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Oral Pathology > Allergies and Immunologic Disease > Flashcards

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
Q

management of oral and genital lesions in behcet’s syndrome

A

potent topical corticosteroids or dapsone

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26
Q

management of ocular lesions associated with behcet’s syndrome

A

cyclosporine, azathioprine, interferon

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27
Q

mortality and prognosis of behcet’s syndrome

A

low mortality
good prognosis

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28
Q

causes of sarcoidosis

A

-unknown etiology
-improper degredation of antigenic material

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29
Q

sarcoidosis symptoms are similar to

A

TB

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30
Q

demographics of sarcoidosis

A

young adults
F>M
african american predilection

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31
Q

systemic findings of sarcoidosis

A

EVERYTHING
ocular lesions (anterior uveitis, keratoconjunctivitis sicca)
salivary glands (mimics sjogren’s)

32
Q

oral and jawbone findings of sarcoidosis

A

submucosal mass
ulceration
granular red inflamed mucosa
ill defined radiolucencies

33
Q

lofgren syndrome of acute sarcoidosis

A

erythema nodosum
bilateral hilar lymphadenopathy
arthralgia

34
Q

heerfordt syndrome of acute sarcoidosis

A

parotid swelling
anterior uveitis
facial paralysis
fever

35
Q

two histological findings of granulomas in sarcoidosis

A
  1. non-necrotizing granulomas with langhan’s and FBGCs
  2. stellate inclusion (asteroid body)
36
Q

diagnosis of sarcoidosis - lab findings

A
  1. elevated serum angiotensin-converting enzyme level
  2. eosinophilia, leukopenia, anemia, thrombocytopenia
  3. increased ESR, serum alkaline phosphates, serum calcium
37
Q

what test is no longer used to diagnose sarcoidosis?

A

KVEIM

38
Q

treatment of sarcoidosis

A

no treatment may be necessary

immunosuppressive therapy if symptoms are severe

39
Q

prognosis of sarcoidosis

A

fair to good
4-10% mortality

40
Q

triad of melkersson-rosenthal syndrome

A

nontender lip swelling
bell’s palsy
fissured tongue

41
Q

what systemic diseases need to be excluded int he diagnosis of orofacial granulomatosis?

A

sarcoidosis
crohn’s
TB

42
Q

how is orofacial granulomatosis treated?

A

remove identifiable trigger
intralesional corticosteroids work best

43
Q

demographics of Wegener’s granulomatosis

A

mean age 41
no gender predilection
90% caucasian

44
Q

another name of wegener’s granulomatosis

A

granulomatosis with polyangiitis

45
Q

classic form of wegener’s granulomatosis

A

nose, sinuses, ears, lungs, kidney

46
Q

limited form of wegener’s granulomatosis

A

respiratory system without immediate renal disease

47
Q

superficial form of wegener’s granulomatosis

A

primarily skin and mucosa without immediate lung and renal disease

48
Q

most common reason to pass away from wegener’s granulomatosis

A

renal disease (2nd lungs)

49
Q

oral lesions of granulomatosis with polyangiitis

A

strawberry gingivitis
oral ulcers

50
Q

histopathology of granulomatosis with polyangiitis

A

subepithelial hemorrhage
poorly formed granumlomas, particularly in oral and nasal lesions
scattered giant cells
vasculitis

51
Q

laboratory makers of granulomatosis with polyangiitis

A

cytoplasmic antineutrophil cytoplasm antibodies (c-ANCA) in 90-95% cases)

52
Q

treatment of granulomatosis with polyangiitis

A
  1. oral prednisone and cyclophosphamide
  2. low dose methotrexate
53
Q

two types of adverse reactions to systemic drug administration

A
  1. augmented reactions
  2. bizarre reactions
54
Q

augmented reactions

A

expected but exaggerated response

55
Q

bizarre reactions

A

idiosyncratic - highly variable person to person

56
Q

reaction patterns to mucosal reactions to systemic drug administration

A
  1. anaphylactic stomatitis
  2. fixed drug eruption
  3. lichenoid reaction
  4. pemphigoid like reaction
  5. lupus like reaction
  6. nonspecific ulcerative lesion
57
Q

diagnosis of mucosal reactions to systemic drug administration

A
  1. drug history
  2. temporal relationship
  3. resolution following discontinuation
58
Q

treatment of mucosal reactions to systemic drug administration

A
  1. consult with physician before treatment
  2. INR testing
  3. discontinue medication and replace with alternative
  4. topical corticosteroids
59
Q

perioral dermatitis

A

inflammatory skin disease involving circumoral area

60
Q

causes of perioral dermatitis

A

idiosyncratic reaction to external factors (ex. tarter control, toothpaste, bubble gum, moisturizer)

61
Q

clinical features of perioral dermatitis

A
  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
Q

management of perioral dermatitis

A
  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
Q

contact cinnamon reaction

A

mucosal change secondary to use of artifically flavored cinnamon products

64
Q

etiology of cinnamon reaction

A

cinnamaldehyde flavoring agent

confectionary, ice cream, soft drinks, gum, etc

65
Q

gingival clinical features of cinnamon reaction

A

edema, erythema, desquamation, erosion resembling erosive lichen planus

66
Q

clinical features of lip with cinnamon reaction

A

exfoliative cheilitis, perioral dermatitis

67
Q

clinical features of buccal mucosa and tongue with cinnamon reaction

A

ragged hyperkeratotic lesions on the buccal mucosa and tongue

resembles cheek / tongue chewing

68
Q

clinical features of lateral tongue with cinnamon reaction

A

lesions may resemble hairy leukoplakia

69
Q

contact amalgam reaction

A

chronic hypersensitivity reaction

70
Q

contact amalgam reaction is clinically similar to

A

lichen planus

71
Q

treatment of contact amalgam reaction

A

replace with plastic restoration results in clearing

72
Q

angioedema

A

acute diffuse edematous swelling of soft tissue of the face, oropharyngeal / laryngeal cavity and neck

type 1 hypersensitivity

73
Q

3 mechanisms of angioedema

A
  1. mast cell. degranulation
  2. non-igE mediated angioedema
  3. angioedema due to activation of complement pathway
74
Q

clinical features of angioedema

A
  1. rapid onset of non-tender welling involving face, lips, tongue, pharynx, larynx
  2. pain is unusual but itching and erythema are common
75
Q

urgency of management for angioedema

A

immediate!!

76
Q

management of angioedema

A
  1. oral antihistamines
  2. if respiratory symptoms are severe, corticosteroids and antihistamines

Oral Pathology (14 decks)

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