Orasprint 5 - crammo Flashcards

1
Q

4 types of Ectodermal Odontogenic Tumors:

A

Ameloblastoma

CEOT - Calcifying Epithelial Odontogenic Tumor

AOT - Adenomatoid Odotogenic Tumor

SOT - Squamous Odontogenic Tumor

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2
Q

4 types of Mesodermal (CT) Odontogenic Tumors:

A

Central Odontogenic fibroma

Peripheral Odontogenic fibroma

Odontogenic myxoma

Cementum Lesions (3)

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3
Q

3 types of Mixed Odontogenic Tumors:

epithelial and CT

A

Ameloblastic fibroma

Ameloblastic fibro-odontoma

Odontoma

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4
Q

Ameloblastoma, common what age?

found where (%/location)

The most…

A

middle age (but found all ages)

75% posterior Mn

Painless

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5
Q

Ameloblastoma, Radiographic location: _____, always _____

Classically see what 3 things on Radiograph:

Pathology: Epithelial islands and cords where peripheral cells show ______ and ________

Tumor invades _______ but tends to expand ______

A

Pericoronal, Radiolucent

multilocular, moved teeth, root resorption

pallisading, reverse nuclear polarity

medullary bone, cortex

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6
Q

Tx, Ameloblastoma:

% recur w/ aggressive curettage:

A

Surgical (aggressive curettage or resection)

50%

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7
Q

4 variants of Ameloblastoma: Which is less aggressive?

which is a solitary confined cyst?

Which is “benign” but metastasizes?

which is malignant, aggressive, and metastasizes?

A

Peripheral extraosseous

Unicystic

Malignant ameloblastoma

Ameloblastic carcinoma

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8
Q

Unicystic Ameloblastoma is less aggressive and recurs ____% with enucleation

A

10-25%

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9
Q

You can definitively diagnose Ameloblastoma variants on incisional biopsy

A

False

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10
Q

CEOT (Calcifying Epithelial Odontogenic Tumor) aka…

Found all ages, but more in what location?

Radiographic:

Often associated with _______

A

Pindborg Tumor

midbody Mn

driven snow (lucent/mixed lucent/opaque)

unerupted teeth

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11
Q

CEOT pathology: islands and sheets of…

Tumor cells function and produce a protein matrix called…

This protein matrix may…

This stains with what?

A

pleomorphic epithelial cells

ODAM (odontogenic ameloblast-like protein)

calcify

amyloid stains

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12
Q

CEOT Tx:

A

Surgical

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13
Q

AOT…

Most prevalent at what age?

what population?

3/4 found where?

Usually under what?

symptoms?

A

Adenomatoid Odontogenic Tumor

1-3 decades, mostly teens

Female

Anterior Mn

unerupted teeth

asymptomatic

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14
Q

AOT, radiographically is…

may contain…

A

pericoronal lucency

flecks of opacity

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15
Q

Adenomatoid Odontogenic Tumor (AOT) pathologically is ________, with swirls of epithelial cells containing ________ or duct-like spaces lined by _______ cells.

A

Encapsulated

Rosettes

cuboidal/columnar

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16
Q

AOT Tx:

A

Enucleation

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17
Q

SOT…

Radiographically seen as…

Pathology, contains _______ of well-differentiated squamous epithelium with the peripheral cells _____

Tx:

A

Squamous Odontogenic Tumor

Lucency around Roots

islands, flattened

Curettage

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18
Q

Central Odontogenic Fibroma, radiographic it is…

WHO type (pathology), the stroma is _______ but may be more mature variable amounts of ________ and _____

Tx:

A

lucent or mixed lucent/opaque

collagenous, odontogenic epithelium, calcifications

Surgical removal

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19
Q

Peripheral Odontogenic fibroma is a reactive gingival lesion of what origin?

increases what age?

Where?

pathology is cellular fibrous CT with ______

A

PDL

young

anterior gingiva

calcifications (bone, cementum, dystrophic)

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20
Q

“Odontogenic” myxoma, occurs at all ages by increases when?

presents?

Radiograph is a lucency containing what?

