16 Oral signs of blood and nerve disorders Flashcards
Define anemia.
Decrease hemoglobin in blood resulting in inability to oxygenate tissue.
Differentiate iron deficiency anemia, pernicious anemia and sickle cell anemia.
Iron deficiency anemia - (most common) - Plummer Vinson Syndrome - dysphagia, increase in oran and esophageal carcinoma.
Pernicious anemia - loss of intrinsic factor, cannot absorb vitamin B12.
Sickle cell anemia - hemoglobinopathy, hemolytic anemia.
Describe the characteristic oral findings associated with sickle cell anemia.
Glossodynia (pain), glossopyrosis (burning), atrophic “glossitis”, angular cheilitis, apthous ulcers, candidosis, loss of bone density.
Describe the histologic and oral findings of polycythemia vera.
Uncontrolled overproduction of RBCs, and often platelets and WBC. Blood becomes viscous. Oral findings - erythrematous mucosa.
Contrast the histologic and clinical findings associated with leukopenia and lymphopenia.
Leukopenia - Decrease in WBC. Agranulocytosis (Neutropenia) - decrease in neutrophils, prone to bacterial infection, ragged non-healing oral ulceration.
Lymphopenia - decrease in lymphocytes (immunosuppression), prone to viral or fungal infection.
Discuss the characteristics of leukemia and describe the primary and secondary symptoms.
Leukemia is the malignancy of WBC, produces leukocytosis.
Oral Primary symptoms - diffuse gingival hyperplasia, radiolucency.
Seconday symptoms - prone to infection (neutropenia, lymphopenia) and bleeding (thrombocytopenia).
Define thrombocytopenia and describe its typical intra oral presentation.
Thrombocytopenia is poverty of thrombocytes (platelets), may be primary or secondary to another condition. Bleeding, petechiae, ecchymosis, purpura are very common to manifest around necks of teeth.
Describe characteristics and etiology of hemophilia.
X-linked deficiency of clotting factor VIII, deep bleeding, into joints and internal organs (men most commonly)
Describe the characteristics, etiology, typical population and location of Bell’s palsy.
Used to be believed as “idopathic” facial VII paralysis, now considered “Postviral Neuropathy” (infection in the nerve). Abrupt onset, unilateral, middle age, most have complete recovery, neurosurgical consulation.
Describe the clinical presentation of Melkersson-Rosenthal syndrome.
Cheilitis granulomatosis, fissured tongue, facial paralysis (not Bells palsy)
Describe the clinical presentation, potential etiology, typical population associated with trigeminal neuralgia.
(Tic Douloureux) Pain of Cranial Nerve V, affects middle aged, in those under 30 suspect Demyelinating plaques of multiple sclerosis. Acute, excruciating pain, abrupt onset, follows “trigger” zone manipulation, lasts seconds to minute, unilateral, affects any division of V, may be caused by anatomic abnormalities in area of ganglion.
Describe some treatment options for trigeminal neuralgia.
Treatment - 75% get relief from anticonvulsants (Tegretol), Percutaneous radiofrequency trigeminal gangliolysis, Gamma knife radiation, Neurosurgical decompression (last resort)
