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Tim's Cards > Oral Medicine II - fishyfishy > Flashcards

Oral Medicine II - fishyfishy Flashcards

1
Q

4 Types of COPD

A

Chronic Bronchitis

Emphysema

Bronchial Asthma

Bronchiectasis

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2
Q

Define Chronic Bronchitis

A

Chronic cough

Sputum production minimum 3 months/year

For 2 Consecutive years

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3
Q

Smoking is the main cause of Chronic bronchitis in ___% of cases

A

90%

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4
Q

Chronic Bronchitis is due to hypertrophy of what?

The mucosa is infiltrated w/ lymphocytes, macrophage, and plasma cells, but no…

Surface epithelium may undergo metaplasia from columnar to…

A

Bronchial mucous glands

neutrophils

stratified squamous

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5
Q

Chronic Bronchitis can result in what type of heart failure?

*This leads to what?

A

Right heart failure

aka Cor Pulmonale

*venous stagnation/cyanosis

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6
Q

Blue Bloaters

Pink Puffers

A

Chronic Bronchitis

Emphysema

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7
Q

Blebs appear on the ____ surface of the lung

Bullae appear in the _____ of the lung

Both are associated with what?

A

pleural

parenchyma (greater than 1 cm)

Emphysema

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8
Q

What causes the actual breakdown of lung tissue in Emphysema?

A

Proteases from bacteria, PMN’s, monocytes, macrophage

*destroys Elastin/Reticular figers

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9
Q

Which COPD has Curschmann Spirals?

A

Bronchial Asthma

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10
Q

Bronchial asthma has many mucosal infiltrates which include…

Mucous sometimes contain whorls of shed epithelial cells called _______ which are seen microscopically

A

Eosinophils

Curshmann’s spirals

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11
Q

Bronchiectasis is a ______ of the bronchi

This is the most common complication of chronic _____

Bronchi/Bronchioles are filled with ______ that stagnates and can’t be cleared with coughing

A

Permanent Dilation

Chronic Bronchitis

Mucopurulent

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12
Q

Hx COPD, difficulty breathing, severe halitosis, respiratory attack, what does the pt have?

A

Bronchioectasis

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13
Q

2 Ways to get Emphysema:

A

Smoking

Genetic (Alpha 1 antitrypsin deficient)

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14
Q

Alpha 1 Antitrypsin is a ________

If you don’t have it what happens?

A

anti-protease

protease destroys lung tissue

***primary function is to neutralize naturally occurring proteases

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15
Q

As opposed to an Alpha 1 Antitrypsin deficiency, in a smoker what causes Emphysema?

A

Inflammatory mediators release elastases

Destroys elastic tissue of the alveolar sac

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16
Q

Usually COPD is related to Pneumonia and Oral Health via

A

Cigarette smoking

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17
Q

Onset of COPD is dependent on smoking (almost always) and repeated _________ can worsen the disease

______ bacteria can travel to the lungs

Teeth bacteria are ______ and lead to pneumonia in smokers w/ COPD

A

bacterial infections (pneumonia)

Periodontal

Strep Viridans

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18
Q

Genus, Species for legionella

It is a G___

American Legion in Philly caused pneumonia via inhalation from humidifiers, thus spread requires…

A

Legionella pneumophilia

gram negative rod

man-made water based environments

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19
Q

What Gram Positive is associated with Pulmonary Abscesses?

A

Stapylococcus aureus

*virulent organisms

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20
Q

Rust Colored Sputum:

Current Jelly Sputum:

**both cause pneumonias, remember, G-‘s can be just as bad as S. aureus

A

Pneumococcal/Streptococcus pneumoniae (Gram +)

Klebsiella pneumonia (Gram -)

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21
Q

4 different routes that can cause Pneumonias:

A

Airborne - inhalation of droplets

Aspiration of gastric infected particles

Aspiration of infected Upper Resp Tract (strep/staph)

Hematogenous spread - sepsis, UTI, GI infections

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22
Q

mycoplasma pneumonia =

mycobacterium tb -

A

Klebsiella

Tuberculosis

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23
Q

Interstitial pneumonias:

Broncho (alveolar) pneumonias:

A

Viral

Bacteria

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24
Q

Alveolar (broncho) pneumonia can be _______

Interstitial (viral) affects _____

A

diffuse/lobular

wall of alveoli

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25
Q

There is an association between ______ pneumonia and Periodontal Disease

This is b/c long-term ______ causes S. aureus, Pseudomonas, Kebsiella to gather in oral cavity

What happens to these pathogens?

