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DH 2 > Autominue conditions Exam 6 > Flashcards

Autominue conditions Exam 6 Flashcards

1
Q

What is scleroderma?

A
  • It is connect tissue disorder characterized by collagen overproduction
  • progressive systemic sclerosis
  • Cause is unknown: microvascular abnormalities, irregular collagen
  • Physical symptom: immobility, rigifity of skin, inflammation
  • Occurs at 30-50 years any age
  • 2-5 times more common in FEMALEs
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2
Q

What are some notable changes with scleroderma?

A
  • skin, gastrointestinal tract, kidney, heart muscles, lungs
  • eventual death from renal failure , cardiac failure, pulmononary insufficiency, intestinal malabsorption
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3
Q

What are the clinical presentation for scleroderma?

A

Joints: pain, swelling, stiffness of fingers and knees
* Polyarthritis: symmetrical
* Skin: hard and fixed, ivory- white, yellow or gray
* Face: Mask-like, expressionless

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4
Q

What are the Oral presentation for scleroderma?

A

Lips: thin, rigid, difficulty opening and closing
* Mucosa: thin, pale, tender, rigid, poor healing
* Gingiva: pale, usually firm
* Teeth: increased mobility
* Radiographic findings: widened PDL
* Mastication: difficult; limited TMJ movement
* Tongue: immobile, speech difficult

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5
Q

What are the medical management for scleroderma?

A
  • Physical therapy
  • Maintain normal actvities
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6
Q

What are the dental management for scleroderma?

A
  • Preserve teeth and gingival health
  • Prevent extensive treatment
  • Dentrue fabrication and wear difficult
  • Sensitivity to cold and dampness
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7
Q

What is systemic lupus erythematosus ?

A
  • Immune system attacks its own tissues, causing widespread inflammation and tissue damage to affected organs
  • Can also affect joints, skin, brain, lungs, kidneys, and blood vessels.
  • Unknown cause
  • Possible triggers: infections, stress, diet, toxins, drugs, sunlight
  • Affects women 8-10x more than men

Signs and Symptoms: Butterfly or malar rash (across nose and cheeks)

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8
Q

What is the medical management for lupus?

A
  • Same medications as other rheumatologic disorder
  • Observation for renal cardiac and clotting issues
  • Avoid sun exposure
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9
Q

What is the dental management of

A
  • Consider physician consult to determine patient needs based on disease status at time of appointment
  • Review oral side effects of medications
  • Possible antibiotic premedication → if taking corticosteroids or cytotoxins and have leukopenia
  • Thrombocytopenia → Obtain platelet count for abnormal
    bleeding (should be 50,000/mL)
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10
Q

What are the oral manifestations and complications for lupus?

A
  • Lesions on lips and mucosa- red with white spots;
  • Possible painful mucosal ulcerations; resemble lichen planus
  • Xerostomia
  • Hyposalivation
  • Dysgeusia
  • Glossodynia
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11
Q

What is Sjogrens Syndrome

A

An immune system disorder characterized by dry eyes and dry mouth. The bodys immune system attacks its own healthy cells that produce saliva and tears

unknown cause

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12
Q

What can sjorgens syndrome lead to?

A
  • Keratoconjunctivitis sicca (dry eyes)
  • Xerostomia
  • Connective tissue disease
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13
Q

What is the clinical presentation of sjogrens syndrome?

A
  • Dry eyes
  • Hyposalivation/xerostomia
  • enlarged parotid gland
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14
Q

What is the medical management ?

A

Medications: Hydroxychloroquine (plaquenil)
Eyes: Cyclosporine
Saliva: Pilocarpine
Immunosuppressives: Methotrexate
NSAIDS

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15
Q

What are the dental management for Sjorgens?

A
  • Focus on palliative and preventive care → relief of symptoms and normal homeostatic environment
  • Moisture and lubrication
  • Treat conditions → mucositis or candidiasis
  • Prevention → OHI, nutritional counseling, importance of frequent recare
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16
Q

What is rheumatoid arthritis?

A
  • Chronic, immunologic systemic disease exhibiting inflammation of joints particulary hands feet and knees
  • Cause: unknown
  • Occurs in 20-40 years and any age
  • More females
17
Q

What are the signs and symptoms of Rheumatoid Arthritis?

