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Oral Pathology - My deck > Chapter 17 > Flashcards

Chapter 17 Flashcards

1
Q

What term describes an excess of bilirubin in the bloodstream that causes a yellowish discoloration of the skin and mucosa?

A

Jaundice

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2
Q

What are the causes of juandice?

A

There are numerous, some are physiologic, many are pathologic

Sickle cell, liver infection, toxins, cancer, Gilbert syndrome

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3
Q

What is Glibert syndrome?

A

It is an inherited, innocuous (not harmful) impaired processing of bilirubin by the liver

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4
Q

What structures accumulate bilirubin in jaundice and why?

A

Sclera, lingual frenum and soft palate because these structures have more elastin, which has a high affinity for elastin

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5
Q

What are some other symptoms due to hyperbilirubinemia that may occur with jaundice?

A

Fever, abdominal pain, anorexia, fatigue

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6
Q

What term describes a group of conditions characterized by the deposition of an extracellular, proteinaceous substance?

A

Amyloidosis

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7
Q

What are the classifications of amyloidosis?

A

Organ limited
Systemic primary
Systemic secondary
Systemic heredofamilial

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8
Q

What are the characteristics of organ-limited amyloidosis?

A

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

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9
Q

What is systemic primary amyloidosis associated with?

A

Myeloma

20% are associated with multiple myeloma

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10
Q

Who does systemic primary amyloidosis typically affect?

A

Older adults, males more than females

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11
Q

What are the initial signs of systemic primary amyloidosis?

A

Initial signs are nonspecific, but eventually carpal tunnel syndromem mucocutaneous lesions, hepatomegaly and macroglossia

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12
Q

What do skin lesions in systemic primary amyloidosis appear as and where do they occur?

A

Smooth-surface, firm, waxy papules and plaques that most commonly affect the eyelid, neck and and lip

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13
Q

What is systemic secondary amyloidosis associated with?

A

Usually Hemodialysis

but can develop as a result of a chronic inflammatory process (TB, sarcoidosis, osteomyelitis)

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14
Q

What does systemic secondary amyloidosis affect?

A

Spares the heart but affects the liver, kidney and spleen

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15
Q

Why is systemic secondary amyloidosis due to TB, sarcoidosis or osteomyelitis uncommon?

A

Because these are usually treated with ABX before the disease progresses to amyloidosis

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16
Q

Why does systemic secondary amyloidosis associated with hemodialysis?

A

Because the protein (amyloid) is not removed by dialysis so it accumulates in the plasma and eventually deposits in the bones and joints

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17
Q

What is systemic heredofamilial amyloidosis?

A

It is an uncommon but significant form of the disease. It is autosomal dominant and causes polyneuropathies, cardiomyopathy, cardiac arrythmias, CHF, and renal failure

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18
Q

What is the treatment of amyloidosis?

A

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

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19
Q

What are the main causes of vitamin deficiencies in the US today?

A

Due to malabsorptions, eating disorders, “fad diets”, and alcoholism

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20
Q

What is Vitamin A called and what is it for? What does a deficiency lead to?

A

Retinol
It is essential for vision
may lead to blindess

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21
Q

What is Vitamin B1 called and what is it for? What does a deficiency lead to?

A

Thiamine
It maintains proper functioning of neurons
May lead to beriberi

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22
Q

What is Vitamin B2 called and what is it for? What does a deficiency lead to?

A

Riboflavin
IT is necessary for cellular oxidation reduction reactions
Can lead to oral alterations like angular cheilitis and glossitis

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23
Q

What is Vitamin B3 called and what is it for? What does a deficiency lead to?

A

Niacin
It acts as a coenzyme for oxidation reduction reactions
It can lead to pellagra which is dermatitis, dementia, and diarrhea

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24
Q

What is Vitamin B6 called and what is it for?

A

Pyroxidine

It is a cofactor associated with enzymes that participate in amino acid synthesis

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25
Q

What is Vitamin C called and what is it for? What does a deficiency lead to?

A

Ascorbic acid
It is necessary for the proper synthesis of collagen
Can lead to scurvy

26
Q

What is Vitamin D considered and what does a deficiency leadt to?

A

Is it considered a hormone
It is necessary for calcium absorption from the gut
Can lead to RIckets/Osteomalacia

27
Q

What is Vitamin E called and what is it for?

A

alpha-tocopherol

It is an antioxidant

28
Q

What is vitamin K for and what does a deficiency lead to?

A

It is necessary for proper clotting (Factors 2, 7, 9, 10)

Bleeding disorders

29
Q

What is the most common cause of anemia in the US and the world?

