chapter 9 oral manifestations of systemic diseases Flashcards
1
Q
excess hormone production by the anterior pituitary; caused by pituitary adenoma;
A
hyperpituitarism
2
Q
____ results if it hyperpituitary occurs before the closure of long bones
A
gigantism
3
Q
results when hypersecretion(hyperpituitarism) occurs during adult life
A
acromegaly
4
Q
poor vision, light sensitivity, enlargement of hands and feet, increase in rib size
A
hyperpituiarism
5
Q
enlargement of maxilla and mandible could cause separation of teeth and malocclusion; frontal bossing, enlagement of nasal bones may lead to deepening of voice
A
hyperpituitarism
6
Q
thickened lips and macroglossia
A
hyperpituitarism
7
Q
common cause is graves disease-autoimmune disorder in which a substance is produced that abnormally stimulates thyroid gland; other causes: hyperplasia of the gland, benign and malignant tumors of thyroid, pituitary gland disease , metastatic tumor
A
hyperthyroidism(thyrotoxicosis)
8
Q
rosy complexion, erythema of palms, excessive sweating, fine hair, softened nails; exophthalmos; anxiety, weakness, restlessness, and cardiac problems
A
hyperthyroidism
9
Q
premature exfoliation of deciduous teeth in children and premature eruption of permanent teeth; osteoporosis; caries and perio develop rapidly; burning tongue
A
hyperthyroidism
10
Q
a decreased output of thyroid hormone causes developmental disturbances, autoimmune disease, iodine deficiency, drugs, and pituitary disease
A
hypothyroidism
11
Q
when hypothy occurs in infancy and childhood
A
cretinism
12
Q
when hypothy occurs in older children and adults
A
myxedema
13
Q
in infants, thickened lips, enlarged tongue, delayed eruption of teeth
adults: enlarged tongue
A
hypothyroidism
14
Q
increases the uptake of dietary calcium from the gi tract and is able to move calcium from bone to circulating blood when necessary
A
parathyroid hormone
15
Q
hypercalcemia and hypophosphatemia
A
hyperparathyroidism
16
Q
may have join stiffness and pain; lethargy and coma with severe disease; loss of lamina dura, mottled bone;
radiolucencies; appear to be central giant cell
bone may have mottled appearance and loss of lamina dura
A
hyperparathyroidism
17
Q
brown tumor
A
hyperparathyroidism
18
Q
caused by rapid osteoclastic activity due to hyperparathyroidism, resulting in a local destructive phenomenon ; ends of long bones, pelvis and ribs, mandible
A
brown tumor
19
Q
______ is the most common cause of secondary hyperparathyroidism
A
kidney failure
20
Q
bones, stones, abdominal groans, psychic moans and fatigue overtones
A
hyperparathyroidism
21
Q
a chronic disorder of carb metabolism characterized by abnormally high blood glucose levels
A
diabetes mellitus
22
Q
a severe hyperglycemia can lead to
A
diabetic coma
23
Q
ketone can be produced by the breakdown of
A
fatty acids- ketoacidosis lowers ph of blood
24
Q
dark, thick, velvety skin in body folds and creases
A
acanthosis nigricans
25
thought to be autoimmune disease; insulin producing cells of pancreas are destroyed; 3-5% of all diabetic patients have this type;
insulin dependent diabetes mellitus
26
acute onset with polydipsia, polyuria, and polyphagia; require insulin all their lives
insulin dependent diabetes
27
low insulin can lead to
ketoacidosis
28
insulin resistance, 95% of all diabetic patients have this type of diabetes; obese; patients 35 to 40 years of age or older
non insulin dependent diabetes
29
___ decreases the number of receptors for insulin binding in sensitive tissues like fat or muscle
obesity
30
atherosclerosis, ulceration and gangrene; retinopathy
non insulin dependent diabetes
31
candidiasis, mucormycosis
non insulin dependent diabetes mellitus
32
bilateral parotid gland enlargement, xerostomia, accentuated response to plaque; slow wound healing; hyperplastic and erythematous gingiva; periodontal breakdown; very high levels of pro-inflammatory mediators
diabetes mellitus
33
