older people

Question 1

Which of the following oral medicine conditions are considered variations of normal anatomy - 2
A.
Black Hairy Tongue
B.
Lichenoid Tissue Reaction
C.
Geographic Tongue
D.
Fibro-epithelial Polyp
E.
MRONJ

Answer 1

A.
Black Hairy Tongue
C.
Geographic Tongue

Question 2

What is not a cause of xerostomia.
a.
Sjogrens Syndrome
b.
Head and neck radiotherapy
c.
Chemotherapy
d.
Diuretics
e.
Dehydration

Answer 2

c.
Chemotherapy

Question 3

what is the most common cause of death in patients with dysphagia associated with neurological impairment

Answer 3

aspiration pneumonia

Question 4

what is dementia

Answer 4

progressive deterioration in cognitive function beyond what is expected for normal ageing

Question 5

what does dementia affect alongside memory

Answer 5

thinking
orientation
learning capacity
language
perception

Question 6

characteristics of dementia

Answer 6

amnesia - difficulty recalling recent events
inability to concentrate
disorientation
intellectual impairment

Question 7

how to test cognitive function

Answer 7

mini mental state exam
delayed word recall
category fluency
clock draw

Question 8

risk factors of dementia

Answer 8

age
gender
genetic background
medical history
lifestyle

Question 9

early stage symptoms of dementia

Answer 9

loss of short term memory
confusion
distress
communication issues

Question 10

why do you do FBC, U and E, kidney, liver and thyroid function tests for dementia patient

Answer 10

to eliminate any treatable cause

Question 11

what protein makes the plaques and tangles in Alzheimer’s
where are the proteins deposited

Answer 11

plaques - beta amyloid - deposited in spaces between nerve cells

tangles - tau protein build up inside cells

Question 12

associated factors of Alzheimer’s

Answer 12

age
women
head injury
lifestyle

Question 13

abnormalities on which 3 chromosomes are associated with alzheimers

Answer 13

1 14 or 21

Question 14

What are 3 types of dementia

Answer 14

alzheimers
vascular
lewy bodies

Question 15

what causes vascular dementia

Answer 15

reduced blood flow to brain - damages and kills brain cells

stroke
blockage of small vessels in brain

Question 16

underlying health conditions and lifestyle factors linked to vascular dementia

Answer 16

high blood pressure
diabetes

obesity
smoking

Question 17

what is lewy bodies dementia

Answer 17

deposits of an abnormal protein called lewybodies inside brain cells

Question 18

what diseases do you find lewy bodies protein in the brain

Answer 18

parkinsons
LB dementia

Question 19

TDP-43 protein is associated with which type of dementia

Answer 19

fronto temporal dementia

Question 20

dementia type with younger age of onset

Answer 20

fronto temporal 45-65

Question 21

what protein is associated with frontotemporal dementia

Answer 21

TDP-43

Question 22

define frailty

Answer 22

increased vulnerability to stressors due to age related decline physiologically

Question 23

the 4 phenotypes of frailty

Answer 23

unintentional weight loss
weakness
slow walking speed
low physical activity

Question 24

between shortened dental arch and RPD, which improves quality of life at 24 months more

Answer 24

SDA - improved quality of life at 24 months

RPD has initial improvement but diminishes

Question 25

What is the aim of caring for smiles

Answer 25

improve OH of older people especially in care homes

Question 26

what is the name of scotlands national oral health promotion, training and support programme to improve OH of older people

Answer 26

Caring for smiles

Question 27

how do you find out if healthcare is being provided in line with standards, where the service is doing well, and where there could be improvements.

Answer 27

clinical audit meaningful feedback

Question 28

what did the francis report reveal

Answer 28

Poor care of older people at mid Staffordshire hospital - NHS

Question 29

what is the main source of infection for aspiration pneumonia

Answer 29

oral bacteria

Question 30

how to reduce risk of aspiration pneumonia

Answer 30

improve oral health - reduces bacteria

Question 31

what is staphylococcal mucositis

Answer 31

build up of dead mucosal cells- scab like Caused by staph aureus

Question 32

what did the francis report highlight needed to change going forward

Answer 32

Patients must be protected form avoidable harm Enhance the education, training and support

Question 33

what does the berwick report identify

Answer 33

importance for vigilance quality of patient care, especially patient safety, above all other aims

