Oral manifestations of disorders of specific systems Flashcards
Which autoimmune diseases of the head and neck diseases are there?
SLE Sjrogens Wegners Sarcoidosis Pemphigus Pemphigoid Graves disease Scleroderma
Sjrogens disease is more common in males. T/F
F
What are the two types of sjrogens disease?
primary and secondary
What is primary sjrogens disease?
Sjrogens disease which affects only the lacrimal and saliavry glands
Which autantibodies are present in sjrogens?
RF (IgG against IgM)
SSA
SSB
Which type of sjorgens has more SSB?
primary
WHich type os sjrogens has a greater risk of lymphoma?
Primary
Where is a sjrogen like disease seenN
GvHD
What is wegners granulomatosis?
This is an incurable vasculitis which reduced tissue perfusion
Where is mainly affcted by wgeners granulomatosis?
nose, oral cavity, sinuses, lungs, kidneys
What if the intra-oral appearance of Wegners granulomatosis?
mashed up strawberries
How do you treat wegners?
long term immunosupression
Which antibodies are detected in wegeners?
ANCA
antineurotropic cytoplasmic AB
What is long term complication of Wegners?
multisystem organ failure
Name some endocrine diseases
Acromegaly Diabetes Hyperparathyroidism Hypoadrenocortisms Pregnancy
What is homeostatic mechanism involved in acromegaly?
GHRH (growth hormone releasing hrome secreted into blood from hypothalmus to ant pit)
GHRH cuases Ant pit to release GH in pulsatile manner
GHIH released from hypothalamus inhhibits secretion of GH from pit
What is the name of the portal system involved in the Growth hormone production?
hypophyseal portal system
What are the features of acromegaly?
Cardiomegaly spade like hands sexual dysfunction large jaw interdentalspacing diabetes osteoporosis
How do you treat acromegaly?
somatostin analgoues
What is diabetes?
B cell dysfunction or insulin resistance
What is diabetes?
Random blood glucose of more then 11mmol/l
fasting blood glucose of more than 7 mmol/l
What is hyperparthyoidism?
when too much PTH is produced
What is the function of PTH?
regulation of calcium and phosphate level
What are the three types of hyperparathyroidism?
primary: hyperfunction of the glands (increased PTH, inc CA)
secondary: increase PTH due to hypocalcamia (inc PTH, low Ca)
tertiary: longterm secondary leads to tertiary: these people develp hyperplasia of the parathyorid glands (high PTH, Ca)
What other feature do people with hyperparathyroidsm suffer from?
Chronic renal failure
What features exist of hyperparathyroidism?
Stones,bones and abdominal groans Epulis calcification peptic ulcer muscular atrophy renal failure osteieits fibrosa cystica sull decalcifcation
What is the action of PTH in the body?
inceases bone resorption
increases ca resorption from GI
increases ca resorption from kidneys
decreases phosphate reabsortption
what is hypoparathyroidisdm?
decreased production of PTH leading to low levels of calcium
what are the symptoms of hypoparathyroissm?
MABS PHFWAL
Muscle twitching arrhythmias bone pain stridor fatigue paraesthesia head ache weight gain loss of hair
What is trousseaus sign and what is it indicative of?l
low calcium
caused when a blood pressure cuff is placed around the arm and inflated greater than the systolic BP
spasm of the arm
What is the chovstek sign? What is it indicative of?
low calcium
less sensitive than troussaeus sign
Abnormal reaction of facial nerve.
How do you tests for Chovstek sign?
When masseter is tapped at angle of mandible all muscles on that same side will contract
WHat are the causes of hypoparathyroidism?
primary due to thrypid disease
secondary due to pituitary dysfunction
What GI problems exist?
Crohns UC Liver GORD Perncious anaemia Peutz Jeger
What is crohns disease?
Non specific inflammatory bowel disease of unknown aetiology
What part of the GI can it affect?
Mouth to anus ileum most common (this is where B12 is absorbed)
What is the prevenlanece of crohns?
2-6/100000
Jews
What are the signs and symtpoms of crohns?
iron, foolate, B12 defeiecneiy lip swelling diorrhoea cramps weight loss mucosal tags perio-oral sweeling
What is the histology behind crohns?
FUNES Focal and diffuse lymphoid infiltration Ulceration-Undermined edges Non caseating epitheloid granulomatous Endovasal granulomatous lymphangigitis Submucosal Oedema and lymphangietasia
What is coelia disease?
Gluten sensitive enteropathy
What is the test for Coeliac?
ATTG (more than 10, than dont have coelic)
What is UC?
Chronic idiopathic inflam bowel disease
Where does UC affect?
rectum and colon
What GI signs are there in UC?