this test is used to assess and monitor blood glucose levels over a 3 month period; patients need a goal of less than 6.5% to cut long term complications of diabets
hba1c
34
primary adrenal cortical insufficiency; to compensate, pituitary gland increases production of acth
addison disease
35
acth causes stimulation of melanocytes; bronzing of the skin may occur, as well as melanotic macules on oral mucosa
addison disease
36
a reduction in the oxygen-carrying capacity of blood; most often related to decrease in number of rbc's
anemia
37
a deficency in a substance required for the normal development of rbc commonly from vitamins
anemia
38
suppression of bone marrow stem cells
anemia
39
pallor of skin and oral mucosa, angular cheilitis, erythema and atrophy of oral mucosa; loss of filiform(1st) and then fungiform papillae
anemia
40
an insuficient amount of iron is supplied to bone marrow for red blood cell development
iron deficiency anema
41
plummer vinson syndrome; dysphagia, atrophy of upper alimentary tract and predisposition of developing oral cancer; angular cheilitis, pallor, erythematous, smooth, painful tongue
iron defiency anemia
42
low hemoglobin content and reduced hematocrit; rbc appear smaller than normal(microcytic) and light in color(hypochromic)
diagnosis of iron deficiency anemia
43
autoimmune disease, caused by a defiency of intrinsic factor- secreted by parietal cells in stomach, necessary for absorption of vit b-12
pernicious anemia
44
megaloblastic rbc; abnormally large and immature megaloblasts with nuclei; schilling test detects an inability to absorb oral b12
pernicious anemia
45
dietary deficiencies; malnutrition; may be found with alcoholism or pregnancy; indistinguishable from pernious anemia
folic acid and vit b12 deficiency anemia
46
meditarranean or cooly anemia
thalassemia
47
group of inherited disorders of hemoglobin synthesis
thalassemia
48
yellow skin, pallor, fever, malaise, and weakness; prominant cheek bones, depression of bridge of nose, or prominent maxilla and protrusion or flaring of maxillary anterior teeth
thalassemia
49
salt and pepper patern
thalassemia
50
rbc develop sickle shape when there is decreased o2; person has weakness, shortness of breath, fatigue, joint pain, and nausea
sickle cell anemia
51
loss of trabeculation and large, irregular marrow spaces appear; hair on end pattern; trabeculae radiate outward
sickle cell anemia
52
sensitivity to wheat gluten; injury to intestinal mucosa; malabsorption of nutrients resulting in anemia
celiac sprue
53
diarrhea, nervousness, paresthesia; painful, burning tongue, atrophy of papillae, ulceration of oral mucosa
celiac sprue
54
a severe depression of bone marrow activity causes a decrease in all circulating blood cells(pancytopenia); primary ____ cause is unknown; secondary is a result of a drug or chemical agent; leukopenia and thrombocytopenia
aplastic anemia
55
infection, spontaneous bleeding, petechiae, and purpuric spots
aplastic anema
56
increase in the number of circulating red blood cells (absolute or relative)
polycythemia
57
a neoplastic proliferation of bone marrow stem cells causes an abnormally high number of circulating red blood cells; unknown cause; impaired blood flow, poor circulation; men; between age 40 and 60 is onset ; headache, dizziness, itching; thrombi
primary polycythemia(polycythemia vera)
58
increase in rbc caused by physiological response to decreased oxygen-- causes an increase in erythropoietin by kidneys, which increase rbc's
may be due to pulmonary disease, heart disease, living at high altitude, or elevation in carbon monoxide
secondary polycythemia
59
caused by a decrease in plasma volume; causes may include diuretics, vomiting, diarrhea, or excessive sweating;
relative polycythemia
60
deep red to purple; gingiva may be edematous and bleed easily; submucosal petechiae, ecchymosis, and hematoma formation may be present
polycythemia
61
disorders of wbc
agranulocytosis, cyclic neutropenia, leukemia
62
a significant reduction in circulating neutrophils
agranulocytosis
