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Allergies and Immunologic Disease Flashcards

1
Q

another name for aphthous ulcers

A

canker sores

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2
Q

what are aphthous ulcers?

A

T cell mediated

-abnormal response to normal antigen
-altered mucosal barrier unmasks antigen

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3
Q

stimulus of aphthous ulcers

A
  1. sodium lauryl sulfate
  2. medications (ex. NSAIDS)
  3. microbiological agents
  4. foods
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4
Q

precipitating factors of aphthous ulcers

A

allergies
nutritional deficiency
hematological abnormalities
hormonal influence
infecitous agents
trauma
stress

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5
Q

systemic conditions that show oral aphthous-like ulcers

A

cyclic neutropenia
HIV / AIDS
Behcet’s syndrome
crohn’s disease
celiac disease

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6
Q

common features of all aphthous ulcerations

A

ulceration
pain
recurrence (come back)

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7
Q

duration of minor aphthous uclers

A

shortest duration (7-14 days)
fewest recurrences

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8
Q

where are minor aphthous ulcers found

A

exclusively on non-keratinized mucosa (lining mucous membranes)

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9
Q

prodromal symptoms of minor aphthous ulcers

A

burning, itching, stinging

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10
Q

physical appearance of minor aphthous ulcers

A

3-10mm ulcer with a fibrinopurulent base and erythematous halo

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11
Q

duration of major aphthous ulcers

A

longest duration per episode (2-6 weeks)

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12
Q

appearance of major aphthous ulcers

A

deep and 1-3 cm in size

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13
Q

location of major aphthous ulcers

A

labial mucosa, soft palate, tonsils

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14
Q

appearance of herpetiform aphthous ulcers

A

each lesion 1-3mm in size, coalesce into larger irregular ulcers

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15
Q

how long does it take for herpetiform aphthous ulcers to heal?

A

7-10 days

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16
Q

management of aphthous ulcers

A

-high potency topical corticosteroids
-viscous xylocaine for pain relief

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17
Q

what is NOT recommended for management of aphthous ulcers

A

silver nitrate

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18
Q

who is prone to bahcet’s syndrome?

A

systemic vasculitis is generally susceptible (HLA-B51+) individuals

young adults

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19
Q

what could trigger bahcet’s syndrome?

A

environmental antigens (bacteria, viruses, pesticides, heavy metals)

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20
Q

distribution of bahcet’s syndrome

A

ancient silk routes (asia, turkey, rome)

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21
Q

oral manifestations of behcet’s syndrome?

A

occur first
aphthous-like ulcerations (affecting oropharynx and soft palate)

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22
Q

genital lesions associated with Behcet’s syndrome

A

resemble oral ulcerations
deeper and heal with scarring

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23
Q

cutaneous lesions associated with behcet’s syndrome

A

erythematous papules, vascicles, pustules, pyoderma, folliculitis, acneiform eruptions, and erythema nodosum-like lesions

