Chapter 13

Question 1

What is the general term for a decrease in volume of RBC?

Answer 1

Anemia

Question 2

What is the defenition of hematocrit?

Answer 2

Volume of RBCs.

Question 3

What are some of the oral symptoms of anemia?

Answer 3

Palor, bald tongue, pain and burning localized to the tongue.

Question 4

What is a hematologic disorder characterized by a markedly decrease number of circulating blood platelets?

What is an oral manifestation of this?

Answer 4

Thrombocytopenia.

Palatal petechiea.

Question 5

What is a normal platelet count?

Answer 5

200,000-400,000/mm³

Question 6

At what platelet count level will you have clinical evidence of thrombocytopenia?

Answer 6

When count is below 100,000/mm³

Question 7

How is thrombocytopenia often first detected?

Answer 7

From the oral lesions.

Question 8

What is the pattern for the pooling of blood in the skin?

Answer 8

Petechiae–> purpura–> ecchymosis–> hematoma.

Question 9

What blood count is considered severe thrombocytopenia?

Answer 9

10,000 platelets/mm³

Question 10

What are the two special types of thromboytopenia? Describe them.

Answer 10

Idiopathic thrombocytopenia purpura (ITP): Occurs in childhood, classically after a viral infection.

Thrombotic thrombocytopenia purpura (TTP): Serious disorder of coagulation and is probably due to endothelial damage.

Question 11

What is the term for enlargment of lymphoid tissue?

What causes it?

Answer 11

Lymphoid hyperplasia.

Typically due to an infection.

Question 12

What is the likely Dx?

Answer 12

Lymphoid hyperplasia.

Question 13

What is the likely Dx?

Answer 13

Lymphoid hyperplasia.

Question 14

What is agranulocytosis referring to?

What are the two subcategories?

Answer 14

Being without granulocytes, usually neutrophils.

Neutropenia and lymphopenia.

Question 15

What is a malignancy of hematopoietic stem cell origin?

Answer 15

Leukemia.

Question 16

What are the classifications of leukemia?

Answer 16

Myeloid vs Lymphoid(lymphoblastic).

Acute vs Chronic.

Question 17

What is the significance of chronic myeloid leukemia?

Answer 17

It has a translocation between the long arms of chromosomes 9 and 22 termed Philadelphia chromosome.

Question 18

What are some of the factors that may lead to leukemia?

Answer 18

Exposure to pesticides, benzene, or ionizing radiation.

Question 19

What is a common childhood malignancy?

Answer 19

Acute lymphoblastic leukemia.

Question 20

What is the most common type of leukemia?

Answer 20

Chonic lymphocytic leukemia.

Question 21

What is the clinical depiction of leukemia that has spread to the oral soft tissues?

Answer 21

Boggy/doughy, non-tender swelling termed granulocytic sarcoma.

Question 22

Where are langerhans cells typically found?

Answer 22

Epidermis, mucosa, lymph nodes, and bone marrow.

Question 23

What is the likely Dx?

Answer 23

Leukemia.

Question 24

What are the spectrums of langerhans cell histiocytosis?

Answer 24

Eosinophilic granuloma of bone: One or multiple lesions, no visceral involvement.

Acute dusseminated histiocytosis: Disease involves bone, skin, and viscera, mostly in infants (Letterer-Siwe disease), more prominent involvement.

Chronic disseminated histiocytosis: Disease involves bone, skin, and viscera (Hand-Schuller-Christian disease).

Question 25

Where are most lesions of langerhans histiocytosis found?

Answer 25

Skull, ribs, vertebrae, mandible.

Question 26

What is the likely Dx?

Answer 26

Langerhans histiocytosis.

Question 27

What is the term for a malignant lymphoproliferative disorder?

Answer 27

Hodgkin’s lymphoma.

Question 28

What is the term for the neoplastic cells of hodgkin’s lymphoma?

Answer 28

Reed-Sternberg cells (owl eye nuclei).

Question 29

What virus is hodgkin’s lymphoma linked to?

What percent of Hodgkin’s lymphoma occurs in the head and neck region?

Answer 29

Epstein-Barr virus.

75%.

Question 30

What is the most common type of lymphoma of the oral cavity?

Answer 30

Non-Hodgkin’s lymphoma, more specifically diffuse large B cell lymphoma (DLBCL).

Question 31

What is the name for the T-cell lymphoma that resembles a fungal infection?

Answer 31

Mycosis Fungoides

Question 32

What is the most common cutaneous lymphoma?

Answer 32

Mycosis Fungoides.

Question 33

What is the syndrome that is an aggressive expression of mycosis fungoides that represents dermapathic T-cell leukemia?

Answer 33

Sezary syndrome.

Question 34

What is the term for a malignancy of B-cell origin?

Where was it first documented?

Answer 34

Burkitt’s Lymphoma.

In african children thus termed African Burkitt’s lymphoma.

Question 35

What is the virus associated with Burkitt’s Lymphoma?

Answer 35

EBV

Question 36

What is the histology of Burkitt’s Lymphoma?

Answer 36

“Starry-sky” pattern due to macrophages.

Question 37

What is another name for angiocentric T-cell Lymphoma?

Answer 37

NK/T-cell Lymphoma.

Question 38

What is the term for a rare process that is characterized by an aggressive, non-relenting destruction of the midline structures of the palate and nsal process?

Answer 38

NK/T-cell lymphoma.

Question 39

What are the three things we have learned so far that will cause a hole in the mouth?

Answer 39

NK/T-cell lymphoma, Syphilis, coccain.

Question 40

What is the likely Dx?

Answer 40

NK/T-cell Lymphoma. Notice it is the hard palate.

Question 41

What is the term for a malignancy of plasma cell origin?

Answer 41

Multiple Myeloma.

Question 42

What is the most common hematologic malignancy of african americans?

Answer 42

Multiple Myeloma.

Question 43

What is the most common presenting symptom of multiple myeloma?

Answer 43

Bone pain.

Question 44

What are the proteins in the urine associted with multiple myeloma?

Answer 44

Bence Jones proteins.

Question 45

What is a unifocal, monoclonal neoplastic proliferation of plasma cells?

Answer 45

Plasmacytoma.