63
can result from a problem in development of neutrophils or accelerated destruction of neutrophils
agranulocytosis
64
the cause is unknown, may be an immunological disorder
primary agranulocytosis
65
a result of chemicals or drugs
secondary agranulocystosis
66
sudden onset of fever, chils, jaundice(icterus), weakness, and sore throat
agranulocytosis
67
what is normal wbc count
5,000-10,000
68
reduction in wbc with agranulocytosis
1,000
69
a cyclic decrease in the number of circulating neutrophilic leukocytes
cyclic neutropenia
70
malignant neoplasms of hematopoietic stem cells; excessive number of abnormal white blood cells in circulating blood
leukemia
71
onset is sudden; very immature cells(blast cells) and a rapidly fatal course if not treated;
acute leukemias
72
involves immature lymphocytes primarily affects children and young adults; good prognosis
acute lymphoblastic leukemia
73
involves immature granulocytes; primarily affects adolescents and young adults; not as good prognosis
acute myeloblastic leukemia
74
weakness, fever, enlargement of lymph nodes, and bleeding; general loss of cells produced by the bone marrow occurs; gingival enlargement; anug; bleeding gums, petechiae, and ecchymosis
acute leukemias
75
laboratory findings include elevated white blood cell count , anemia, and low platelet count
acute leukemias
76
slow onset(primarily affects adults); easy fatigability, weakness, weight loss, anorexia; pallor of lips and gingiva, gingival enlargement, petechiae, ecchymosis, gingival bleeding, and atypical perio disease
chronic leukemia
77
a cancer of blood forming organs that is characterized by rapid growth of immature white blood cells
leukemia
78
hemorrhage, ulceration, gingival enlargement, spongy texture, and MAGENTA COLORATION OF GINGIVA; enlargement of lymph nodes, symptoms of anemia
leukemia
79
bleeding disorders
hemostasis, purpura, hemophilia
80
pinpoint
petechiae
81
up to one cm
purpura
82
>1cm
ecchymosis
83
this is a deep bleed/brown to black in color due to the blood clotting
hematoma
84
blood vessel is damaged; vasoconstriction of vessels occurs in an attempt to stop the flow of blood; platelets adhere to damaged surface and aggregate to form a temporary clot, fibrin must be produced to bind the platelets and stop the bleeding permanently; fibrin is converted to fibrinogen by a cascade of circulating proteins called clotting factors or coagulation factors; this helps form the final clot
hemostasis
85
cessation of bleeding
hemostasis
86
defects may be caused by abnormalities of either platelets of coagulation factors
hemostasis
87
to determine the number of platelets
platelet count
88
normal platelet count
150,000 to 400,000
89
spontaneous gingival bleeding may occur if the count if less than
20,000
90
platelet count less than 100,000
thrombocytopenia
91
bleeding time
1-6 min
92
prothrombin time
11-16 secs
93
partial thromboplastin time
25-40 secs
94
measures the adequacy of platelet function, not platelet number; how long it takes to form a temporary clot
bleeding time
95
measures the patient's ability to form a final clot through the extrinsic pathway; calcium and a tissue factor are added to the patients plasma
prothrombin time(PT)
96
the ratio of PT to thromboplastin activity; this is a more accurate and standardized expression for the determination of PT
inr- international normalized ratio
97
normal is usually between 11 and 16 secs
prothrombin time
98
measures the patients ability to form a final clot through the intrinsic pathway; addition of kaolin and cephalin to the patients plasma
partial thromboplastin time(PTT)
99
values less than 3 are considered normal; patients on anticoags may have __ values of 4 to 5
inr values; PT
100
measures the other way by which clot formation occurs; prolongation to 45 to 50 secs may be associated with bleeding problems; over 50 secs may be severe
partial thromboplastin time (PTT)
101
