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06 salivary gland dysfunction, assessment and management in geriatrics

Terms in this set (19)

SJOGRENS SYNDROME (SS)

this is a systemic [ ] disorder which is an inflammation of the [ ] AND DESTRUCTION OF [ ]

gender ratio is [ ]
age is [ ] and [ ]
prevalence is approximately [ ] people affected in USA

symptoms:
-xerostomia [ ]
-oral dryness ([ ])
-ocular dryness ([ ]) = [ ]
-other exocrine tissues: thyroid, lungs, and kidney
-no definitive [ ]


PRIMARY SS:
-systemic disorder that includes [ ] dysfunctions without another autoimmune condition
-presence of any [ ] of the 6 items is indicative of primary SS as long as either item [ ] or [ ] is positive
-presence of any [ ] of 4 major objective criteria (items [ ])

SECONDARY SS:
-salivary and/or lacrimal gland dysfunction in the setting of [ ]
-[ ], polymyositis, dermatomyositis
-presence of item [ ]
-plus any 2 from items [ ] is indicative of secondary SS

CLINICALLY:
-full spectrum of oral complications of salivary gland hypofunction
-[ ]% of SS patients have experienced enlarged parotid glands
-[ ] parotid gland enlargement found in [ ]% of all patients
-[ ] sensation ([ ])2nd to fungal infection
-peripheral nervous system is affected [ ]% of the time with [ ]
-dysphagia, malnutrition and prone to trauma

SYSTEMIC MANIFESTATIONS
-[ ]
-neuropathy
-vasculitis
-disorders of [ ]
-[ ] fold INCREASE frequency of [ ] compared to general population. this is a [ ] lymphoma and [ ]% of SS cases will have this complication

known questions correlated with objective findings of SGD:
-does the amount of saliva in your mouth seem to be too little, too much, or you don't notice it?
-do you have any difficulty swallowing?
-does your mouth feel dry when eating a meal?
-do you sip liquids to aid in swallowing dry foods?
SJOGRENS SYNDROME (SS)

this is a systemic chronic autoimmune disorder which is an inflammation of the EPITHELIAL TISSUES AND DESTRUCTION OF EXOCRINE GLANDS

gender ratio is F>M (9:1)
age is mid 50s and post menopausal
prevalence is approximately 1 million people affected in USA

symptoms:
-xerostomia >3 months
-oral dryness (salivary glands)
-ocular dryness (lacrimal gland) = XEROPTHALMIA
-other exocrine tissues: thyroid, lungs, and kidney
-no definitive cure


PRIMARY SS:
-systemic disorder that includes both lacrimal and salivary gland dysfunctions without another autoimmune condition
-presence of any 4 of the 6 items is indicative of primary SS as long as either item 4 (histopathology) or 6(serology) is positive
-presence of any 3 of 4 major objective criteria (items 3-6)

SECONDARY SS:
-salivary and/or lacrimal gland dysfunction in the setting of another connective-tissue disorder
-SLE, RA, scleroderma, polymyositis, dermatomyositis
-presence of item 1 or 2
-plus any 2 from items 3-5 is indicative of secondary SS


CLINICALLY:
-full spectrum of oral complications of salivary gland hypofunction
-20-40% of SS patients have experienced enlarged parotid glands
-B/L parotid gland enlargement found in 25-60% of all patients
-ORAL BURNING sensation (GLOSSODYNIA) 2nd to fungal infection
-peripheral nervous system is affected 5-20% of the time with excruciating, burning pain of extremities
-dysphagia, malnutrition and prone to trauma

SYSTEMIC MANIFESTATIONS
-synovitis
-neuropathy
-vasculitis
-disorders of skin, thyroid, GI tract
-40-44 fold INCREASE frequency of B-CEL LYMPHOMA (MALT) compared to general population. this is a NON-HODGKIN'S lymphoma and 4-10% of SS cases will have this complication

known questions correlated with objective findings of SGD:
-does the amount of saliva in your mouth seem to be too little, too much, or you don't notice it?
-do you have any difficulty swallowing?
-does your mouth feel dry when eating a meal?
-do you sip liquids to aid in swallowing dry foods?