Salivary gland diseases

Question 1

inflammation of salivary glands aka

Answer 1

sialadenitis

Question 2

sialadenitis breakdown

Answer 2

viral infection

• mumps
• HIV

bacterial infection

sarcoid sialenditits

Question 3

mumps cause

Answer 3

paramyxovirus

Question 4

incubation of mumps

Answer 4

14-21 day incubation

acute onset - within 2 weeks

Question 5

mumps onset, location and prediclition to

Answer 5

usually in children
- bilateral or unilaeal parotid gland enlargment

low grade fever

Question 6

high grade fevers with mumps

Answer 6

suggestive of metastatic orchitis - in 25 % of males or meningitis

Question 7

diagnosis of mumps

Answer 7

enlargmentof parotid

isolate in saliva

uses RT- PCR

paired serum IgG IgA / IgM – acute vs convalescent serum
- 4 fold rise in mumps antibody titers

IgM raised in early stage

Question 8

histopathology of mumps

Answer 8

biopsy is not customarily to diagnose

Question 9

treatment of chldren in mumps

Answer 9

self limiting in 1-2 weeks
- hydration, rest, isolation

nno specific therapy is given other than bed rest, analgesic and hydration

rare deaths occur from meningitis progressing to encephalitis

Question 10

mumps vaccine when

Answer 10

15 months second to 4-6 years

with the MMR – mumps-measles-rubella

Question 11

dont give vaccination of mumps to who

Answer 11

immunocompromised or those allergic to eggs or neomycin

Question 12

HIV infection manifestations

Answer 12

salivary gland enlargment of unknown etiolgy – but viruses are the suspected cause

parotid is involved 98% of the time and disease is bilateral in 60% of the cases

more common in children than adults

Question 13

HIV parotitis

Answer 13

fluid filled cysts of all sizes together with a diffuse inflammation,

thin epithelial lining with sever inflammation

CD 8 lymphocytes
NOT CD4

Question 14

cytomegalovirus associated with

Answer 14

human herpes 5 – with the HIV parotitis

Question 15

tx of the HIV parotitis

Answer 15

remove cyst and the surrounding gland tissue

can supplement

Question 16

bacterial infection lovation

Answer 16

usually UNILATERAL

- VS viral = bilateral

Question 17

bacterial infection in salivary glands?

Answer 17

actinomycosis - sulfur granules

Question 18

actinomycosis ?

Answer 18

if occurs in the salivary glands – accompanied by SULFUR granules in the purulent discharge

Question 19

tx in acute suppurative sialadenitis

Answer 19

must be treated aggresssively

surgical drainage more imp than medications

Question 20

sarcoid sialadenitis

Answer 20

sarcoidosis is a multisystem granulomatous disease with lympho- proliferation

systemic disease

Question 21

cause of sarcoidosis

Answer 21

atypical mycobacterial infection or an altered reaction to mycobacterial tuberculosis

Question 22

clinical features of sarcoid sialadenitis

Answer 22

BILATERAL DIFFUSE ENLARGMENT OF THE PAROTID GLANDS – indicates an early involvment in sarcoidosis

Question 23

diagnosis of sarcoidosis

Answer 23

ESR elevated

CBC – leucopenia and or eosinophilia

Question 24

diagnosis of sarcoidosis

Answer 24

ESR elevated

CBC – leucopenia and or eosinophilia

hypercalcemia – in advanced stages of disease he range of 50-80 mmHg

arterial hypoxema PaO2 in t

Question 25

biopsy of sarcoid

Answer 25

incisional parotid gland biopsy but if it has all 4 clinical signs -- do not need to biopsy - then just follow

Question 26

tx for sarcoidosis

Answer 26

those with certain organ involvments or disease manifestations require corticosteroid therapy --like prednisone

Question 27

sialoliths form around..**

Answer 27

a nidus in CONCENTRIC layers -- suggesting that some event - inflammation - bacterial colonization - foreign body - sloughed cells precedes their formation * the presence of tumors can initiate stone formation

