Ch 17 Systemic Diseases 2 Flashcards
What is the alternate name for xanthelasma?
xanthelasma palpebrarum
What is the most common cutaneous xanthoma?
xanthelasma
Xanthelasma has been related to what two systemic conditions?
- increased risk of atherosclerosis
2. elevated serum lipids
Xanthelasma removal is considered cosmetic, do they recur?
Recurrence is not unusual, even after controlling serum lipids
VITAMINS! _______ (retinol) is essential for the maintenance of vision, and it also plays a role in growth and tissue differentiation
Vitamin A
VITAMINS! Vitamin A can be obtained directly from dietary sources, such as organ meats (particularly ______ ), or the body can synthesize it from _______, which is abundant in red and yellow vegetables.
liver…. β-carotene
VITAMINS! Vitamin B1 (______) acts as a coenzyme for several metabolic reactions and is thought to maintain the proper functioning of ________. It is found in many animal and vegetable food sources.
thiamin….neurons
VITAMINS! Vitamin B2 (______) is necessary for cellular oxidation reduction reactions. Foods that contain significant amounts of this include milk, green vegetables, lean meat, fish, legumes, and eggs.
riboflavin
VITAMINS! Vitamin B3 (_____) acts as a coenzyme for oxidationreduction reactions. Rich sources include food from animal sources, especially lean meat and liver, milk, eggs, whole grains, peanuts, yeast, and cereal bran or germ.
niacin
Vitamin B6 (\_\_\_\_\_\_\_) serves as a cofactor associated with enzymes that participate in amino acid synthesis. It is found in many animal and vegetable food sources.
pyridoxine
Vitamin C (\_\_\_\_\_\_\_) is necessary for the proper synthesis of collagen. This vitamin is present in a wide variety of vegetables and fruits, although it is particularly abundant in citrus fruits.
ascorbic acid
Vitamin ____, which is now considered to be a hormone, can be synthesized in adequate amounts within the epidermis if the skin is exposed to a moderate degree of sunlight.
D
Vitamin \_\_ (α-tocopherol) is a fat-soluble vitamin that is widely stored throughout the body. It probably functions as an antioxidant. Vegetable oils, meats, nuts, cereal grains, and fresh greens and vegetables are good sources
E
Vitamin ___ is a fat-soluble vitamin found in a wide
variety of green vegetables, as well as milk, butter, and liver; intestinal bacteria also produce it. This vitamin is necessary for the proper synthesis of various proteins, including the clotting factors ________
K….II, VII, IX, and X.
Name that vitamin deficiency: The early changes associated with a lack of this vitamin later in life include an inability of the eye to adapt to reduced light conditions (i.e., night blindness). With more severe, prolonged deficiency, dryness of the skin and conjunctiva develop, and the ocular changes may progress to ulceration of the cornea, leading to blindness.
Vitamin A (retinol)
Name that vitamin deficiency: beriberi, a problem that is relatively uncommon in the Western world except in alcoholics or other individuals who do not
receive a balanced diet
Thiamin (Vitamin B1)…I wish it was B2 since beriberi has 2 B’s
Name that vitamin deficiency: Wernicke encepholopathy
Thiamin B1
Name that vitamin deficiency: Oral alterations (glossitis, angular cheilitis, sore throat, swelling, erythmia)
Riboflavin B2
Name that vitamin deficiency: pellagra
Niacin B3
Name that vitamin deficiency: Where in the US was pellagra once common?
Southeast (Vit B3 def)
Name that vitamin deficiency: What are the three classic signs/symptoms of pellagra? (think the three D’s)
(Vit B3 def)
- Dermatitis (sun exposed areas)
- Dementia
- Diarrhea
Name that vitamin deficiency: What are the two oral manifestations of pellagra (Vit B3 def)?
- Stomatitis
2. Glossitis (red, smooth, raw)
Name that vitamin deficiency: What are the 3 oral manifestations of pellagra (Vit B3 def)?
- Stomatitis
- Glossitis (red, smooth, raw)
- Cheilitis
Name that vitamin deficiency: can be caused by antituberculosis meds (isonazid)
Pyridoxine B6..the med is an antagonist for B6
Name that vitamin deficiency: What are the two oral manifestations of Pyridoxine B6 deficincy?
- Cheilitis
2. Glossitis
Name that vitamin deficiency: Which organ system is affected the most by Pyridoxine B6 deficincy?
nervous system (resulting in weakness, dizziness, seizure)
Name that vitamin deficiency: What two age groups/populations are affected most often by scurvy?
- Inner city infants (milk-only diet)
2. older edentulous men (no fruits/veggies in diet)
Name that vitamin deficiency: What is the term for the gingival lesions associated with vitamin c deficincy?
Scorbutic gingivitis
Name that vitamin deficiency: What is typically the method of death in untreated scurvy?
intracranial hemorrhage
Name that vitamin deficiency: What is the term for Vitamin D deficiency during infancy?
rickets
Name that vitamin deficiency: What is the term for vitamin D deficiency during adulthood?
osteomalaica
Name that vitamin deficiency: What is the term for the prominent costochondral junctions in rickets?
rachitic rosary
Name that vitamin deficiency: What is the result of Vit D deficincy on the developing teeth?
hypomineralization
Name that vitamin deficiency: What is the effect of osteomalacia (Vit D def in adults) on the bones?
diffuse skeletal pain and fracture
Name that vitamin deficiency: A result of chronic cholestatic liver disease…which organ system is most affected?
Vit E deficincy..CNS/PNS
Name that vitamin deficiency: long-term broad-spectrum antibiotic use
Vit K deficiency
Name that vitamin deficiency: oral anticoagulants (dicumarol) inhibit this vitamin’s normal enzymatic activity
Vit K
Name that vitamin deficiency: What effect does a Vit K def have on the clotting of blood?
Lack of Vit K leads to coagulopathy (hemorrhage) due to inadequate synthesis of prothrombin and other clotting factors
Name that vitamin deficiency: most often manifested by gingival bleeding
Vit K
What is the most common cause of anemia?
iron deficiency
What % of women of childbearing age are affected by iron-deficinency anemia due to menorrhagia?
11%
What are 3 intestinal causes of iron-deficiency anemia?
complete gastrectomy and celiac sprue and hookworms
What are 3 oral manifestations of iron-deficiency anemia?
- angular cheilitis
- atrophic glossitis (diffuse or patchy, dorsal, burning)
- generalized oral mucosal atrophy
What infection is often associated with the oral manifestations of iron-deficiency anemia?
candidiasis (although not as frequent in the US, since the iron-def anemia is usually detected before the candidiasis can occur)
What are the 4 characteristic blood lab findings for iron-def anemia?
- hypochromic microcytic RBCs, which may be reduced in numbers
- low serum iron
- low serum ferritin
- increased iron-binding capacity
How long does it take for supplemental iron to correct an iron def anemia?
1-2 months (better than the 3-4 months needed to make an RBC!)