A

nosocomial

Abx

Aspirated to lungs (poor cough/gag reflex)

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26
Q

TB stains how?

_____ acid that is anti-phagocytic

It causes what in the lungs?

A

Acid Fast

Mycolic

Caseating granulomas

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27
Q

2:

Most common portal of entry for TB:

A

Respiratory

GI

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28
Q

TB infecting Cervical Lymph nodes:

A

Scroffula

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29
Q

Initial lung lesion of TB that appears in the lower lobes:

_____ lung lesion draining to ______ (combines to form this thing)

A

Gohn Complex

subpleural, hilar lymph node

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30
Q

Primary TB starts with what?

***when pt First Exposed

A

Gohn Complex

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31
Q

Pott’s Disease is a form of ______ TB

TB can appear where?

Causing what?

A

milliary

Vertebrae (interevertebral joints)

Arthritis

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32
Q

Tuberculoma:

mimics:

Well-defined ____ mass

Most common occurs in what 2 areas?

A

TB conglomerates Tubercles into Firm Lump

cancer

focal

Brain/Lung

33
Q

PPD:

Used for:

A

Purified Protein Derivative

TB skin test

*makes wheal

34
Q

AFB:

Used for:

A

Acid Fast Bacilli

staining TB cells

35
Q

BCG:

Skin test implications:

A

TB immunization used outside US

positive for skin test but negative for TB

36
Q

INH

A

Isoniazid

TB tx

37
Q

Primary TB:

Secondary TB:

A

Gohn Complex, in immunosuppressed out of control

Reactivation spreads to Apex

38
Q

Non-productive, dry cough, low-grade fever, no appetit, minor hemoptysis

A

Secondary TB

39
Q

Tubercobacillus secretes toxins

A

False

***we secrete those to keep it in check

40
Q

The part of our immunity that drives the response to TB:

There is no:

A

cell-mediated

Antibodies (IgG, etc)

41
Q

What type of hypersensitivity is seen in the NRL (Natural Rubber Latex) protein allergy?

What Antibody is involved?

A

Type 1 hypersensitivity

IgE

42
Q

NRL second exposure is IgE + degranulation =

A

release of histamine

43
Q

What type of hypersensitivity Rxn is seen in ACD (Allergic Contact Dermatitis)?

Cell that mediates:

A

Type IV delayed

T-cell lymphocyte (cell mediated)

*no plasma cells (b cells)

44
Q

ICD is what kind of rxn?

due to:

A

non-hypersensitivity

inflammation of physical/mechanical/chemical irritation

**no immune cells involved

45
Q

Type I hypersensitivity rxn

Type IV delayed hypersensitivity rxn

inflammation rxn (no hypersensitiviy)

A

NRL - natural rubber latex

ACD - allergy contact dermatitis

ICD - irritant contact dermatitis

46
Q

Glutaraldehyde:

Donning Powder:

Both can cause:

A

Cleaning disinfectant

Irritant

ICD

47
Q

Glutaraldehyde can cause ICD/ACD

A

True

48
Q

Bonding agents contain ______, which can cause ACD

A

methacrylates

49
Q

2 kinds of Hiatal Hernia:

Which is Tx w/ surgery?

A

Sliding (95%) (medically treated)

Paraesophageal - SURGICAL

50
Q

Hiatal hernia is a separation in the _______

A

Diaphragm

51
Q

Which Hiatal Hernia is associated with Reflux Esophagitis?

