Inflammatory diseases of salivary glands

Question 1

The most common cause of bilateral enlargement of the parotid gland and causative pathogen

Answer 1

Mumps

Parmyxovirus

Question 2

Symptoms of mumps

Answer 2

include swelling of the gland, pain, erythema and swelling of the duct, without purulent secretions and displacement of the auricle

Question 3

Glands involved in mumps

Answer 3

The parotid glands primarily, but the submandibular and sublingual glands may be involved on occasion

Question 4

Mumps immunisation given to children after 12 months of age.

Answer 4

Live attenuated mumps vaccine as part of mumps, measles and rubella

Question 5

Aetiology of Acute bacterial infections of salivary glands

Answer 5

by retrograde transmission of bacteria from the oral cavity or by stasis of salivary flow

Question 6

Clinical features of Acute bacterial infections

Answer 6

pain, swollen gland, pyrexia, and systemic upset.

The skin above the gland may be erythematous and fluctuation may be felt.

The purulent exsudate can be seen coming from the opening of the duct, which is erythematous and oedematous; trismus may be present

Question 7

Acute parotitis commonly affects

Answer 7

older, weakened, dehydrated patients with poor oral hygiene

Question 8

The most common microorganism causing acute bacterial parotitis

Answer 8

Staphylococcus aureus

Question 9

Chronic sialadenitis

Answer 9

Characterised by recurring inflammation and swelling of the gland, minor pain, and sialorrhoea (which may be slightly purulent)

Question 10

usual infecting microorganism in Chronic sialadenitis

Answer 10

Streptococcus viridans

Question 11

Common symptoms of Chronic sialadenitis

Answer 11

pain and swelling after a meal. Trismus

Question 12

Sialosis

Answer 12

Diffuse, non-inflammatory, non-neoplastic recurrent enlargement of the major salivary glands

Question 13

A variety of systemic causes of sialosis

Answer 13

Sjögren’s syndrome

Mikulicz disease

Heerfordt syndrome

Question 14

Sjögren’s syndrome

Answer 14

chronic autoimmune disorder of many organ systems, including the exocrine glands, which affects predominantly the salivary glands

Question 15

Sx of Sjögren’s syndrome

Answer 15

Xerostomia (dry mouth) and keratoconjuctivitis sicca (dry eyes) are characteristic;

diffuse enlargement of the parotid gland affects a large number of patients.

chronic recurring joint disorders,

rheumatic purpura,

periarteritis nodosa

and scleroderma

Question 16

Treatment of Sjögren’s syndrome

Answer 16

Symptomatic

Question 17

Dx. of Sjögren’s syndrome

Answer 17

according to clinical findings supplemented by biopsy of the mucous gland of the lower lip

Question 18

Mikulicz disease

Answer 18

affects salivary and lacrimal glands, but it is not systemic. It is characterised by slow-growing, soft, painless swelling of the parotid gland

Question 19

Mikulicz syndrome

Answer 19

symmetrical swelling of salivary and lacrimal glands and any of the following:

lymphadenopathy,

chronic lymphatic leukaemia,

Hodgkin’s and non-Hodgkin’s lymphoma, and

haematogenous metastases

Question 20

Heerfordt syndrome

Answer 20

parotid swelling and swelling of the lacrimal glands,

facial nerve paralysis,

uveitis,

and meningoencephalitis

Question 21

Pathogenesis of Heerfordt syndrome

and treatment

Answer 21

sarcoid tissue changes in the gland parenchyma. Steroids are used for treatment.

Question 22

Sialolithiasis

Answer 22

formation of calculi within the salivary gland or duct into which the salivary gland drains

Question 23

%s of which glands are affected by Sialolithiasis

Answer 23

(85% of cases in the submandibular gland, 15% in the parotid gland)

Question 24

Salivary duct calculi

Answer 24

accumulation of calcium and phosphate crystals

Question 25

Aetiology and pathogenesis of Sialolithiasis

Answer 25

when the water content of saliva is decreased.

Certain medications also predispose to the formation of calculi.

These medications include antihistamines, antidepressants and diuretics

Question 26

Clinical feaTures of Sialolithiasis

Answer 26

Pain and swelling of the affected gland are typical. The pain usually worsens at mealtimes, when more saliva is produced

Question 27

Treatment of Sialolithiasis

Answer 27

The calculus may be pushed or milked out of the duct by a firm massage if it is small enough.

However, for larger calculi that cannot completely pass from the opening of the duct, a small incision may be made to remove it or the salivary duct may be probed

extraction and excision