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Dent Y3 > Human Health and Disease > Flashcards

Human Health and Disease Flashcards

1
Q

How many valves in the heart?

A

4

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2
Q

What are the four valves in the heart?

A

Tricuspid, Mitral, Pulmonary, Aortic

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3
Q

Which valves are open during systole (contraction)?

A

Pulmonary and Aortic

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4
Q

Which valves are open during asystole (relaxation)?

A

tricuspid and mitral

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5
Q

What does non-return valve mean?

A

no back-flow of blood once the valve is shut

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6
Q

Are cardiac valves non-return?

A

yes

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7
Q

What are the two main types of valvular heart disease?

A

valvular stenosis and valvular incompetence

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8
Q

What is valvular stenosis?

A

narrowing of the valve orifice that limits the quantity of blood passing through the valve

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9
Q

What is valvular incompetence?

A

failure of the non-return function of valves leading to valvular regurgitation

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10
Q

What valves are affected in left heart valvular disease?

A

Mitral and aortic

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11
Q

Which or mitral and aortic valvular disease is more common?

A

mitral

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12
Q

What can cause mitral stenosis?

A

age related calcification of the valve or rheumatic heart disease

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13
Q

What can cause mitral regurgitation?

A

age related degeneration, rheumatic heart disease, mitral valve prolapse, rupture of papillary muscle due to IHD

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14
Q

Which valves are affected in right hear valvular disease?

A

tricuspid and pulmonary

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15
Q

What is the dental relevance of valvular disease?

A

increased bleeding risk, increased infective endocarditis risk, reduction in cardiac output, heart failure

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16
Q

What are some dentally relevant side effects of the drugs used to treat valvular disease?

A

increased bleeding risk due to anticoagulants, gingival hyperplasia due to calcium channel blockers, ulceration by ACE inhibitors, dry mouth by polypharmacy

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17
Q

Are damaged valves more or less likely to become infected?

A

more likely

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18
Q

What can turbulent blood flow (often caused by poorly functioning valves) predispose an individual to?

A

infective endocarditis

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19
Q

What is infective endocarditis?

A

an acute or chronic disease resulting from an infection of a focal area of the endocardium, usually involving a heart valve.

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20
Q

What is acute infective endocarditits?

A

a destructive infection of a previously normal heart valve with a highly virulent organism

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21
Q

What is chronic infective endocarditis?

A

a slow often symptomless infection of a previously abnormal valve with organisms of low virulence

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22
Q

Where do the organisms that can cause infective endocarditis come from?

A

Oropharynx, respiratory tract, skin, gastrointestinal and urinary tract

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23
Q

Is left or right heart infective endocarditis more common?

A

left (95% of cases are left sided)

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24
Q

What are the lesions that appear due to infective endocarditis?

A

called vegetations, they are grape-like masses composed of bacteria and blood clot components

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25
Q

What are the steps involved in formation of infective endocarditis vegetations?

A

endocardial injury followed by adherence of platelets and fibrin, this mass becomes infected by microorganisms in the blood

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26
Q

What are some specific symptoms from infective endocarditis?

A

Splinter Haemorrhages, Roth Spots, Janeway Lesions

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27
Q

What are splinter haemorrhages?

A

tiny blood clots that run vertically in fingernails

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28
Q

What are janeway lesions?

A

non-painful red lesions on the palms and soles due to de-positioned immune complexes

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29
Q

What are roth spots?

A

areas of retinal haemorrhage due to a breakdown of vessels

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30
Q

Which dental procedure gives the highest risk of bacteraemia?

A

dental extraction and periodontal surgery

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31
Q

What are the five major types of arthritis?

A

osteoarthritis, rheymatoid arthritis, ankylosing spondylitits, gout, septic arthritis

32
Q

What is osteoarthritis?

A

arthritis caused by cartilage death

33
Q

What is rheumatoid arthritis?

A

arthritis caused by synovial inflammation and overgrowth

34
Q

What is ankylosing spondylitis?

A

arthritis caused by inflammation and new bone formation at the entheses

35
Q

What is gout?

A

arthritis caused by crystals in the synovial fluid

36
Q

What is septic arthritis?

A

arthritis caused by an infection within the joint

37
Q

What is the point in a synovial joint where tendons/ligaments/joint capsules inset into the bone called?

A

entheses

38
Q

Where is synovial fluid produced?

