Ch. 9 Allergy/Immunologic, Part 1 Flashcards

1
Q

Transient lingual papillitis other names

A

bumps, tongue torches

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2
Q

Local irritation, inflammation, hormones, stress, hypersensitivity cause a reaction of the ______ papillae in transient lingual papillitis

A

fungiform

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3
Q

3 clinical patterns of transient lingual papilitis

A

Localized
Generalized
Papulokeratotic

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4
Q

Most common location for localized transient lingual papillitis, the condition usually lasts for _____

A

anterior dorsal tongue

hours to days

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5
Q

Causative agent for:
localized TLP
generalized TLP

A

localized: maybe a food allergy
generalized: maybe viral as it is passed around families

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6
Q

Large % of the fungiform papillae located on the ______ tongue are affected in generalized TLP

A

tip and lateral dorsal

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7
Q

T/F papillae involved by papulokeratotic variant of TLP are symptomatic

A

false- asymptomatic

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8
Q

What causes the white appearance of the papulokeratotic variant of TLP

A

thickened parakeratotic cap

bacterial colonization

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9
Q

On average ____% of the population are affected by recurrent aphthous stomatitis

A

20%

ranges from 5-66%

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10
Q

Systemic disorders associated with recurrent aphthous stomatitis (11)

A
Behcet syndrome
IgA deficiency
Celiac disease
Cyclic neutropenia
Nutritional deficiencies
IBD
HIV and other immunocompromised
Reactive arthritis
-Sweet syndrome: very rare inflammatory skin condition characterized by a sudden onset of fever and painful rash on the arms, legs, trunk, face, or neck.
-MAGIC syndrome: mouth and genital ulcers with inflamed cartilage
-PFAPA syndrome: periodic fever, aphthous stomatitis, pharyngitis, cervical adenitis 
Ulcus vulvae acutum
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11
Q

____% of patients with recurrent aphthous stomatitis have some underlying condition

A

60%

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12
Q

3 clinical variants of aphthous stomatitis and their alternative names

A
Minor aphthous (Mikulicz aphthae)
Major aphthous (Sutton disease)
Herpetiform aphthae
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13
Q

what % of aphthae are each type

A

80% minor
10% major
10% herpetiform

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14
Q

which type of aphthae are typically adult onset

A

herpetiform type

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15
Q

Simple vs complex aphthosis

A

Simple aphthosis: few lesions, heal in 1-2 weeks, recur infrequently
Complex aphthosis: 3 or more lesions, almost constant overlapping bouts of lesions; severe pain and large size are frequent

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16
Q

Behcet syndrome alternate names

A

Behcet disease, Adamantiades syndrome

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17
Q

classic triad of behcet syndrome

A

oral, genital and ocular inflammation

now we include systemic vasculitis

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18
Q

What genetic variation is associated with increased risk of Behcet syndrome

A

HLA-B51

frequent in japan, turkey, and eastern mediterranean

19
Q

demographics of behcets

A

slight male predominance

3rd-4th decades

20
Q

almost all behcet patients have oral ulcers. Most commonly what type?

A

Minor, but up to 40% have major type, and only 3% have herpetiform type

21
Q

What % of behcet syndrome patients have genital ulcers?

A

75%

deep ulcers that tend to scar

22
Q

T/F Blindness occurs in 25% of patients with ocular involvement of behcet disease

23
Q

What % of patients with behcet disease have CNS involvement

A

10-25%

poor prognosis

24
Q

International study group criteria for diagnosis of Behcet disease (no lab criteria)

A

Major criteria: oral aphthae

(2) Minor criteria: recurrent genital ulcers, eye lesions, skin lesions, positive pathergy test

25
What is a positive pathergy test? What is it used to diagnose
Stick a sterile 20 gauge needle into the skin, inject saline One to two days later a sterile papule arises *occurs in 60% of mediterranean behcets patients but only 3% of caucasians - used to aid in the diagnosis of Behcets
26
what histologic pattern is seen in behcets ulcerations
leukocytoclastic vasculitis Vessels show: intramural invasion by neutrophils, karyorrhexis(destructive fragmentation of the nucleus) of neutrophils, extravasation of red blood cells, and fibrinoid necrosis of the vessel wall
27
Demographics for sarcoidosis
black, female, before age 50
28
what % of patients with sarcoid are asymptomatic at diagnosis
20%
29
Predominant sites affected by sarcoidosis
lungs, lymph nodes, salivary glands, skin and eyes | *Mediastinal and paratracheal lymph nodes
30
What is a common radiographic sign of sarcoid of chest xray
bilateral hilar LAD
31
what are the indurated skin lesions of the nose,ears,lips and face in sarcoid?
lupus pernio - Occurs in 25% of patients - Frequent in head and neck region
32
What is a non-specific skin lesion often on the lower leg in sarcoidosis?
erythema nodosum
33
If sarcoidosis affects the lacrimal gland what condition can it mimic
keratoconjunctivitis sicca of sjogrens syndrome
34
What are the two clinical syndromes of Acute sarcoidosis
1. Lofgren syndrome | 2. Heerfordt syndrome
35
Features of Lofgren syndrome
1. erythema nodosum 2. bilateral hilar LAD 3. arthralgia
36
Features of Heerfordt syndrome aka uveoparotid fever
1. parotid enlargement 2. anterior uveitis 3. facial paralysis (ON THE BELLS PALSY DIFFERENTIAL) 4. fever
37
In what % of patients are oral manifestations the first sign of sarcoidosis
2/3 66%
38
Are there intraosseous lesions of sarcoid?
yes- 1/4 of patients
39
3 Histologic buzzwords for sarcoid
- tight epithelioid GRANULOMAS - Schaumann bodies: laminated basophilic calcifications within the granulomas - Asteroid bodies: entrapped collagen within the granuloma
40
serum marker that can be elevated in sarcoidosis
60% of patients have elevated ACE
41
What WAS the skin test for sarcoid?
Kveim test (intradermal injection of sterilized suspension of sarcoid tissue)....Not done anymore
42
Helpful diagnostic aid which leads to diagnosis in 93% of patients
parotid biopsy
43
What % of patients have spontaneous resolution of sarcoidosis in 2 years
60%....10-20% of patients do not get resolution even with treatment...4-10% die of cardiac, respiratory, or CNS complications
44
Ocular involvment in sarcoid: 25% of the time and what is the clinical term (presentation)?
anterior uveitis