Question 28

name for submandibular and parotid glands

Answer 28

sialocele

Question 29

ranula

Answer 29

sublingual

Question 30

mucocele

Answer 30

minor salivary gland

Question 31

tx of mucocele

Answer 31

remove completely

Question 32

ranula results of

Answer 32

from extravasation of saliva from any one of the 20 ducts that arise from t he sublingual gland, initiated by ductal injury or inflammation created by sialoliths of the whartons ducts large 3-6 cm and form a blue, tense vesicle in the floor of the mouth treated by excision of the fibrous capsule and the entire sublingual gland from which it arises

Question 33

superficial mucocele where

Answer 33

formed after a duct rupture in the subepithelial location of the palate and retromolar areas as small yellow or gray vesicles difficult to find entire gland

Question 34

treatment for ranula

Answer 34

excision of the fibrous capsule and the ENTIRE sublingual gland from which it arises

Question 35

dry mouth causes

Answer 35

``` drug induced radiation plummer inson syndrome diabetes HIV subjective dry mouth - exclude any other possible causes ```

Question 36

normal daily secretion of saliva

Answer 36

1 and 1.5 L

Question 37

#1 drug that causes dry mouth

Answer 37

antidepressant medication trcyclic antidepressants cause morme of these side-efffects than the newer biocyclic and tetracyclic agents #2 = azathioprine

Question 38

azathioprine

Answer 38

immunosuppressive medication commonly used for renal transplantaion and RA may cause dry mouth during the t

Question 39

radiation induced dry mouth

Answer 39

2 years after local side effect only with radation that is covering the gland area can get severe mucositis and xerostmia

Question 40

plummer vinsom syndrome

Answer 40

manifestation of iron-deficiency anemia particulary in females estimated that between 5 and 30 ercent of woman in US are iron deficient -- while in some parts of the world is 50%

Question 41

clinical features of plummer vincon syndrome

Answer 41

dry mouth cracks and fissures at the corners of the mouth smooth red and painful tongue atrophy of the upper alimentary tract -- high risk of gastric cancer -- atrophic change of gastric mucosa -- can go to cancer lab low serum iron low red blood cell count no megaloblasts typical of pernicious anemia lower hemociderin

Question 42

sjogren syndrome

Answer 42

autoimmune destruction of salivary and lacrimal glands that produces the clinical manifestations of dry mouth and dry ees and in more than 50% of cases - parotid enlargment

Question 43

insulin dependent diabetes

Answer 43

dry mouth and candidiasis can be common

Question 44

HIV patient and dry mouth?

Answer 44

yes + erythmatous candidiasis 1. side effect of anti viral medication + there is involvment of the parotid erythema -- because immunocompromised

Question 45

infiltration of what in sjorgren

Answer 45

lymphocytes

Question 46

hallmark of sjorgens

Answer 46

lymphocytic infiltratino of glands is the hallmark of sjorgens histopathology

Question 47

punctate sialectasis

Answer 47

think sjorgen's

Question 48

tear test

Answer 48

schirmer tear function test

Question 49

asymptomatic mass

Answer 49

salivary gland neoplasm is on your dx

Question 50

largest number of salivary gland tumor is located

Answer 50

parotid gland benign and malignant

Question 51

% of tumors in parotid that are benign

Answer 51

80%

Question 52

if mass found in ___ more likely to be malignant

Answer 52

sublingual gland -- as it is an uncoomon site for neoplasms so majority are malignant

Question 53

most common tumore in both major and minor

Answer 53

pleomorphic adenoma

Question 54

which tumors have strong prediliction for warthin tumor

Answer 54

warthin tumor, basal cell adenomas, onocytomas, acinic cell carcinoma, and sebaceous tumor

Question 55

prediliction for minor salivary glands

Answer 55

pleomorphic low grade adenocarcinoma

Question 56

most intraoral salivary gland tumors favor what

Answer 56

favor the palate

Question 57

benign malignant ratio is minor salivary gland tumors is

Answer 57

1:1

Question 58

palate with normal epitheium mass nodular - no symptoms

Answer 58

ddx | - minor salivary gland tumor should be on

Question 59

free margin of surgical removal

Answer 59

adequate resection of pleomorphic adenoma extracapsular stuff could be left behind if do not have enough margin -- will come back

Question 60

clinical margins

Answer 60

1-1.5 cm including the full palatal thicckness of muscosa and periosteum

Question 61

granulation of palate will occur in

Answer 61

after 2 weeks -- can remove the splint 2 months