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Dental hygiene > Chapter9 pathology > Flashcards

Chapter9 pathology Flashcards

1
Q

Endocrine disorders

A

-hyperpituitarism
-Hyperthyroidism
-hypothyroidism
-hyperparathyroidism
-Diabetes mellitus
-Addisons disease

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2
Q

Hyperpituitarism

A

Most common cause benign pituitary adenoma
#1 cause is excessive production of growth hormone from the anterior pituitary gland

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3
Q

Gigantism

A
  • Increase in growth hormone during development
  • Before closure of the long bone
  • Excessive growth of the whole skeleton, in proportion
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4
Q

Acromegaly

A
  • after closure of the epipysis
  • Enlargement of hands and feet
    -sensitive to light
    -elongated mandible
    -slow insidious onset
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5
Q

Hyperthyroidism (Thyrotoxicosis)

A
  • Goiter or hyperplasia of gland maybe the cause
  • Graves’ disease is a common disease
  • Excess production of the thyroid hormone
  • leads to increased metabolism
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6
Q

Hyperthyroidism oral manifestation

A
  • premature loss of primary teeth
  • Early eruption of permanent
  • dental caries/ periodontal disease
  • osteoporosis in mandible/ maxilla
  • burning tongue
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7
Q

Hypothyroidism- cretinism

A
  • Decreased output of thyroid
  • decreased metabolism
  • may have enlarged tongue
  • Causes of hypothyroidism: development disturbances, autoimmune disease, Iodine deficiency, Drugs and pituitary problems
  • Cretinism is the infancy and children version (delayed exfoliation)
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8
Q

Hypothyroidism- myxedema

A
  • In older children and adults
  • systemic edema is common
    -more severe than Cretinism
  • edema in the gingiva and tongue, fatigue, weakness, and dry lips
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9
Q

Hyperparathyroidism

A
  • parathyroid glands are concerned with control of calcium metabolism by mobilizing it into the bloodstream and maintaining normal calcium level
  • affects only calcified structures that re forming during the period of dysfunction of those that have a readily mobile source of calcium
    -caused by benign tumor of the parathyroid
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10
Q

Primary Hyperparathyroidism

A
  • hyperplasia of thyroid gland caused by either benign tumor or malignant tumor
  • elevated calcium sometimes leads to kidney stones
  • low levels of phosphorus
  • Browns tumor lesion identical to entrap giant cell granuloma (seen in both primary and secondary hypothyroidism)
  • browns tumor seen in secondary hyperparathyroidism
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11
Q

Secondary hyperparathyroidism

A
  • over production of parathyroid hormone (PTH) in response to long term decreased levels of serum calcium often associated with chronic renal disease (kidney disease)
  • Secondary presents “ground glass”
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12
Q

T/F- Gigantism occurs after the closure of the long bone epiphysis

A

False

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13
Q

T/F A goiter maybe associated with hyperthyroidism

A

True

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14
Q

T/F Hypothyroidism in adults is called Cretinism.

A

False

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15
Q

Cause of diabetes

A
  • Inadequate release of insulin from the beta cell of the pancreas
  • Decrease in insulin prevents the glucose in the bloodstream to move into the fat and skeletal muscle cells
  • blood has abnormal high levels of glucose (hyperglycemia)
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16
Q

Type 1

A
  • 5-10% this type with usual onset in 20’s
    -3 P’s: Polydipsia, Polyphagia, and polyuria
  • difficult to control insulin levels and there are major complications to body organ (eyes,kidneys, and nerves)
    -Controlled usually with multiple injection of insulin throughout the day or by an insulin pump ( Allows for better control blood sugar)
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17
Q

Type 2

A
  • 90% of people
  • gradual onset
  • Organ complication are less common than type 1
  • Weight gain and metabolic rate are contributing factors
  • some still need insulin
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18
Q

Oral manifestation

A
  • Vascular system most affected/ slow wound healing
    -advanced periodontitis
  • Nodular, fiery red, hyperplastic gingivitis
  • secondary candida lesions from altered oral flora
    -severe periodontal with hyperplastic and erythematous gingiva
  • xerostomia
    -chronic gingivitis
  • gingival abscess
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19
Q