Question 34

treatment of burning mouth syndrome

Answer 34

no cure Tricyclics mindfulness relaxation all get FBC and haematinics test

Question 35

causes of burning mouth syndrome

Answer 35

ACE inhibitors dry mouth candidosis haematinic deficiency parafunction no cause identified in 50%

Question 36

what is a haemangioma

Answer 36

malformation of blood vessels will bleed if trauma

Question 37

where are haemangiomas often found

Answer 37

inside lip edge of tongue under tongue

Question 38

describe a fibroepithelial polyp

Answer 38

same mucosa as surrounding nothing to worry but can ulcer due to trauma if get too big so remove

Question 39

what is black hairy tongue

Answer 39

overgrowth on surface of tongue which picks up stains e.g. tea, smoking smell nothing to worry about - variation of normal

Question 40

who is more susceptible to black hairy tongue

Answer 40

smokers

Question 41

what is geographic tongue

Answer 41

tongue looks like a map - areas of atrophy surrounded by white raised areas variation of normal

Question 42

what is atrophic glossitis

Answer 42

really smooth/shiny tongue

Question 43

what is the most common cause of atrophic glossitis

Answer 43

low iron or vit b12

Question 44

what should you do if you see a patient with atropic glossitis

Answer 44

ask GMP for blood test - anaemia

Question 45

what is frictional keratosis

Answer 45

white patch caused by trauma and keratinisation

Question 46

what is speckled leukoplakia

Answer 46

hyperplastic candidosis pre malignant lesion

Question 47

pt complains of pain in upper right gum and thinks her new denture is rubbing on examination you see a white lesion in the buccal sulcus and the denture does appear to be snug in that area. what is the white lesion likely to be

Answer 47

traumatic keratosis

Question 48

what causes denture induced hyperplasia

Answer 48

ill fitting dentures

Question 49

treatment of denture induced hyperplasia

Answer 49

surgical removal new denture

Question 50

how does denture induced stomatitis present

Answer 50

erythema

Question 51

what causes denture induced stomatitis

Answer 51

candidal infection

Question 52

how to avoid denture induced stomatitis

Answer 52

good OH remove denture at night denture hygiene

Question 53

what virus causes heroes zoster (shingles)

Answer 53

varicellar zoster virus

Question 54

describe the presentation of herpes zoster trigeminal neuralgia

Answer 54

affects any branch of trigeminal often unilateral 2-3 days later rash in mouth and face painful

Question 55

how to treat herpetic trigeminal neuralgia

Answer 55

antidepressants carbamazepine cryotherapy neurectomy alcohol injection

Question 56

risk factors for trigeminal neuralgia

Answer 56

female maxillary and mandibular branch

Question 57

MRONJ risk factors

Answer 57

concurrent steroids invasive dental procedure previous MRONJ duration of therapy - OH, smoker, alcohol, perio

Question 58

what are bisphosphonates used to treat

Answer 58

osteoporosis paget's multiple myeloma

Question 59

what is angular chelitis

Answer 59

bacterial/fungal infection at corner of mouth

Question 60

causes of angular chelitis

Answer 60

reduced OVD denture hygiene low haematinics

Question 61

causes of xerostomia

Answer 61

poly pharmacy sjogrens radiotherapy

Question 62

management of xerostomia

Answer 62

change medication saliva replacement saliva stimulants - chew gum

Question 63

two drugs that ill burn mucosa if used topically

Answer 63

aspirin iron

Question 64

difference between lichen planus and lichenoid tissue reaction

Answer 64

both mucocutaneous disorders LP is a dermatology condition LTR is a reaction to certain drugs e.g. NSAIDS

Question 65

drugs associated with lichenoid tissue reaction

Answer 65

NSAIDS beta blockers diuretics

Question 66

how do bisphosphonates function

Answer 66

reduce bone resorption by inhibiting osteoclast formation and function

Question 67

MRONJ requires 3 key characteristics to be present what are they

Answer 67

current or previous antiresorptive/antiangiogenic treatment exposed bone for more than 8 weeks no history of radiation therapy or metastatic disease

Question 68

who is at low risk of MRONJ while taking bisphosphonates

Answer 68

taking for management to prevention of osteoporosis

Question 69

high risk of MRONJ

Answer 69

previous diagnosis concurrent use of corticosteroids taking for management of malignant condition

Question 70

What are FOUR cognitive tests for a person with dementia

Answer 70

MMSE: mini mental state examination MoCA: Montreal cognitive assessment Clock draw Delayed word recall