Linera ulcers
inflamation in mucosa only compared with Crohns where inflammation affects all layers of gut
polypoid appearance
What haematological diseases are there?
THALLM Thalassemia Hamatinic def Amyloidosis Leukamia Lymphoma Multiple myeloma
What is Amyloidosis?
myeloid proteins abnormally deposited into organs and tissues
what are the symptoms of Amyloidosis?
dependant upon which tissues the myeloid proteins are deposited in
WHat are the types of amyloidosis?
primary
secondary
what is primary amyloid?
arises from a disease where there is abnormal immune cell function eg chronic myeloma
What is secondary amyloid?
complication of chronic inflamm or tissue destruction
What is the histopathalogy behind amyloidosis?
Histopath shows
cross-beta sheet structure identified with apple-green biofreingence
What stain is needed to identify meyloid proteins in amyloidosis?
congo red and polarized light
What other disease is associated with meyloid proteins?
alzheimers
What is a syptom of myeloid depoitition in the tongue?
Macroglossia
What is Leukaemia?
Clonal proliferation of malignant blood cells which are derived from haemopoietic stem cells within the bone marrow
How does leukaemia cause blood problems?
the malignant cells suppress production of normal healthy cells
What are the symptoms of leukaemia?
shortness of breath Muscular weakness bone and joint pain Night sweats lymph node swelling
What is lymphoma?
cancer of lymphatic system
What types of lymphoma exist?
hodgkin and non hodkins
What age group is mainly affected by lymphoma?
30-55
Where can lymphoma affect the mouth?
waldeyers ring: tongue and palate
more commonly non hodkins in mouth
what are the signs and symptoms of lymphoma?
Painless swelling in the neck/armpit/groin fever and sweating loss of appetite, weight loss cough and breathlessness itchy tired
what is multiple myeloma?
A cancer of plasma cells which produce antibodies
What happens to the plasma cells in myeloma?
they grow out of control and form tumours within bone marrow
this makes it harder for the healthy bone marrow to produce blood cells
What is the demographics of multiple myeloma?
African american
M>F
WHat are the signs and symptoms of multiple myeloma?
Bleeding anaemia infection bone paon numbness and weakness pathological bone fractyres
What mediations will people suffering from multiple myeloma take?
chemotherapeutics and bisphosphonates
What are the types of immunological diseases are there?
HIV
Langerhands cells histiocytosis
Myasthina gravis
wegners
What is langerhans cells histiocytosis?
clonal proliferation of langerhans cells
what is the demogrpahics of langerhans cell histio?
M.F 2;1
1-15 years old
What are the signs and symptoms of langerhans cell histio?
non specific immune inflam response fever weightloss lethargy bone swellings and pain akin rash and scalp eruptions
What percentage of people with Langerhans cells histiocytosis have enlarged lymph?
50%
What percentage of people with Langerhans cells histiocytosis have enlarged spleen?
30%
What percentage of people with Langerhans cells histiocytosis have enlarged liver?
20%
how do you treat langer hans cells histio?
chemotherapy
if solitary lesions then excision or radiotherapy
What is myasthnia gravis?
AI
neuromuscular disease
What is the pothology behing Myasthnia?
autoanitbodies block the acetylcholine receptors and post syna[tic NMJ
What are the signs and myasthnia?
muscle weakenss fluctuating
fatigue
How do you manage myasthenia?
immunosuppressants and anticholinsterase inhibitors
How does UC presnt in the mouth?
Pyostomatitis vegetans
Apthous type ulcer
Atypical ulcer
What is coeliac disease?
Gluten sensitive enteropthy
Which starts in childhood after weaning
Loss of villi which leads to malabsorption
T/F people with coeliac suffer from fatty stools?
T
Steatorrhoea
T/F people with coeliac suffer from Apthous ulcer?
T
What are the oral manifestation of coeliac disease?
Apthous stomatis
Dermatitis herpetiformis
GORD
How can upper GI maligancy present?
Chronic GI bleeding Dysphagia Progressive unintentional weight loss Persistent vomiting Iron def anameia Epigastric mass
What are the oral manifestation of malabsorption conditions?
Atrophic glossitis
Angular chelitis
Apthous ulcer
Dysaesthesia
What are the systemic signs and symptoms of tuberculosis ?
Night sweats
Fever
Weight loss
Blood tinged sputum
Which stains are used in tuberculosis?
Ziehl neelson or Fite stains
What does biopsy of TB show?
Granulomatous inflammation with Largerhans giant cells
Which media is needed to identity mycobacterium in samples?
Lowenstein jensens with a prolonged incubation period