a reddish blue or purplish discoloration of skin or mucosa from spontaneous extravasation of bleed; may be due to a defect or deficiency in blood platelets; blood may ooze from gingival margins
purpura
102
a bleeding disorder that results from a severe reduction in circulating platelets
thrombocytopenia purpura
103
cause is unknown
idiopathic throm purpura
104
an autoimmune type process;
immune thrombo
105
often associated with drugs
secondary thrombo purpura
106
spontaneous purpuric or hemorrhagic lesions on the skin; patients may bruise easily, may have blood in urine and have frequent nosebleeds
thrombocytopenia purpura
107
spontaneous bleeding occurs when platelets fall to less than
20,000
108
bleeding disorders that can result from either a defect in capillary walls or disorders of platelet function; vit C deficiency and infections or chemicals and allergy may be the cause of alterations in vascular walls; drugs, allergy, and autoimmune diseases may cause disorders of platelet function(aspirin and ibuprofen)
nonthrombocytopenic purpura
109
an autosomal dominant disorder of platelet function
von williebrand disease
110
spontaneous gingival bleeding, petechiae, ecchymosis, and hemorrhagic blisters- same as tp; platelet count is NORMAL; bleeding time is prolonged
nonthrombocytopenic purpura
111
disorder of blood coagulation; results in severely prolonged clotting time; due to deficiency in plasma proteins involved in coagulation; therefore, patients cannot produce fibrin
hemophilia
112
caused by a deficiency of plasma thromboplastinogen or factor VII
TYPE a hemophilia
113
christmas disease; less common, the clotting defect is plasma thromboplastin or factor IX
type b hemophilia
114
spontaneous gingival bleeding, petechiae, and ecchymosis(x linked recessive diseases
hemophilia
115
the bleeding time and PT in hemophilia are
normal
116
what is prolonged in hemophilia
PTT IS PROLONGED
117
susceptible to bacterial infections; B cell or antibody
humoral response deficiency
118
susceptible to viral, fungal infections and tuberculosis; t cell
cell mediated response deficiency
119
of genetic origin; very rare(bruton disease, digeorge syndrome, severe combined immunodeficiency)
primary immunodeficiencies
120
occurs as a result of an underlying disorder; malnutrition, viral infection, cancer, renal disease, and hodgkins disease; may occur with immunosuppressive drugs, drugs used along with radiation, chemotherapy
secondary immunodeficiencies
121
prevention of rejection of renal transplants; treatment of rheumatoid arthritis
azathioprine
122
prevention of rejection of renal transplants
cyclosporine
123
cancer therapy
cyclophosphamide, methotrexate
124
treatment of autoimmune disease(rheumatoid arthritis, pemphigus vulgaris, behcet syndrome, lupus erythematosus)
prednisone
125
begins about the second week of therapy and subsides a few weeks after its completion; painful and appears as an erythematous and ulcerated mucosa; patients may have difficulty eating, pain on swallowing, and loss of taste
mucositis
126
destruction of major salivary glands may result in
xerostomia in radiation therapy
127
necrosis of the bone is site of radiation injury, because of decreased blood supply to bone; more common in mandible; potential sources of infection must be eliminated before initiating radiation therapy
osteoradionecrosis involving the mandible
128
drugs used for cancer chemotherapy affect ___ cells of epithelium
basal
129
mucositis, and oral ulceration; and decrease in all blood cells may occur(rbc-anemia, wbc- infections, platelets-bleeding problems)
chemotherapy
130
suppresses the immune system and can lead to candidiasis and oral infections; antibiotics may increase risk of candidiasis
prednisone
131
blood pressure drugs, antianxiety drugs, antipsychotic medications, and antihistamines can cause
xerostomia
132
can cause tooth discoloration
tetracycline
133
can cause gingival enlargement
phenytoin(dilantin-seizure meds), nifedipine(procardia), and cyclosporine-decrease immune system for transplants