A

young

asymptomatic

residual opaque trabeculae

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21
Q

“Odontogenic” myxoma pathology. This is a _____ tumor with scattered plump _______ cells

Has delicate ______ and abundant _______

Often mistaken for….

A

hypocellular, fibroblastic

collagen fibrils, ground substance (glycosaminoglycans)

normal anatomy

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22
Q

“Odontogenic” myxoma Tx:

A

Block resection

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23
Q

What are the 3 Cementum Lesions?

A

Central cemento-ossifying fibroma

Benign cementoblastoma (true cementoma)

Gigantiform cementoma

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24
Q

Central cemento-ossifying fibroma is a neoplasm of _____ origin.

Radiographically it is well circumscribed, and associated with what?

Lucency?

fibroblastic stoma, trabeculae, globules of acellular cemntum

Usually…

Tx:

A

PDL

tooth roots

lucent/mixed/opaque

fibroma, ossifying, cementifying (or both = cemento-issifying)

Encapsulated

Enucleation

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25
Benign cementoblastoma is a _____ cementoma what age? where? Looks like what? Except the tooth is what?
true 2-4 decades Mn 1st molar condensing osteitis vital
26
Begnign cementoblastoma is radiographically pathognomonic, including a ______ mass with peripheral _______ It is fused to the _____
sclerotic, radiolucent zone root
27
Benign cementoblastoma, pathology includes ______ trabeculae of cementum variable amounts of active fibroblastic stroma with ______ cells Peripheral trabeculae characteristically at ______ to surface Central trabeculae fused with ______
sclerotic giant right angles root
28
Benign cementoblastoma Tx: recurrence:
Surgical removal rare
29
Gigantoform cementoma must be: Radiograph, multiquadrant ______ opacities Pathology is globular _____ masses of _______ Tx:
Autosomal dominant globular sclerotic, cementum case by case
30
Ameloblastic fibroma, seen in what age? Where? symptoms: Radiographically always:
1-3 decades posterior Mn asymptomatic lucent
31
Ameloblastic fibroma, pathology has long strands/cords of ______ cells resembling _______ (embedded in CT of fibroblasts/delicate collagen fibrils) Tx: Variant:
epithelial, dental lamina Surgical removal Ameloblastic fibrosarcoma (rare malignant)
32
Ameloblastic fibro-odontoma, aka... Age: Symptoms: Radiographic shade: occurring where?
developing odontoma 1-3 decades asymptomatic mixed lucent/opaque overlying unerupted tooth
33
Ameloblastic fibro-odontoma, pathology like ameloblastic fibroma, except areas of _______ The pallisading, reverse nuclear polarity is a manifestation of what? Tx:
odontogenesis (enamel, dentin, cementum) function (not pathology) Surgical removal
34
What is the most common Odontogenic Tumor?
Odontoma
35
Odontoma is a mix of what two cells? and produces the products of what? Not a neoplasm, it is a...
Epithelial, mesenchymal odontogenesis develpmental hemartoma
36
Odontoma seen at what age? symptoms? Radiographic shade: Radiographically either Compound (tooth-like) found where? or Complex (random deposition) found where?
1-3 decades (young) asymptomatic radiopaque w/ lucent border, over unerupted teeth anterior Mn posterior Mn
37
Odontoma early lesions tend to be more active, like Ameloblastic fibro-odontoma Late lesions more mature enamel, dentin, cementum, pulp
True True
38
Odontoma Tx: Complications:
Surgical removal dentigerous cyst, ameloblastoma
39
Infective Stomatitis can be bacterial, fungal, viral
True
40
Impetigo is a skin infection caused by what 2 pathogens?
strep pyogenes staph aureus
41
