Ch 17 Systemic Diseases 2

Question 1

What is the alternate name for xanthelasma?

Answer 1

xanthelasma palpebrarum

Question 2

What is the most common cutaneous xanthoma?

Answer 2

xanthelasma

Question 3

Xanthelasma has been related to what two systemic conditions?

Answer 3

1. increased risk of atherosclerosis

2. elevated serum lipids

Question 4

Xanthelasma removal is considered cosmetic, do they recur?

Answer 4

Recurrence is not unusual, even after controlling serum lipids

Question 5

VITAMINS! _______ (retinol) is essential for the maintenance of vision, and it also plays a role in growth and tissue differentiation

Answer 5

Vitamin A

Question 6

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.

Answer 6

liver…. β-carotene

Question 7

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.

Answer 7

thiamin….neurons

Question 8

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.

Answer 8

riboflavin

Question 9

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.

Answer 9

niacin

Question 10

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.

Answer 10

pyridoxine

Question 11

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.

Answer 11

ascorbic acid

Question 12

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.

Answer 12

D

Question 13

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

Answer 13

E

Question 14

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 ________

Answer 14

K….II, VII, IX, and X.

Question 15

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.

Answer 15

Vitamin A (retinol)

Question 16

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

Answer 16

Thiamin (Vitamin B1)…I wish it was B2 since beriberi has 2 B’s

Question 17

Name that vitamin deficiency: Wernicke encepholopathy

Answer 17

Thiamin B1

Question 18

Name that vitamin deficiency: Oral alterations (glossitis, angular cheilitis, sore throat, swelling, erythmia)

Answer 18

Riboflavin B2

Question 19

Name that vitamin deficiency: pellagra

Answer 19

Niacin B3

Question 20

Name that vitamin deficiency: Where in the US was pellagra once common?

Answer 20

Southeast (Vit B3 def)

Question 21

Name that vitamin deficiency: What are the three classic signs/symptoms of pellagra? (think the three D’s)

Answer 21

(Vit B3 def)

1. Dermatitis (sun exposed areas)
2. Dementia
3. Diarrhea

Question 22

Name that vitamin deficiency: What are the two oral manifestations of pellagra (Vit B3 def)?

Answer 22

1. Stomatitis

2. Glossitis (red, smooth, raw)

Question 23

Name that vitamin deficiency: What are the 3 oral manifestations of pellagra (Vit B3 def)?

Answer 23

1. Stomatitis
2. Glossitis (red, smooth, raw)
3. Cheilitis

Question 24

Name that vitamin deficiency: can be caused by antituberculosis meds (isonazid)

Answer 24

Pyridoxine B6..the med is an antagonist for B6

Question 25

Name that vitamin deficiency: What are the two oral manifestations of Pyridoxine B6 deficincy?

Answer 25

1. Cheilitis

2. Glossitis

Question 26

Name that vitamin deficiency: Which organ system is affected the most by Pyridoxine B6 deficincy?

Answer 26

nervous system (resulting in weakness, dizziness, seizure)

Question 27

Name that vitamin deficiency: What two age groups/populations are affected most often by scurvy?

Answer 27

1. Inner city infants (milk-only diet)

2. older edentulous men (no fruits/veggies in diet)

Question 28

Name that vitamin deficiency: What is the term for the gingival lesions associated with vitamin c deficincy?

Answer 28

Scorbutic gingivitis

Question 29

Name that vitamin deficiency: What is typically the method of death in untreated scurvy?

Answer 29

intracranial hemorrhage

Question 30

Name that vitamin deficiency: What is the term for Vitamin D deficiency during infancy?

Answer 30

rickets

Question 31

Name that vitamin deficiency: What is the term for vitamin D deficiency during adulthood?

Answer 31

osteomalaica

Question 32

Name that vitamin deficiency: What is the term for the prominent costochondral junctions in rickets?

Answer 32

rachitic rosary

Question 33

Name that vitamin deficiency: What is the result of Vit D deficincy on the developing teeth?

Answer 33

hypomineralization

Question 34

Name that vitamin deficiency: What is the effect of osteomalacia (Vit D def in adults) on the bones?

Answer 34

diffuse skeletal pain and fracture

Question 35

Name that vitamin deficiency: A result of chronic cholestatic liver disease…which organ system is most affected?

Answer 35

Vit E deficincy..CNS/PNS

Question 36

Name that vitamin deficiency: long-term broad-spectrum antibiotic use

Answer 36

Vit K deficiency

Question 37

Name that vitamin deficiency: oral anticoagulants (dicumarol) inhibit this vitamin’s normal enzymatic activity

Answer 37

Vit K

Question 38

Name that vitamin deficiency: What effect does a Vit K def have on the clotting of blood?

Answer 38

Lack of Vit K leads to coagulopathy (hemorrhage) due to inadequate synthesis of prothrombin and other clotting factors

Question 39

Name that vitamin deficiency: most often manifested by gingival bleeding

Answer 39

Vit K

Question 40

What is the most common cause of anemia?

Answer 40

iron deficiency

Question 41

What % of women of childbearing age are affected by iron-deficinency anemia due to menorrhagia?

Answer 41

11%

Question 42

What are 3 intestinal causes of iron-deficiency anemia?

Answer 42

complete gastrectomy and celiac sprue and hookworms

Question 43

What are 3 oral manifestations of iron-deficiency anemia?

Answer 43

1. angular cheilitis
2. atrophic glossitis (diffuse or patchy, dorsal, burning)
3. generalized oral mucosal atrophy

Question 44

What infection is often associated with the oral manifestations of iron-deficiency anemia?

Answer 44

candidiasis (although not as frequent in the US, since the iron-def anemia is usually detected before the candidiasis can occur)

Question 45

What are the 4 characteristic blood lab findings for iron-def anemia?

Answer 45

1. hypochromic microcytic RBCs, which may be reduced in numbers
2. low serum iron
3. low serum ferritin
4. increased iron-binding capacity

Question 46

How long does it take for supplemental iron to correct an iron def anemia?

Answer 46

1-2 months (better than the 3-4 months needed to make an RBC!)