Diabetes and acanthosis nigricans

A
  • skin disorder
  • associated with type 2 diabetes
  • useful indicator in screening
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20
Q

Modifications for diabetes

A
  • Most common cause of death in diabetes is a heart attack
  • Best to treat after breakfast
  • May need to snack around 10am and 3pm
  • Recall every 3-4 months
  • stress management
  • avoid chronic use of NSAID’s and steroid
  • New drug by Etta, subcutaneous injection for type 2
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21
Q

Addison Disease

A
  • insufficient production of adrenal steriods
  • increases relapse of ACTH
  • causes increase in release of melanocytes
  • main oral manifestation is oral macules
  • Bronzing on the skin
  • Treatment is steroid administration
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22
Q

How Addison disease works

A
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23
Q

anemia

A

Reduction in oxygen carrying capacity of blood
- Iron deficiency anemia
- Pernicious Anemia
- folic acid/ Vitamin B12 deficiency anemia

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24
Q

thalassemia

A
  • inherited disorder of hemoglobin synthesis
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25
Q

Sickle cell anemia

A

Inherited disorder of abnormal hemoglobin creating sickle shaped cell, due to decreased oxygen

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26
Q

Celiac sprue

A

Sensitivity of dietary gluten

27
Q

Aplastic anemia

A

Decrease in circulation blood cells

28
Q

polycythemia

A

Abnormal increase in circulating RBC

29
Q

All anemias

A
  • Reduction in he oxygen carrying capacity f the blood
  • skin and mucosal pallor, weakness and fatigue
  • Angular cheilitis
    -erythema and atrophy of oral mucosa
  • loss of fungiform and filliform papillae
  • circumvallate and foliage papillae not affected
  • Do Not administer aspirin or ibuprofen
  • main issue is poor wound healing
30
Q

iron deficiency anemia (Plummer-vision syndrome)

A
  • insufficient iron in the bone marrow for RBC production
    -RBC are microcytic and hypochromatic
  • causes: menstruation, low iron intake, poor absorption of iron and pregnancy
  • treatment: iron supplement
31
Q

Pernicious anemia “red beefy tongue”

A
  • Autoimmune disease
  • pernicious anemia called megaloblastic anemia and presents with macro cystic RBC that have nucleus
  • caused by a deficiency of intrinsic factor, released from the parietal cells of the stomach
    -intrinsic factor in needed for proper Vitamin B12 absorption
32
Q

Folic Acid and Vitamin B12 deficiency

A

-caused by malnutrition or increased metabolic requirements
- same oral signs as pernicious anemia
- Vitamin B12 anemia can be detected by the schilling test
- Treat with dietary supplements
- lack of folic acid may lead to spin bifida

33
Q

Thalassemia

A
  • inherited disorders of hemoglobin synthesis
  • prominent cheekbones, depressed, nasal bridge
  • prominent premaxilla, protrusion of anterior teeth
  • “ hair on end” skull pattern
  • Abnormal thickened trabecular bone pattern “salt and pepper” bone appearance
34
Q

Thalassemia major

A
  • severe hemolytic anemia from damaged RBC’s
35
Q

Thalassemia minor

A

Mild and asymptomatic

36
Q

Sickle cell anemia blood smear

A
  • abnormal hemoglobin in RBC leads to lack of oxygen in cells and they take a sickle cell shape from lack of oxygen
37
Q

Celiac sprue

A
  • caused by disorders in the RBC and hemoglobin/ injury to the intestinal mucosa
  • chronic sensitivity to dietary gluten
  • oral symptoms: glossitis, burning tongue, atrophy of tongue papilla and mucosal ulcers
38
Q

Aplastic anemia

A
  • Decrease in a blood cells (RBC, WBC, and Platelets)
    -Secondary aplastic anemia- severe depression of bone marrow due to drug or chemical agent
39
Q

