Chapter 17

Question 1

What is a group of conditions characterized by the deposition of an extracellular proteinaceous substance? There are several types (Organ-limited, Systemic, Primary, Myeloma associated, Secondary, Hemodialysis associated and Heredofamilial) what makes them different?

Answer 1

• Amyloidosis (Amyloid)
  • Organ-limited:
  o Can occur in a variety of organs, but is rarely seen in the oral cavity
  • Systemic – primary & myeloma-associated:
  o Most commonly affected areas are the eyelid, neck, and lips
  • Systemic – secondary: Affects the liver, kidney, spleen.
  • Systemic – hemodialysis-associated: Protein isn’t removed by dialysis.
  • Systemic – Heredofamilial: Patients have polyneuropathies primarily

Question 2

Vitamin deficiency of different vitamins can cause different problems, what are they? (A, B1, B2, B3, B6, C, D, E, K)

Answer 2

• Vitamin A (retinol): essential for vision. May lead to blindness.
• Vitamin B1 (thiamin): maintain proper functioning of neurons. Beriberi.
• Vitamin B2 (riboflavin): necessary for cellular oxidation-reduction reactions. Oral alterations like angular cheilitis, glossitis.
• Vitamin B3 (niacin): acts as a coenzyme for oxidation-reduction reactions. Pellagra= dermatitis, dementia, diarrhea.
• Vitamin B6 (pyridoxine): cofactor associated with enzymes that participate in amino acid synthesis.
• Vitamin C (ascorbic acid): necessary for the proper synthesis of collagen. Scurvy.
• Vitamin D: considered a hormone, necessary for calcium absorption from the gut. Rickets, Osteomalacia.
• Vitamin E (α-tocopherol): antioxidant.
• Vitamin K: necessary for proper clotting (needed in clotting factors II,VII, IX, X). Coagulopathy because of inadequate synthesis or prothrombin.

Question 3

What is the most common cause of anemia in the U.S and the World, Develops from excessive blood loss, increased demand for RBC’s and occurs in 20% women of childbearing years? What are the oral manifestations? Lab findings?

Answer 3

• Iron Deficiency Anemia
• Oral manifestations: angular cheilitis, atrophic glossitis.
• Laboratory finding: hypochromic microcytic RBC’s

Question 4

What is a system complex characterized by Iron-deficiency anemia, Glossitis, and Dysphagia?
Another sign is an alteration of the growth pattern of the nails, what is this called?

Answer 4

• Plummer-Vinson Syndrome

- Koilonychia

Question 5

What is a Megaloblastic anemia, Caused by poor absorption of cobalamin (Vitamin B12, extrinsic factor), Most patients lack intrinsic factor because of autoimmune destruction of the parietal cells of the stomach, which results in decreased absorption of cobalamin? What is the oral manifestation?

Answer 5

• Pernicious Anemia

- Oral manifestations: atrophic glossitis

Question 6

What is Increased production of growth hormone, usually related to a functioning pituitary adenoma, and Takes place before the closure of the epiphyseal plates? Oral findings?

Answer 6

• Gigantism

- Generalized macrodontia

Question 7

What is Excessive production of growth hormone after the closure of the epiphyseal plates, Increased growth of mandible (prognathism) with diastema formation, macroglossia?

Answer 7

• Acromegaly

Question 8

What is Decreased levels of thyroid hormone?
What is this called when it occurs during infancy?
What is this called when it occurs during adulthood?

Answer 8

• Hypothyroidism
• Cretinism
• Myxedema

Question 9

What is has many complications that are due microangiopathy, which results in occlusion of the small blood vessels; a decrease in tissue perfusion results, impairment of neutrophil function, Periodontal disease, Delayed healing, Increased probability of infection, Enlargement and erythema of the attached gingiva, Oral candidiasis is higher, and Xerostomia?

Answer 9

• Diabetes Mellitus

Question 10

What is an Inflammatory and immunologically mediated condition of unknown cause, Manifestations can be seen anywhere along the GI tract (from mouth to anus), Oral lesions are significant, Most patients are teenagers at first, GI signs include abdominal cramping, diarrhea, pain, nausea, and fever, Weight loss and malnutrition may develop? What do the oral lesions look like/include?

Answer 10

• Crohn’s Disease
• • Oral lesions are nonspecific:
  • Diffuse, nodular swellings
  • “Cobblestone appearance” of the oral mucosa
  • Linear ulcerations of the buccal vestibule
  • Treatment is usually with a sulfa drug
  • Systemic prednisone is used in more severe cases
  Oral lesions clear with treatment of GI disease

Question 11

What is associated with abnormal high levels of calcium, along with excessive thirst and loss of appetite? What disease is associated with bronze pigmentation of skin, weight loss, hypoglycemia, and GI problems?

Answer 11

• Hyperparathyroidism

- Addison’s Disease *(Adrenal Glands don’t produce enough)

Question 11

What is Is due to alkaline phosphates (ALP)
This is associated when pediatric teeth usually have just the crown fall out because the roots are resorbed, however, when a parent comes in with an entire tooth when trauma isn’t involved. It is due to a lack of cementum, you will also see many bone defects throughout the body (ribs, long bones and wrist defects)?
When only found in teeth it is called ___________________.
It is due to a mutation in the gene _____________.

Answer 11

• Hypophsophatasia
• Odontohypophosphatasia
• TNSALP