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24
Q

ocular lesions associated with behcet’s syndrome

A

posterior uveitis, conjunctivitis, corneal ulcerations, cataracts, glaucoma

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25
management of oral and genital lesions in behcet's syndrome
potent topical corticosteroids or dapsone
26
management of ocular lesions associated with behcet's syndrome
cyclosporine, azathioprine, interferon
27
mortality and prognosis of behcet's syndrome
low mortality good prognosis
28
causes of sarcoidosis
-unknown etiology -improper degredation of antigenic material
29
sarcoidosis symptoms are similar to
TB
30
demographics of sarcoidosis
young adults F>M african american predilection
31
systemic findings of sarcoidosis
EVERYTHING ocular lesions (anterior uveitis, keratoconjunctivitis sicca) salivary glands (mimics sjogren's)
32
oral and jawbone findings of sarcoidosis
submucosal mass ulceration granular red inflamed mucosa ill defined radiolucencies
33
lofgren syndrome of acute sarcoidosis
erythema nodosum bilateral hilar lymphadenopathy arthralgia
34
heerfordt syndrome of acute sarcoidosis
parotid swelling anterior uveitis facial paralysis fever
35
two histological findings of granulomas in sarcoidosis
1. non-necrotizing granulomas with langhan's and FBGCs 2. stellate inclusion (asteroid body)
36
diagnosis of sarcoidosis - lab findings
1. elevated serum angiotensin-converting enzyme level 2. eosinophilia, leukopenia, anemia, thrombocytopenia 3. increased ESR, serum alkaline phosphates, serum calcium
37
what test is no longer used to diagnose sarcoidosis?
KVEIM
38
treatment of sarcoidosis
no treatment may be necessary immunosuppressive therapy if symptoms are severe
39
prognosis of sarcoidosis
fair to good 4-10% mortality
40
triad of melkersson-rosenthal syndrome
nontender lip swelling bell's palsy fissured tongue
41
what systemic diseases need to be excluded int he diagnosis of orofacial granulomatosis?
sarcoidosis crohn's TB
42
how is orofacial granulomatosis treated?
remove identifiable trigger intralesional corticosteroids work best
43
demographics of Wegener's granulomatosis
mean age 41 no gender predilection 90% caucasian
44
another name of wegener's granulomatosis
granulomatosis with polyangiitis
45
classic form of wegener's granulomatosis
nose, sinuses, ears, lungs, kidney
46
limited form of wegener's granulomatosis
respiratory system without immediate renal disease
47
superficial form of wegener's granulomatosis
primarily skin and mucosa without immediate lung and renal disease
48
most common reason to pass away from wegener's granulomatosis
renal disease (2nd lungs)
49
oral lesions of granulomatosis with polyangiitis
strawberry gingivitis oral ulcers
50
histopathology of granulomatosis with polyangiitis
subepithelial hemorrhage poorly formed granumlomas, particularly in oral and nasal lesions scattered giant cells vasculitis
51
laboratory makers of granulomatosis with polyangiitis
cytoplasmic antineutrophil cytoplasm antibodies (c-ANCA) in 90-95% cases)
52
treatment of granulomatosis with polyangiitis
1. oral prednisone and cyclophosphamide 2. low dose methotrexate
53
two types of adverse reactions to systemic drug administration
1. augmented reactions 2. bizarre reactions
54
augmented reactions
expected but exaggerated response
55
bizarre reactions
idiosyncratic - highly variable person to person
56
reaction patterns to mucosal reactions to systemic drug administration
1. anaphylactic stomatitis 2. fixed drug eruption 3. lichenoid reaction 4. pemphigoid like reaction 5. lupus like reaction 6. nonspecific ulcerative lesion
57
diagnosis of mucosal reactions to systemic drug administration
1. drug history 2. temporal relationship 3. resolution following discontinuation
58
treatment of mucosal reactions to systemic drug administration
1. consult with physician before treatment 2. INR testing 3. discontinue medication and replace with alternative 4. topical corticosteroids
59
perioral dermatitis
inflammatory skin disease involving circumoral area
60
causes of perioral dermatitis
idiosyncratic reaction to external factors (ex. tarter control, toothpaste, bubble gum, moisturizer)
61
clinical features of perioral dermatitis
1. irritant or allergic contact dermatitis 2. persistent erythematous papules and pustules 3. zone of spared skin immeidatley adjacent to vermilion 4. pruritus is vairable
62
management of perioral dermatitis
1. worsens on application of steroids 2. identify and remove cause 3. discontinue steroid use 4. topical application of metronidazole 5. keep skin dry
63
contact cinnamon reaction
mucosal change secondary to use of artifically flavored cinnamon products
64
etiology of cinnamon reaction
cinnamaldehyde flavoring agent confectionary, ice cream, soft drinks, gum, etc
65
gingival clinical features of cinnamon reaction
edema, erythema, desquamation, erosion resembling erosive lichen planus
66
clinical features of lip with cinnamon reaction
exfoliative cheilitis, perioral dermatitis
67
clinical features of buccal mucosa and tongue with cinnamon reaction
ragged hyperkeratotic lesions on the buccal mucosa and tongue resembles cheek / tongue chewing
68
clinical features of lateral tongue with cinnamon reaction
lesions may resemble hairy leukoplakia
69
contact amalgam reaction
chronic hypersensitivity reaction
70
contact amalgam reaction is clinically similar to
lichen planus
71
treatment of contact amalgam reaction
replace with plastic restoration results in clearing
72
angioedema
acute diffuse edematous swelling of soft tissue of the face, oropharyngeal / laryngeal cavity and neck type 1 hypersensitivity
73
3 mechanisms of angioedema
1. mast cell. degranulation 2. non-igE mediated angioedema 3. angioedema due to activation of complement pathway
74
clinical features of angioedema
1. rapid onset of non-tender welling involving face, lips, tongue, pharynx, larynx 2. pain is unusual but itching and erythema are common
75
urgency of management for angioedema
immediate!!
76
management of angioedema
1. oral antihistamines 2. if respiratory symptoms are severe, corticosteroids and antihistamines

Oral Pathology (14 decks)

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