Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Oms > orofacial pain > Flashcards

orofacial pain Flashcards

1
Q

ways to measure pain

A

visual analogue scale
hospital anxiety and depression scale
mcgill pain questionnaire
oral impacts on daily performance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

classification of orofacial pain

A

acute
chronic continuous
chronic acute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

possible etiologies of acute orofacial pain

A 
tmj
facial trauma
dental and oral causes
maxillary sinusitis
salivary gland disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is most common form of non dental facial pain

A

TMD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how to differentiate between the different forms of TMD

A

palpate the joint and muscle
if joint hurts –> arthritic
if muscle hurts –> myalgic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

in masticatory tmd, the discomfort/pain is usually located at

A 
muscles of mastication
temple
retromolar pad
ear
neck
directly over TMJ area
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

characteristics of tmd

A

sudden onset of pain
pain is continuous, gets worse through out the day/night, worsen with function
deep aching pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

tmd aggravating factors

A

prolonged chewing
jaw movement
prolonged mouth opening eg at dental appointmetn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

tmd associated factors

A

parafunctional habits eg clenching, bruxing
headache
migraines
tmj disc problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

treatment of tmd

A

Pharmacological:
NSAIDs, paracetamol, opioids
Injecting steroids/glucocorticoids into the joint (very effective if TMD due to arthritis associated with systemic inflammation)
Myalgia — diazepam, botox, TCA

Non pharmacological:
TMJ luxation — treat with manual repositioning
Jaw exercises, stretching, Occlusal correction
Arthrocentesis, discectomy with reduction, arthroscopy without reduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

burning mouth syndrome demographics

A

only occur in women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

location for burning mouth syndrome

A

tongue (most common)
lips
palate
buccal mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

nature of pain or burning mouth syndrome

A

stinging, burning
continuous
mild to severe
itchy, sore

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

associated factors with burning mouth syndrome

A

depression
menopause (hormonal changes)
dry mouth
abnormal taste

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

management of burning mouth syndrome

A

exclude any secondary causes eg diabetes, drugs, anemia (full blood count, hematinics eg ferritin, b12 deficiency that can cause secondary burning mouth)

alphalipoic acid with gabapentin with or without benzydamine mouthwash for symptomatic relief around meal times

cognitive behavioural therapy to help you feel better about the pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

management of persistent idiopathic facial pain

A

this is a diagnosis of exclusion

anti depressants, cognitive behavioural therapy, acknowledge patient’s pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

location of post herpetic neuralgia

A

at the same site as where you had herpes zoster

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

presentation of post herpetic neuralgia

A

burning, tingling, itchy pain, may be sharp

moderate to severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

aggravating factors of post herpetic neuralgia

A

(≠initiating factors, pain is there all the time
light touch
eating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

associated factors with post herpetic neuralgia

A

herpes zoster

ramsay hunt syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

management of post herpetic neuralgia

A

can be reduced by early treAtment of herpes zoster with acyclovir

spontaneous resolution, about 15% remain at one year

gabapentin, carbamzepine (must take blood test to test for allergic reaction which might result in acute erythema multiforme)

22
Q

presentation of post traumatic trigeminal neuropathic pain

A 
continuous burning pain
unilateral
can be sharp and very severe
up to 6 months after trauma (more severe trauma can last longer)
triggered by touch, hot , cold
23
Q

management of post traumatic trigeminal neuropathic pain

A

reassurance that pain will pass quickly
anti convulsants
gabapentin

24
Q

presentation of persistent dentoalveolar pain

A

diagnosis of exclusion
pain is localised to tooth or tooth bearing area
continuous ache, dull, throbbing
may be aggravated by touch

25
Q

management of persistent dentoalveolar pain

A

support, gabapentin, anticonvulsant

26
Q

what is giant cell arteritis

A

inflammation of lining of arteries

27
Q

giant cell arthritis may cause pain that is bilateral, or multifocal.
giant cell arthritis at __ artery causes what symptom
lingual, occipital, maxillary, retinal

A

lingual artery – ischemic tongue, vascular necrosis of tongue

occipital artery – headache at back of head

maxillary artery – masticatory claudication

retinal artery – visual impairment due to giant cell infiltration in retinal arteries

28
Q

nature of pain brough on by giant cell arteritis

A

continuous, uni or bilateral
sudden onset
dull, throbbing
claudication pain (may mimic tmj)