A

Iron deficiency anemia

30
Q

What is the cause of iron deficiency anemia?

A

Excessive blood loss, increased demand for RBCs (excercise), decreased uptake/absorption of iron

31
Q

Who is commonly affected by iron deficiency anemia?

A

20% are women of childbearing years from chronic blood loss (menorrhagia)

32
Q

What are the oral manifestations of iron deficiency anemia?

A

Angular cheilitis and atrophic glossitis

33
Q

What are the laboratory findings in iron deficiency anemia?

A

Hypochromic microcytic RBCs

34
Q

What is Plummer Vinson SYndrome?

A

Iron deficiency anemia, glossitis, dysphagia

35
Q

Why is Plummer Vinson SYndrome significant?

A

It has been associated with a high frequency of both oral and esophageal squamous cell carcinoma – it is considered a premalignant process, and have anywhere from 5-50% of developing a malignancy

36
Q

Who is most commonly affected by Plummer Vinson Syndrome?

A

Women of Scandinavian or Northern European background between the ages of 30-50

37
Q

What do patients with Plummer Vinson SYndrome often complain of?

A

A burning sensation with the tongue and oral mucosa

38
Q

What other oral sign might there be in Plummer Vinson syndrome (besides the glossitis, and burning tongue and dysphagia)

A

Angular cheilitis (Duh they have an iron deficiency)

39
Q

What is present in the esophagus in Plummer Vinson Syndrome?

A

Abnormal bands of tissues called esophageal webs

40
Q

What is another sign of Plummer Vinson Syndrome?

A

Alteration of the growth pattern of the nails – spoon shaped = koilonychia
And brittle nails

41
Q

How is Plummer Vinson syndrome treated?

A

Dietary iron supplementation (may need an injection if they cannot absorb iron), and periodic evaulation for oral, pharyngeal and esophageal carcinoma

42
Q

What is caused by the poor absorption of Vitamin B 12 and what is the name of Vitamin B 12?

A

Pernicious anemia

Cobalamin

43
Q

Why are patients with pernicious anemia unable to absorb vitamin b12?

A

Many patients lack intrinsic factor because of autoimmune destruction of the parietal cells of the stomach

44
Q

What is the oral manifestation of pernicious anemia?

A

Atrophic glossitis or a werid metallic taste

45
Q

What are the laboratory findings in pernicious anemia?

A

Megaloblastic anemia

46
Q

What term descriebs an excessive production of growth hormone before the closure of the epiphyseal plates?

A

Gigantism

47
Q

What is an oral finding in patients with gigantism?

A

Generalized macrodontia

48
Q

What is usually the cause of gigantism and excessive growth hormone?

A

A pituitary adenoma

49
Q

What term describes an excessive production of growth hormone after the closure of the epiphyseal plates?

A

Acromegaly

50
Q

What are some oral findings in patients with acromegaly?

A

Increased growth of the mandible (prognathism) with diastema formation and macroglossia

51
Q

What term describes decreased levels of thyroid hormone?

A

Hypothyroidism

52
Q

What is the term for hypothyroidism in infants?

A

Cretinism

53
Q

What is the term for hypothyroidsin in adulthood?

A

Myxedema

54
Q

What vasculature structures are mainly affected in Diabetes Mellitus?

A

Arteries so a decrease in tissue perfusion results

55
Q

What leukocyte is also impaired in patients with diabetes mellitus?

A

Neutrophil dysfunction

56
Q

What are the oral manifestations associated with diabetes mellitus?

A

Periodontal disease (more frequent and rapid), delayed healing, increased probability of infection, enlargement and erythema of the attached gingiva, oral candidiasis (30%), zygomycosis, xerostomia (30%), diabetic sialadenosis

57
Q

What is Crohn’s disease?

A

An inflammatory and immunologically mediated condition of unknown causes with manifestations anywhere along the GI tract

58
Q

When does Crohn’s disease usually become evident?

A

During teenage years

59
Q

What usually precedes GI lesions in Crohn’s disease and how often?

A

ORal lesions precede the GI lesions 30% of the time

60
Q

What are some of the GI signs of Crohn’s?

A

Abdominal cramping, diarrhea, pain, nausea, fever, weight loss and malnutrition may develop

61
Q

What are the oral lesions observed in Crohn’s disease?

A

Oral lesions are non specific! Can be diffuse nodular swellings, cobblestone appearance of the oral mucosa, linear ulcerations of the buccal vestibule (usually mandibular), pyostomatitis vegetans

62
Q

How is Crohn’s treated?

A

Usually with a sulfa drug, or systemic prednisome in more severe cases

Oral Pathology - My deck (22 decks)

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