Impetigo is usually found in what population? where? Facial lesions usually around ____ and ______ Caused by poor ____, crowded conditions, humidity Spread by?
young children face/extremities nose, mouth hygiene skin contact
42
Impetigo, _____ ruptures leaving _____ crusts described as... How is it unlike HSV? Topical Abx: Systemic Abx:
vescicles amber cornflakes glued to surface lesions persist until Tx Mupirocin Cephalexin, Dicloxacillin
43
Tonsillitis/pharyngitis can be bacterial or viral bacterial class: sore throat, headache fever, tonsillar hyperplasia, yellowish exudate, erythema, palatal petechiae, lymphadenopathy Children aged ____ years Spread by: Culture/Tx w/
True group A beta hemolytic streptococci Strep throat 5-15 contact, nasal, oral secretions Abx (penicillin, amoxicillin, cephalosporin)
44
3 complications of Strep Throat:
Scarlet Fever (3-12 y/o), attacks vessels, strawberry tongue Rheumatic fever (heart, joints, CNS) Glomerulonephritis
45
Syphilis, a bacteria called... Spread by: African americans, prostitutes, drug abusers, 50-100x higher prevalence in US compared to other industrialized countries
Treponema pallidum direct contact w/ mucosa True
46
Primary Syphilis, painless ulcer at inoculation site: occurs __-___ days after initial exposure Regional ______ TPHA + FTA-ABS (blood tests) Highly infectious
Chancre 3-90 days lymphadenopathy True True
47
Secondary Syphilis occurs ___-___ weeks post infection ____ patches _____ ulcers 2 skin manifestations: Lymphadenopathy, sore throat, fever, highly infectious
4-10 weeks mucous snail track conduylomata lata, maculopapular rash True
48
Latent Syphilis: ___-____ years
1-30 years
49
Tertiary Syphilis develops in ___% of pts Manifests in a unique type of necrosis called: with 3 characteristics: Intraorally this is seen where? 3 other manifestations:
30% Gumma indurated, nodular, ulcerated lesion palate dorsal atrophic luetic glossitis, syphiulitic leukoplakia, CV/CNS involvement
50
Congenital Syphilis, what happens to the head? Underdeveloped... Palate: Deformity:
Frontal bossing Mx high, arched saddle nose
51
Presentation of Congenital Syphilis:
Hutchinson't triad
52
Hutchinson's Triad: | include 2 dental abnormalities
Interstitial keratitis of cornea VIII nerve deafness Hutchinson't incisors (srewdriver), mulberry molars (bumps)
53
Sensitive but not specific blood test for Syphilis: other one: Why is mucosal smear not recommended? Abx Tx:
VDRL RPR TPHA and FTA-ABS spirochetes penicillin
54
Species causing TB: Immunodeficiency can progress disease: Spread through droplets in pts w/ active disease
Mycobacterium tuberculosis (acid-fast bacillus) True True
55
Fever, night sweats, fatigue, weiht loss, productive cough, hemoptysis:
TB
56
Scrofula: Lupus vulgaris
lymph node involvement TB skin involvement TB
57
2 TB oral manifestations: Biopsy shows granulomas w/ central areas of ______ AFB PCR, PPD Tx:
chronic painless ulceration on tongue/palate, atypical periodontitis necrosis Acid fast bacillus stain tests Isoniazid/rifampin
58
Bacterial infection that looks like a fungus:
Actinomycosis israelii
59
Actinomycosis is a normal ______ anaerobic inhabitant of the oral cavity Hx of: % cases occur in cervicofacial areas:
saprophytic surgery/trauma 55%
60
Actinomycosis manifests as... colonies are what color? Tx: Localized acute infections Tx more ________ Removal of infected tissue aerates and Abx not needed
abscesses/sinus tracts yellow "sulphur granules" long-term high dose Abx conservatively True
61
NUG (trench mouth), 2 causative bacteria: Highly inflamed/hemmorhagic... punched out papillae necrotic and covered with... Fetid odor and _____ pain 2 Tx's: Systemic Abx if:
Bacillus fusiformis, Borrelia vincetii papillae gray pseudomembrane intense Debridement, CHX fever/lymphadenopathy
62
Candida albicans has a yeast form and a _______ pathogenic form White matl that can be wiped off: has what taste?
hyphal pseudomembranous candidosis metallic
63
Acute atrophic candidosis - 3 features
painful burning affects gingiva loss of filiform papillae on tongue
64
Chronic atrophic candiddosis - 3 features
Erythematous Mx only in dentures asymptomatic or symptoms
65
Chronic hyperplastic candidosis is indistiguishable from what? This white lesion differs from pseudomembranous how? If AF does not resolve, then...
leukoplakia does not wipe off biopsy
66
Angular chelitis is candida ___% of the time otherwise it is _____ or ______ reduced vertical dimension predisposes
90% strep, staph True
67
Median rhomboid glossitis, aka... Central _____ atrophy erythematous diamond shaped area found where? Often...
chronic atrophic candidosis papillary midline, posterior dorsal tongue asymptomatic
68
Candida Dx w/ ____ smear, tissue culture, exfoliative cytology (PAS stain) Nystatin Rx: Clotrimazole Rx: 2 azoles absorbed systemically: Fluconazole Rx:
mucosal 1 tsp 5x daily, 2 wks 10 mg 5x daily, 7-10 days ketoconazole, fluconazole 2 tabs (200 mg) day 1, then 1 tab daily, 2 wks
69
Chronic, non-healing intraoral ulcers that can mimic SCC:
Deep fungal infections
70
Most deep fungal infections cause primary lung involvement
True
71
Histoplasmosis, Coccidomycosis, Blastomycosis, Cryptococcosis, Aspergillosis
Deep fungal infections
72
SubQ fungal infection species:
Sporotrichosis
73
Opportunistic fungal infection species:
Zygomycosis (mucormysosis)
74
HPV papilloma caused by what 2 subtypes? White/red/normal color ______ shaped exophytic
6 and 11 cauliflower
75
Verruca vulgaris, HPV subtypes: Common wart usually found where? If oral mucosa, found where?
2, 4, 6, 40 skin of hands vermillion border, labial mucosa, anterior tongue
76
Koilocytes (enlarged cells w/ cytoplasmic clearing) Keratohyaline granules contagious
Verruca vulgaris (HPV 2, 4, 6, 40)
77
Verruca Vulgaris (HPV 2, 4, 6, 40) Tx:
liquid nitrogen
78
Condylomata acuminatum, caused by: This is _____ HPV incubation: Anogenital condylomata, what 2 HPV forms increase malignant risk? often occur in clusters, not as exophytic as papillary/papilloma/verruca
HPV 2, 6, 11, 53, 54, 16, 18 sexually transmitted 1-3 months 16, 18 True
79
Focal epithelial hyperplasia caused by: "_____ Disease" flat, soft, _____ papules Most common in malnourished ________ 1st described in Native Americans/Eskimos ______ and _____ cells
HPV 13, 32 Heck's clustered children True Koilocytes, Mitosoid
80
Focal epithelial hyperplasia caused by HPV 13,32 identified by DNA insutu hybridization, PCR, and may undergo regression after improved living conditions
True
81
2 types of HPV w/ cancer risk: causes _____ cancer and MOST ______ cancer 30 years ago, 15% of throat cancer HPV, now ___%
16, 18 cervical, oropharyngeal 80%
82
HPV, HHV, both ____ viruses
DNA
83
HSV-1 HSV-2
oral infections genital infections
84
More than 90% HSV (HHV) are asymptomatic
True
85
Acute herpetic gingivostomatitis is... age range: _____, lymphadenopathy, nausea, irritability erythematous gingiva, coalescing vescicles spread to Lesions heal ______
Very Acute in Onset 6 mo - 5 yrs Fever marinated ulcers spontaneously
86
Recurrent herpes occurs in _-__% of population cold sore/fever blister, called herpes _____ apthae occur where? Intraorally limited to what?
15-45% labialis vermillion/skin border keratinized mucosa
87
At any time, _-__% of pts will asymptomatically excrete and will have HSV DNA in saliva
5-30%
88
3 types of antivirals that are effective when administered in prodrome for herpes infection:
Acyclovir Famciclovir Valacyclovir
89
Varicella-zoster virus, HHV __? Primary infection: Reactivation:
HHV-3 Chickenpox Shingles
90
Primary HHV-3 incubation: Recovery:
10-21 days 2-3 weeks *now vaccine
91
Reactivation HHV-3, occurs how often? Oral lesions occur if what nerve is involved? ***Chronic Infection that may take months to resolve?
1 in 3 Trigeminal nerve Postherpetic Neuralgia
92
Infection of external auditory canal, ipsilateral facial/auditory nerved produce facial paralysis, hearing deficits, vertigo (HHV-3)
Ramsay Hunt Syndrome
93
EBV, HHV-__? Infectious ______ Prodrome has _____ on hard/soft palate _____ antibody, elevated WBC count
HHV-4 mononucleosis petechiae heterophil
94
Hairy leukoplakia is a corrugated white lesion usually found where? It can be wiped off. Associated w/ candida, but often caused by what? This is most common in ____ pts
lateral border tongue False EBV HIV
95
2 EBV neoplasms:
Burkitt's lymphoma (and other lymphomas) Nasopharyngeal carcinoma
96
Cytomegalovirus, HHV-_? Affects ____ and immunosuppressed adults ___% infection asymptomatic, rest mono-like serious complications like organ failure, blindness, mental/motor retardation
HHV-5 newborns 90% True
97
CMV (HHV-5) oral lesions: resides latently where? Infected cell appearance? Systemic antiviral if....
chronic ulceration salivary glands owl eye immunosuppressed
98
Kaposi's sarcoma causative virus: Orally most common on palate, gingiva, tongue most cases associated w/ AIDS
HHV-8 True True
99
Coxsackie A viruses cause what 3 things?
Herpangina Hand-foot-mouth disease Acute lymphonodular pharyngitis
100
Acute lymphonodular pharyngitis, caused by... affects children under _____, often in epidemics Painful _____ and ______ intraorally Vescicles on ________ lymphoid tissue is ______ hand-foot-toes-fingers: Infection resolves in ______ days
Coxsackie A virus 5 vescicles, ulcers soft palate hyperplastic papules 7-10 days
101
Measles/Mumps caused by
Paramyxoviruses
102
Measles, aka... ______ spots are early intraoral manifestation they are small, red patches w/ white _____ centers
Rubeola Koplik's necrotic
103
Recurrent Aphthous Stomatitis is occur in ___% of the population immnologically, ___ cell mediated Histocompatibility antigens are associated and suggest...
non-infective 20-50% T-cell genetic
104
Recurrent Aphthous Stomatitis is 90% 10%...
Minor aphthae Major aphthae
105
Minor aphthae affect what sex more? exclusively on ______ mucosa Heal in 7 to ___days recurrence variable
female moveable 14 True
106
Major aphthae (5%), aka _____ disease onset when? ***most common on soft palate and...
Sutton's adolescence tonsillar fauces/pharyngeal mucosa
107
Herpetiform aphthae (5%), onset... affect what sex more? heals in 7-10 days resembles ulcers caused by what?
adult female True HSV
108
3 Tx's for Aphthous ulcers:
Topical steroids (dexamethasone/flucononide) CHX Amlexanox
109
Pseudo aphthae are associated with what 3 Systemic Diseases?
GI (Crohn's) Vitamin deficiencies Behcet's syndrome
110
Systemic vasculitis causing chronic, recurrent disease and pseudo-aphthae:
Behcet's syndrome
111
Behcet's syndrome has an immunogenetic basis, strong associaton w/ specific HLA types correltation w/ _____ antigens Oral (99%), Ocular (70-85%), genital (75%) Oral lesions like aphthous w/ ragged borders and surrounded by... Use topical/systemic _______, other immunosuppressives, CHX
True environmental True diffuse erythema steroids
112
Lichen Planus, cause unknown but immune __ mediated Slight association with: age: affect what sex? Affects skin, oral mucosa, tissues irritated/traumatize: _____ phenomenon
T cell Hep C middle aged adults 2/3 female Koebner
113
Skin: Purple, pruritic, polygonal papules Oral: reticular/erosive/bullous, plaques **vesiculo-bullous (blistering) diseases