29
Q

diagnosis of giant cell arteritis

A

suspect if esr and crp high
if suspicious, do temporal artery biopsy and look for periluminal dark halo on colour duplex ultrasonography

give high dose steroids on speculation

30
Q

presentation of post stroke pain

A 
ipsilateral side as weakness (contralateral side to cerebral hemisphere insult)
whole side of face
continuous
burning/prickling
moderate pain
may be delayed onset
31
Q

migraine headache disorder is most common in what demographic

A

young females

32
Q

etiology of migraine

A

abnormal 5-HT activity with cerebral oedema

association with TMD

33
Q

presentation of migraine

A

unilateral
Initially poorly localised, then localised (to temporal, frontal, orbital regions)
may have aura
episodic (attacks decrease in frequency with age)

34
Q

aggravating factors for migraine

A

hormonal (OCP can increase frequency in those predisposed)

diet

flashing lights

stress

sleep deprivation

35
Q

migraines may be associated with

A

photophobia
nausea
vomitnig
tmj pain/tmd

36
Q

treatment for migraines

A

acute treatment: 5 HT antagonist eg ergotamine, sumatriptan

prophylaxis: beta blockers, calcium channel blockers, antihistamines

37
Q

dental things to note when treating patient who is on prophylactic mediaction for migraines

A

patient may be taking propranolol which is non selective, should not give LA containing adrenaline (risk of hypertensive reaction)

patient may be taking calcium channel blockrs eg verapamil which can cause gingival hypertrophy

38
Q

what are the two types of trigeminal autonomic cephalgia

A

short unilateral neuralgiform pain with cranial autonomic features eg crying, sweating

short unilateral neuralgiform pain with conjunctival injection and tearing eg lacrimation, nasal suymptoms, ptosis

39
Q

presentation of trigeminal autonomic cephalgia

A 
unilateral
cluster headaches
usually around the eyes (v1, v2)
rapid, short lived attacks (seconds-minutes)
sharp stabbing pain
non refractory, frequent 
elicited by touch
40
Q

management of trigeminal autonomic cephalgia

A

anticonvulsants, iamotrigine

41
Q

the two types of trigeminal neuralgia

A

type 1:
classical type
episodic
paroxysmal attack, short lasting (2s to minutes)
usually in older patients
nerve root compression at posterior cranial fossa by branch of pca

type 2:
longer lasting
central cns aetiology eg brain tumour, demyelination disease

42
Q

location of trigeminal neuralgia

A

unilateral

usually lower divisions ie v2, v3

43
Q

nature of trigeminal neuralgia pain

A 
episodic unilateral 
has refractory periods ie cannot elicit pain twice in a short period of time
periods of remission
electric shock with burning afterpain
moderate to severe
44
Q

aggravating factors of trigeminal neuralgia

A

light touch
cold wind
brushing teeth

45
Q

treatment for trigeminal neuralgia

A

type 1 usually responds to medication. if not, neurosurgery
type 2 mri to check for demyelination

cognitive behavioural therapy for fear 
steroids for demyelination 
antidepressants (depression due to pain)
carbamazepine
gabapentin with ropivacaine
pregabalin
46
Q

what neurosurgery do you do for trigeminal neuralgia

A

microvascular decompression, rhizotomy, peripheral neurolysis

47
Q

what is the complication of carbamazepine

A

may cause acute erythema multiforme, need to take blood test to test HLA type before taking

48
Q

presentation of glossopharyngeal neuralgia

A

triggered by swallowing, coughing, touching ear
unilateral in ear, tongue base, tonsils
radiating pain
paroxysmal, 2s to minutes
electric shock
patient may get syncope due to severity of pain

49
Q

management of glossopharyngeal neuralgia

A

carbamazepine
gabapentin
pregabalin
lamotrigine

50
Q

systemic diseases with characteristic facial pain/headaches

A 
pagets
hyperthyroidism
metastatic disease
multiple myeloma
vitamin b defiicency 
SLE
chemotherapy 
folic acid and iron deficiency anemia
hyperparathyroidsm
51
Q

red flags for orofacial pain

A

TUMOUR:
spontaneous focal pain or altered sensation may indicate tumour invasion

new onset headache with increasing severity, nausea, abnromal neurologic signs eg decreased sensation across face –> intra cranial tumour

pregnancy + ear ache+ trismus + altered sensation in mandibular distribution –> acoustic nerve tumour

CARDIAC:
pain at angle of mandible esp left, brought on by exertion and relieved by rest –> cardiac ischemia

SYSTEMIC:
systemic signs of anorexia, fever, weight loss, malaise, sweating

trigeminal neuralgia in patient under 50 years old may suggest multiple sclerosis (a type of demyelination disease)

TEMPORAL ARTERITIS:
suspect temporal arteritis when:
- over 50 y/o, localised progressive headache, superficial temporal artery swelling and tenderness
- jaw claudication, palpably tender superficial temporal arteries

Oms (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions