Chapter 17 Flashcards
What term describes an excess of bilirubin in the bloodstream that causes a yellowish discoloration of the skin and mucosa?
Jaundice
What are the causes of juandice?
There are numerous, some are physiologic, many are pathologic
Sickle cell, liver infection, toxins, cancer, Gilbert syndrome
What is Glibert syndrome?
It is an inherited, innocuous (not harmful) impaired processing of bilirubin by the liver
What structures accumulate bilirubin in jaundice and why?
Sclera, lingual frenum and soft palate because these structures have more elastin, which has a high affinity for elastin
What are some other symptoms due to hyperbilirubinemia that may occur with jaundice?
Fever, abdominal pain, anorexia, fatigue
What term describes a group of conditions characterized by the deposition of an extracellular, proteinaceous substance?
Amyloidosis
What are the classifications of amyloidosis?
Organ limited
Systemic primary
Systemic secondary
Systemic heredofamilial
What are the characteristics of organ-limited amyloidosis?
Is in no association with a systemic condition. Can occur in a variety of organs but is rarely seen in the oral cavity. May have a submucosal amyloid nodule
What is systemic primary amyloidosis associated with?
Myeloma
20% are associated with multiple myeloma
Who does systemic primary amyloidosis typically affect?
Older adults, males more than females
What are the initial signs of systemic primary amyloidosis?
Initial signs are nonspecific, but eventually carpal tunnel syndromem mucocutaneous lesions, hepatomegaly and macroglossia
What do skin lesions in systemic primary amyloidosis appear as and where do they occur?
Smooth-surface, firm, waxy papules and plaques that most commonly affect the eyelid, neck and and lip
What is systemic secondary amyloidosis associated with?
Usually Hemodialysis
but can develop as a result of a chronic inflammatory process (TB, sarcoidosis, osteomyelitis)
What does systemic secondary amyloidosis affect?
Spares the heart but affects the liver, kidney and spleen
Why is systemic secondary amyloidosis due to TB, sarcoidosis or osteomyelitis uncommon?
Because these are usually treated with ABX before the disease progresses to amyloidosis
Why does systemic secondary amyloidosis associated with hemodialysis?
Because the protein (amyloid) is not removed by dialysis so it accumulates in the plasma and eventually deposits in the bones and joints
What is systemic heredofamilial amyloidosis?
It is an uncommon but significant form of the disease. It is autosomal dominant and causes polyneuropathies, cardiomyopathy, cardiac arrythmias, CHF, and renal failure
What is the treatment of amyloidosis?
In most instances, there is no effective therapy available. Most patients with the systemic form succumb to cardiac failure, arrythmias or renal disease within months to a few years of the dx
What are the main causes of vitamin deficiencies in the US today?
Due to malabsorptions, eating disorders, “fad diets”, and alcoholism
What is Vitamin A called and what is it for? What does a deficiency lead to?
Retinol
It is essential for vision
may lead to blindess
What is Vitamin B1 called and what is it for? What does a deficiency lead to?
Thiamine
It maintains proper functioning of neurons
May lead to beriberi
What is Vitamin B2 called and what is it for? What does a deficiency lead to?
Riboflavin
IT is necessary for cellular oxidation reduction reactions
Can lead to oral alterations like angular cheilitis and glossitis
What is Vitamin B3 called and what is it for? What does a deficiency lead to?
Niacin
It acts as a coenzyme for oxidation reduction reactions
It can lead to pellagra which is dermatitis, dementia, and diarrhea
What is Vitamin B6 called and what is it for?
Pyroxidine
It is a cofactor associated with enzymes that participate in amino acid synthesis
