heparin therapy

19
Q

Why is it important to notice and question submucosal bleeding?

A

Indications of pt health/medication etc

20
Q

What biochemical blood tests can be performed?

A
  • Liver function test
  • Random blood glucose
  • Haematinic assays
  • CRP
21
Q

What immunological test can be performed?

A
  • Autoantibodies
  • Immunoglobulin levels
  • Electrophoresis
  • Complement levels
22
Q

What are some microbiological investigations for infection? Direct lesional sampling and serum based assays.

A

Direct lesional:

  • Swab for culture and sensitivity
  • Swab for PCR
  • Tissue biopsy

Serum based assays:
- Serology

23
Q

What is hairy leukoplakia? What can it be caused by? What is a diagnostic factor? Is it benign?

A

White area of keratosis on the tongue with a corrugated or hairy appearance. Can be caused by Epstein-Barr virus, smoking and occurs usually in people who are immunocompromised. The white lesion cannot be scraped off (firmly attached to underlying mucosa); benign; usually used to diagnose underlying problems.

24
Q

What is an example of a referral investigation?

A

Allergen testing.

25
Q

What can result in a nociceptive stimulus?

A

Any injury; mediators of inflammatory response are closely associated with nociception.

Oral Disease (3 decks)

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