A
  • Joint pain and swelling
  • Morning stiffness; stiffness after inactivity
  • Weakness, fatigue, loss of appetite and
    weight, anemia, low-grade fever
  • Progressive deformity, limited motion and
    muscle atrophy
18
Q

What is the medical management for rheumatoid arthritis?

A
  • Pain relief and prevent joint damage
  • Medications: Corticosteroids, NSAIDs
  • Disease modifying antirheumatics: (Methotrexate, Plaquenil, Azulfidine, Arava, Imuran), Biologic agents to slow disease (Azathioprine, Cyclosporine)
  • Physical and occupational therapy
  • Joint replacement surger
19
Q

What is the dental management for rheumatoid arthritis?

A
  • Assistance with ambulation
  • Adjust chair based on patient comfort
  • Short appointments and frequent breaks
  • Physical supports like pillows, etc. especially for long appointments.
  • Medications for condition?
  • Bleeding related to medications
  • Corticosteroid therapy puts patient at risk for adrenal suppression, Immunosuppressive agents → anemia, agranulocytosis, thrombocytopenia, Possible physician consult for lab test results
  • Joint replacement? Premedication?
  • Radiographic narrowing of joint space,
    articular surface irregularities, bone spurs,
    sclerosis, remodeling
  • TMJ disc replacement
  • Difficulty grasping a toothbrush or lifting arm
  • Instrumentation
  • Fatigue of TMJ
  • Minimize pressure on mandible
20
Q

What is Psoriasis ?

A
  • Chronic disease where the immune system becomes overactive, causing skin cells to multiply too quickly
21
Q

What is Psoriatic arthritis?

A

A form of arthritis that affects some people who have the skin condition psoriasis

22
Q

What is the clinical presentation for psoriasis and prsoriatic arthritis?

A
  • Flaky skin patches
  • Swollen fingers and toes with pain
  • Foot pain
  • Lower back pain
  • Small dents or pits in nails; nails may crumble or separate from the nail bed
  • Eye inflammation including eye pain, redness, blurry vision; may lead to vision loss if untreated
23
Q

What is the medical and dental management for psoriatic arthritis ?

A

Medical Management
* Medications
* Abatacept: Decreases blood level of cytokines and inflammatory proteins
* Enbrel: Reduce symptoms such as swelling, stiffness, and joint pain (used for severe RA)

Dental Management
* Same as a patient with Rheumatoid Arthritis
* May reschedule if skin lesions causing discomfort

24
Q

What is osteoarthritis?

A
  • Most common degenerative joint disease
  • Affects weight-bearing joints in particular
  • Inflammation not joint problem
  • Unknown cause
25
Q

What is predisposing factors for osteoarthritis?

A

Repeated trauma, obesity, age-related changes, mechanical stress, genetic predisposition

Occurrence
* 50-70 years old
* Onset 20 years later than rheumatoid arthritis

26
Q

What are the symptoms of osteoarthritis?

A
  • More pain, deformity, limited movement in a single joint
  • Hips, knees, fingers, vertebrae
  • Dull ache and stiffness in morning or after inactivity; diminishes with exercise
  • Pain aggravated by temperature changes; bearing body weight
27
Q

What is the medical management for osetoarthritis?

A
  • Moderate exercise
  • Pain-relieving drug therapy
  • Weight reduction for obese patients
  • Physical therapy
  • Orthopedic surgical procedures
  • Total hip or knee joint replacement
  • Analgesic medications: Acetaminophen, aspirin, NSAIDs, steroid injections
28
Q

What is Fibromyalgia ?

A
  • Chronic disorder that causes pain and tenderness, fatigue, and trouble sleeping.
  • Heightened sensitivity to pain
29
Q

What is the medical management for fibromyalgia?

A
  • Heterocyclic and selective
    serotonin reuptake inhibitor
  • Antidepressants
  • Anticonvulsants
30
Q

What is the dental management for fibromyalgia?

A
  • Consider comfort level of patient and adjust chair
    accordingly
  • May cause TMJ pain which worsens throughout the day so
    morning appointments may be considered

DH 2 (21 decks)

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