Lichen Planus
114
Most common Lichen Planus is ______ w/ _____ Striae
reticular, Wickham's
115
What is the most common cause of Desquamative Gingivitis? also pemphigus vulgaris, pemphigoid, allergy
Lichen Planus
116
Saw-toothed rete ridges Destruction basal cell layer
Lichen Planus
117
Lichen Planus look-alike associated w/ systemic drugs, hypersensitivity rxn (cinnamon/amalgam, etc)
Lichenoid rxns
118
2 topical steroids for Lichen Planus:
Fluocinonide Clobetasol
119
Greek for blister
Pemphigus
120
Pemphigus is a ________ disease
autoimmune severe, progressive
121
Pemphigus 1st appears when? Circulating auto-Ab to what?
adults 40's to 50's desmosomes (desmoglein 3)
122
Nikolski sign of Pemphigus: Dx is ______ epithelial separation with acantholysis Tx:
induces separation suprabasilar steroids
123
Type of pemphigus that affects pts w/ neoplasm, lymphoma, leukemia it is very serious w/ high morbidity/mortality
Paraneoplastic pemphigus
124
Pemphigus: Benign mucous membrane pemphigoid (cicatricial pamphigoid):
desmosomes hemidesmosomes
125
Benign mucous membrane pemphigoid: more common in females, avg age: more common than... if untreated _____ can progress to blindness Similar to pemphigus but not as severe
50-60 pemphigus ocular scarring True
126
Benign mucous membrane pemphigoid: +Nikolski sign Most commonly affected site: Bullae form where? Dx:
True gingiva (desquamative gingivitis) epithelium/CT junction biopsy epithelial separation
127
Benign mucous membrane pemphigoid Tx:
Ophthalmologic consult Topical/systemic steroids
128
Desquamative Gingivitis can manifest from what 4 conditions?
Lichen Planus Pemphigus vulgaris Mucous membrand pemphigoid Allergy
129
Erythema multiforme: ____ onset, ______ mediated ______ condition follows...
acute immune mucocutaneous systemic meds/post infection
130
Erythema multiforme affects what sex? adults 20's - 30's w/ ___% recurrence
men more often 20%
131
Lesions highly variable (multiforme) bulls eye lesions palms/soles
Erythema multiforme
132
More severe form of Erythema Multiforme: (has extensive mucosal ulceration, genital/ocular involved) Most severe form of Erythema Multiforme: (female prediliction)
Steven-Johnson syndrome Toxic epidermal necrolysis
133
Erythema migrans/benign migratory glossitis
Geographic tongue
134
Geographic tongue is _______ condition of unknown origin 1-3% population 2x more common in what sex? occasional burning, correlated with... Tx:
inflammatory True Females psoriasis not needed, topical steroids if symptoms
135
Rare syndrome w/ urethritis, arthritis, conjuctivitis Oral lesions look like geographic tongue
Reiter's Syndrome
136
Lupus erythematosus, 8x more common in: ave age: 50-80% have classic:
women 31 butterfly rash
137
Discoid LE: Systemic LE:
lesions in skin only (25% oral) chronic, progressive, life-threatening (CNS, heart, kidney)
138
LE lab test include:
ANA (antinuclear antibodies) *Ab to own DNA
139
Tx LE: | systemic
corticosteroids anti-malarials
140
Systemic Sclerosis (Scleroderma): rare ______ mediated deposition of _______ in skin/tissues vasoconstrictive event in extremities: Hide bound disease
immune, collagen Raynaud's phenomenon skin hard and taut
141
4 oral manifestations Scleroderma:
Diffuse widening PDL Microstomia (70%) Dysphagia Condylar resorption
142
Scleroderma can lead to organ failure Dx: Anti ____ antibodies Tx: Prognosis:
True Scl70 (topoisomerase1) D-penicillamine/Ca channel blockers organ involvement dependent
143
GVHD is what type of rxn? acute: chronic: Oral lesions appear ______ and are painful Tx: Increased risk for:
immune first 100 days over 100 days lichenoid immunosuppressives/corticosteroids dysplasia, oral cancer