A

the synovium

39
Q

Why is it important that the synovium passes nutrients to the cartilage?

A

the cartilage itself has no blood vessels or nerve cells

40
Q

What happens to the cartilage in osteoarthritis?

A

it dies in patches

41
Q

What happens to the bones in osteoarthritis?

A

they sit closer and eventually rub together leading for formation of sclerotic bone

42
Q

What happens to the joint capsule in osteoarthrits?

A

it gets stretched, thicker and more fibrotic

43
Q

What are seronegative spondyloarthropathies?

A

a group of joint disorders negative for rheumatoid factors

44
Q

What are the four types of seronegative spondyloarthropathies?

A

ankylosing spondylitis, reactive spondylitis, psoriatic arthritis, enteropathic arthritis

45
Q

What is ankylosing spondylitis?

A

inflammation and new bone formation at the entheses which eventually forms bone bridges between the vertebrae causing ridigity in the joints

46
Q

What is the characteristic posture of a person with ankylosing spondylitis?

A

question mark posture

47
Q

Does ankylosing spondylisits always occur at joints?

A

no, it can occur at any entheses

48
Q

What happens in gout?

A

if urate levels get too high, they can deposit as crystals in the synovial fluid causing an intense inflammatory response

49
Q

Which conditions predispose an individual to gout?

A

renal and cardiac

50
Q

What are gouty tophi?

A

swellings under the skin with a yellowish discolouration which can show calcification on a radiograph

51
Q

Drinking which type of alcohol in particular in excess can predispose an individual to gout?

A

beer

52
Q

Is septic arthritis more common in undamaged joints or in joints previously damaged by arthritis?

A

joints previously damaged by arthritis

53
Q

What becomes inflamed in rheumatoid arthritis?

A

the synovium

54
Q

How do the bones get damaged in rheumatoid arthritis?

A

the synovium cells become overgrown and invasive which eats into the bones additionally, the persistent inflammation can cause generalised cartilage loss

55
Q

What is swan-necking in relation to rheumatoid arthritis?

A

the joint at the base of the finger flexes, the middle joint extends and the distal joint flexes

56
Q

What is boutonniere in relation to rheumatoid arthritis?

A

the middle joint become stuck in a flexed position and the outermost joint hyperextends

57
Q

What is sjogren’s syndrome?

A

an autoimmune disorder characterised by progressive inflammation and destruction of epithelial exocrine glands

58
Q

What are some predominant symptoms relating to sjogren’s?

A

dry eyes, dry mouth, dry skin, joint pains, fatigue, respiratory problems, raynaud’s, parotid swelling

59
Q

What are common oral health problems related to sjogren’s?

A

oral ulceration, dryness, dental caries

60
Q

What drug type can be used to treat most types of arthritis?

A

non-steroidal anti-inflammatory drugs

61
Q

Give two examples of NSAIDs

A

ibuprofen and naproxen

62
Q

What are some side effects of NSAIDs?

A

gastric or duodenal ulceration, increased risk of heart attack or stroke, kidney problems

63
Q

Which type of arthritis should you not give NSAIDs to?

A

osteoarthritis

64
Q

Which is the first treatment for inflammatory arthritis?

A

corticosteroids

65
Q

What are the potential treatment options for inflammatory arthritis?

A

disease modifying agents, biological agents, bisphosphonates

66
Q

Why would you start with corticosteroids and another treatment for inflammatory arthritis?

A

the steroids act as a bridge, to reduce symptoms while the main medication begins to work

67
Q

Give three examples of disease modifying agents

A

methotrexate, sulphasalazine, leflunomide

68
Q

What are some side effects of methotrexate?

A

hepatoxicity, pulmonary toxicity, stomatitis

69
Q

What are some side effects of sulphasalazine?

A

skin reactions or diarrhoea

70
Q

What are some side effects of leflunomide?

A

hypertension

71
Q

What is an example of a biological agent used to treat inflammatory arthritis?

A

anti-TNF

72
Q

What are some side effects of anti-TNF?

A

the patient will be immunosuppressed and predisposed to infection

73
Q

What are some side effects of bisphosphonates?

A

patients can be predisposed to osteonecrosis of the jaw

74
Q

What is the medication used for acute attacks of gout?

A

colchicine

75
Q

What is the medication used to prevent gout recurrence?

A

allopurinol

Dent Y3 (23 decks)

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