Primary aplastic anemia

A

-chemotherapy radioactive isotopes, radium and radiant energy, unknown cause

40
Q

Polycythemia Vera

A

-neoplastic proliferation of the bone marrow stem cell that results in a abnormal high number of circulating RBC
- Impaired blood flow, poor circulation and vascular stasis Unknown cause

41
Q

Secondary polycythemia

A
  • caused by a physiologic response to decreased oxygen triggers an increase in erythropoietin form the Kidneys
  • carbon monoxide, pulmonary disease, heart disease and high altitudes
42
Q

Relative polycythemia

A

Decreased plasma volume not an increase in RBC
-causes diuretics, vomiting, diarrhea and excessive sweating
- increased problems with heart, strokes and heart attacks

43
Q

Agranulocytosis

A
  • reduction in circulating neutrophils (leukopenia)
    -Causes problems with the development of neutrophils and with accelerated destruction of neutrophils
  • same disease as cyclic neutropenia except there is no cycle
44
Q

Agranulocytosis oral manifestations

A
  • ulcerations
  • angular cheilitis
  • necrotizing ulceration
  • infection and gingival enlargement
    -rapid loss of supporting bone- tooth loss
  • treatment: transfusions, antibiotics, control infection, remove cause
45
Q

Hemostasis

A
  • Stoppage of blood flow
46
Q

Defect in hemostasis

A
  • abnormalities in platelets or coagulation factors
47
Q

Normal platelet count

A

150,000-400,000

48
Q

Abnormal platelet count (platelet deficiency purpura)

A

<100,000 = thrombocytopenia
<20,000. = spontaneous bleeding
-reddish-blue or purple mucosa or skin
- blood oozing from margins

49
Q

Normal Bleeding time

A

1-6 min

50
Q

Abnormal bleeding time

A

5-10 min

51
Q

Normal prothrombin time

A

11-16 seconds

52
Q

Abnormal prothrombin time

A

16> seconds

53
Q

Normal Partial thromboplastin time

A

25-40 seconds

54
Q

Abnormal partial thromboplastin time

A

> 50 seconds

55
Q

Thrombocytopenia purpura

A
  • reddish- blue or purple
  • severe reduction of circulating platelets
  • safe for minor dental TX >50,000
56
Q

Nonthrombocytopenic Purpura

A

-Most common cause: drugs that affect platelet function ( Indomethacin, Naproxen, Ibuprofen, aspirin)
-Von Willebrand disease (worst case)
- Spontaneous bleeding petechiae, ecchymosis, and hemorrhagic blister

57
Q

Hemophilia X linked inheritance

A

-severe problem in blood coagulation
- Type A is most common
-plasma proteins deficient specifically Factor VIII
Treatment replace missing cascade factor

58
Q

Hemophilia Manifestations

A

-swollen knees
Gingival hemorrhage after routine curettage
Echymosis and petechiae

59
Q

Primary Immunodeficiency

A
  • genetic origin
    -B-cell and T-cell
    -Autoimmune diseases
60
Q

Secondary Immunodeficiency

A

-Results from underlying disorder
-from drugs taken for disorders (transplant rejection drugs, chemotherapeutic agents, prednisone)
-Infection is the greatest concern
-most common
-HIV

61
Q

Radiation therapy oral cancer

A
  • mucositis
    -red and ulcerated
    -painful
    -difficulty eating
  • difficulty swallowing
  • loss of taste
    -xerostomia
    -radiation caries
    -osteoradionecrosis
    -should have a complete oral exam before starting treatment
62
Q

Chemotherapy oral cancer

A

-mucositis
-oral ulcerations
-decrease in bone marrow cells
-leads to opportunistic infections “candida”
-bleeding problems

63
Q

Effects of therapy for oral cancer

A
  • tooth and gingival discoloration (tetracycline, minocycline)
    -gingival enlargement medications ( Phenytoin(Dilantin), Nifedipine (procardia), Cyclosporine (transplant drug)
64
Q

HIV and AIDS

A

Sexual contact/ blood
-HIV CD4 T-helper cell; depleted as progressees; decreases ad condition worsens
- immune system continues to depress AIDS eventually develop

Dental hygiene (20 decks)

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