GVHD

Question 1

What does GVHD stand for?

Answer 1

Graft Versus Host Disease

Question 2

What type of transplant commonly causes GVHD?

Answer 2

Allogeneic bone marrow transplant (BMT)

Question 3

What causes GVHD?

Answer 3

Donor T cells attack recipient’s tissues due to HLA mismatch

Question 4

What are two main types of GVHD?

Answer 4

Acute and Chronic

Question 5

When does acute GVHD occur?

Answer 5

Within 100 days post-transplant

Question 6

When does chronic GVHD occur?

Answer 6

After 100 days post-transplant (commonly 3–12 months)

Question 7

What oral symptoms suggest chronic GVHD?

Answer 7

Reticular white striae, erythematous background, mucosal ulceration, xerostomia

Question 8

What medication is this patient taking that increases GVHD risk?

Answer 8

Systemic prednisone and methotrexate

Question 9

What are the differential diagnoses for oral lesions in GVHD?

Answer 9

Oral Hairy Leukoplakia (OHL), Oral Lichen Planus (OLP), Trauma

Question 10

What does the lateral tongue show in chronic GVHD?

Answer 10

Reticular white striae on erythematous background, poorly demarcated

Question 11

What is a common location for OHL?

Answer 11

Lateral borders of the tongue

Question 12

What virus is associated with OHL?

Answer 12

Epstein-Barr virus (EBV)

Question 13

What is the appearance of OHL?

Answer 13

White, hairy, corrugated plaque that cannot be wiped off

Question 14

What distinguishes GVHD from OHL in histology?

Answer 14

GVHD mimics lichen planus; OHL has ballooning epithelial cells

Question 15

How is chronic GVHD diagnosed?

Answer 15

Clinical + confirmed with biopsy if uncertain

Question 16

What condition must be ruled out before diagnosing GVHD?

Answer 16

Oral lichen planus, OHL, trauma

Question 17

What is the most common symptom patients report with oral GVHD?

Answer 17

Burning sensation or pain

Question 18

What topical treatment can relieve GVHD symptoms?

Answer 18

Topical corticosteroids or anesthetics

Question 19

Which topical immunosuppressive agents may help GVHD?

Answer 19

Tacrolimus, PUVA, Psoralen

Question 20

How is xerostomia managed in GVHD?

Answer 20

Saliva substitutes, Pilocarpine, sialogogues, frequent sips of water

Question 21

What oral hygiene measures are advised for GVHD patients?

Answer 21

Alcohol-free mouthwash, fluoridated toothpaste, good diet

Question 22

Why should systemic steroids be considered before dental treatment?

Answer 22

Risk of adrenal insufficiency; may need steroid cover

Question 23

What is ANC and why is it important in GVHD dental care?

Answer 23

Absolute Neutrophil Count; guides antibiotic need and safety for procedures

Question 24

What ANC level allows elective treatment without antibiotics?

Answer 24

ANC > 1000/mm3

Question 25

What ANC level requires delaying elective treatment or giving antibiotics?

Answer 25

ANC 500-1000/mm3

Question 26

What ANC level contraindicates elective dental treatment?

Answer 26

ANC <500/mm3 cubic millimeter

Question 27

What antibiotic is given for prophylaxis if not allergic?

Answer 27

Amoxicillin 50 mg/kg

Question 28

What post-op advice is given for GVHD patients?

Answer 28

Use chlorhexidine rinse and syringe irrigation for healing

Question 29

Why are GVHD patients at high risk after surgery?

Answer 29

Delayed healing, immunosuppression, high infection risk

Question 30

What systemic signs may indicate chronic GVHD?

Answer 30

Xerostomia, arthritis, dysphagia, scleroderma-like symptoms

Question 31

What are features of acute GVHD?

Answer 31

Rash, mucosal ulcers, diarrhea, liver enzyme elevation

Question 32

What organs can chronic GVHD affect?

Answer 32

Liver, eyes, skin, esophagus, GI tract, salivary glands