A

Sliding

*95%, medically Tx

52
Q

In a Hiatal Hernia the stomach goes up into the Thorax and when the pt ______ the symptoms are worse

A

Lays down

53
Q

Paraesophageal (hiatal) hernia progressively enlarges and the cause in unknown

A

True

54
Q

Candida Esophagitis:

Herpes Esophagitis:

CMV Esophagitis:

A

AIDS/immunocompromised

HSV1, Lymphoma/Leukemia, vescicular, PINK

AIDS/Basophilic inclusion bodies, not in Epithelium (in endothelial cells and fibroblasts of granulation tissue)

*all 3 can be due to HIV

55
Q

Candida Esophagitis:

Herpes Esophagitis:

CMV Esophagitis:

A

Pseudohyphae

Acidophilic internuclear inclusions

Basophilic internuclear inclusions

56
Q

Barrett’s esophagus metaplastic chain:

A

Squamous cell epithelium replaces with

Columnar epithelium

Adenocarcinoma (from stomach, not squamous of esophagus)

57
Q

Barrett’s occurs where?

A

lower 1/3 of esophagus

  • white men
  • 2x smokers
58
Q

How does healing occur in Barrett’s Esophagitis?

A

??

59
Q

2 types of PUD (peptic ulcer disease)

A

Gastric ulcers

Duodenal ulcers

60
Q

What bacteria causes Gastric/Duodenal ulcers of PUD?

common factor besides this

A

Helicobacter pylori

HCl over secretion

61
Q

Duodenal Ulcer peak age:

Gastric:

Duodenal ulcer sex distribution:

Gastric:

A

30-60

middle and elderly more than younger

male

both

62
Q

O blood has an association w/ what ulcer?

how much higher?

A

Duodenal

*30% higher

63
Q

___% of pts w/ gastric ulcers harbor H. pylori

A

75%

64
Q

Which ulcer has kissing pairs?

A

Duodenal

65
Q

All racial/ethnic groups equally susceptible to ulcers in US

what liver disease is associated?

aspirin/nsaids/corticosteroids associated

Malignant transformation occur commonly:

A

True

Cirrhosis/alcohol

True

False (only 1%)

66
Q

PUD associated w/ cigarettes

A

True

67
Q

4 features of Crohn’s Disease:

A

Skip lesions

Transmural inflamation

Ulcerations

Fissures

68
Q

2 features of CUC (chronic ulcerative colitis)

A

Pseudopolyp

Ulcer

69
Q

Crohn’s vs. CUC: which has pseudopolyps?

fistula formation?

Transmural inflammation?

Cobblestoning?

rubber hose fibrosis?

toxic megacolon?

higher malignant transformation?

higher bleeding?

Granulomas?

Skip lesions?

Diffuse?

A

CUC

Crohn’s

Crohn’s

Crohn’s

Crohn’s

CUC

CUC

CUC

Crohn’s

Crohn’s

CUC

70
Q

What is not seen in CUC, but is diagnostic in Crohn’s?

A

non-caseating Granulomas

71
Q

Crohn’s is a chronic inflammation of the GI that most often involves the _____ and ______

A

terminal ileum

colon

72
Q

Granuloma’s seen in Crohn’s causes the wall to thicken and become rigid, termed

also has ____ on the surface of the serosa

lesions?

adjacent adhesion:

A

Rubber-Hose Fibrosis

Creeping Fat

Skip

fistula

73
Q

CUC most often involves the _____

unlike Crohn’s, CUC location:

Usually does not extend into ileum, but there is

A

colon

diffuse

backwash ileitis

74
Q

CUC is not transmural but is limited to what 2 layers?

Mucosa shows what?

spread of these ulcerations create?

A

mucosa/submucosa

crypt abscesses

inflammatory pseudopolyps

75
Q

Most significant late complication of CUC:

70%

20%

10%

A

malignant transformation

chronic

fulminant (surgery)

single episode

76
Q

Left side of colon:

Right side of colon:

A

CUC

Crohn’s

77
Q

CUC ulcers:

Crohn’s ulcers:

A

wide/diffuse/pseudopolyps

linear/cobblestones

78
Q

more friable and bleed more:

colonic wall thinner:

thicker:

higher risk of cancer:

A

CUC

CUC - toxic megacolon

Crohns - transmural inflammation

CUC

79
Q

Extraintestinal complications Crohn’s vs CUC

name 3

A

same

*arthritis, eye lesions, skin lesions

Tim's Cards (140 decks)

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