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Tim's Cards > Orathon4: adventures in cramming > Flashcards

Orathon4: adventures in cramming Flashcards

1
Q

By definition, Pulpitis is inflammation involving the _________

Sometimes only dilation of _________

A

dental pulp

blood vessels

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2
Q

2 causes Pulpitis?

A

Caries

Trauma (Dental restorative procedures!)

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3
Q

Symptom of Pulpitis:

A

Pain

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4
Q

Reversible Pulpitis: Pain from hot/cold ______ after stimulus removed

Pain is ______ in intensity (intermittent, not always present/reproducible)

Radiographic appearance:

Tx:

A

fades rapidly

variable

normal

Remove cause if ID or Time!

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5
Q

Irreversible Pulpitis: After stimulus removed:

Varying pain, mild, intermittent to _______

3 stimuli that can produce pain:

Pain may be spontaneous and could be triggered by what?

Pain may be _______

Radiograph:

Tx:

A

Pain lingers

excruciating

Hot/Cold, Chewing pressure, Percussion

Lying down

continuous

widened PDL

Endo or Extraction

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6
Q

Chronic Hyperplastic Pulpitis, aka…

Caused by what?

Pulp does what?

Typically very sensitive to what?

Tx:

A

Pulp Polyp

Carious exposure of pulp

Pulp grows into crown (soft red tissue mass)

touch

Endo or Extraction

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7
Q

Pulp Necrosis: death of the pulp due to overwhelming ______ in a confined environment

Bleeding in the pulp chamber results in RBC’s spilling into _______, causing _______

Symptoms:

Often sensitive to :

Radiographs: (2 things)

A

inflammation

dentinal tubules, discoloration

no pain to intense pain

percussion

PDL thickening or destruction of periapical bone

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8
Q

Periapical lesions are the result of what?

A

pulpitis (pulpal inflammation)

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9
Q

What % of periapical lesions progress to pulp necrosis?

A

95% or greater

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10
Q

A tooth with periapical pathology will be _______ when tested

A

non-vital

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11
Q

3 results of testing a non-vital tooth with periapical pathology

A

no response to hot/cold

no response to electric pulp testing

percussion/mastication tenderness may still be present

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12
Q

What is the earliest change in periapical pathology?

longer duration?

A

widened PDL at apex

symmetric apical radiolucency

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13
Q

4 types of localized periapical lesions:

A

periapical granuloma

apical periodontal cyst

periapical abscess

periapical scar

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14
Q

3 potential sequelae to localized lesions:

A

sinus tract

osteomyelitis

cellulitis

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15
Q

Periapical Granuloma, aka…

A

Chronic Apical Periodontitis

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16
Q

What is the most common periapical pathosis?

A

Periapical Granuloma

aka Chronic Apical Periodontitis

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17
Q

Periapical Granuloma is the accumulation of apical inflammatory tissue in response to what?

what type of inflammation?

may be found in transition from what 2 things?

A

noxious products of pulp necrosis

chronic

periapical abscess/apical perio cyst

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18
Q

Periapical Granuloma Clinical presentation:

Radiographic presentation:

Tx:

A

asymptomatic, tooth not mobile, not percussion sensitive

variable, symmetrical, well defined, punched out border, diffuse, loss of Lamina Dura, root resorption

endo (surgical/conventional) or extraction

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19
Q

Periapical Granuloma will see the loss of what in the root tip area of the radiolucency

A

Lamina Dura

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20
Q

Apical Periodontal Cyst aka…. (2 things)

A

Periapical Cyst

Radicular Cyst

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21
Q

Apical Periodontal cyst is an epithelial proliferation/cyst formation resulting from what?

A

inflammatory stimulation of epithelial remnants of Hertwig’s Epithelial Root Sheath

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22
Q

How does Apical Periodontal Cyst present clinically? (4 things)

A

asymptomatic

not mobile

adjacent tooth displacement can occur

does not enlarge alveolar bone

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23
Q

Apical Periodontal Cyst radiographic presentation:

A

lucent lesion, variable, punched out border, lamina dura loss, root resorption

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24
Q

3 patterns of Apical Perio Cyst radiographic presentation:

A

Classic: root tip lucency

Lateral: side of root (lateral root canal)

Residual: remains following extraction

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25
Q

Tx of Apical Perio Cyst:

A

surgical/conventional endo or Extraction

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26
Q

Acute inflammation due to pulpal necrosis with spread of noxious products into the periapical region

A

Periapical Abscess

*can also be periapical granuloma

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27
Q

Periapical Abscess can result from what 2 apical conditions?

A

periapical granuloma

apical periodontal cyst

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28
Q

Symptomatic Periapical Abscess clinical presentation:

Asymptomatic:

A

percussion/mastication/palpation pain, variable intensity, increasing pain w/ time, Swelling, Active infection

painless, swelling in vestibule/periapically may accompany

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29
Q

Periabical abscess radiographic findings:

Tx:

A

none obvious to radiolucency, ill-defined, PDL thickening possible

conventional endo/extraction/analgesics for pain

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30
Q

Periapical Scar is due to healing ________, _______, or _______

typically occurs when there has been destruction of ______ on lingual and buccal to tooth

most commonly follow _______

A

periapical granuloma, apical perio cyst, periapical abscess

cortical bone

surgical endo therapy

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31
Q

3 major types of Sequelae to Periapical Pathology:

A

Sinus

Osteomyelitis

Cellulitis

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32
Q

Sinus sequelae to Periapical Pathology results from what?

A

Pus dissecting through bone

*path of least resistance

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33
Q

Depending on the tooth involved and the path of least resistance, Sinus Tract Sequelae from periapical pathology can result in what 2 areas?

A

Oral cavity

Skin surface

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34
Q

Sinus trace sequelae from periapical pathology resulting in pus to Oral Cavity, aka…

What are the 2 types?

A

gum boil

hole w/ redness, enlarged nodular mass

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35
Q

Enlarged Nodular Mass (periapical pathology causing sinus tract sequelae) can be what colors?

sessile or polyploid

most are found on what aspect? Why?

Tendency to _____ perforation

A

yellow/white/red/purple

true

buccal, thinner cortical bone

lingual perforation:

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36
Q

If a Nodular Mass (periapical pathology causing oral cavity sinus tract sequelae) has a Lingual Perforation, what 3 teeth are usually involved?

A

Mx LI’s

Mx molars - palatal roots

Mn 2nd and 3rd molars

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37
Q

If periapical sequelae reaches the skin it typically involves…

multi-colored, and what teeth are involved?

A

enlarged nodular mass

mandibular teeth

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38
Q

Periapical inflammation spreading into adjacent bone w/o drainage

A

Osteomyelitis

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39
Q

Inflammation unable to etsablish drainage that spreads through soft tissues:

A

Cellulitis

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40
Q

Cellulitis usually spreads through ______

What are the 2 types associated w/ Dental Infections?

A

layers (planes)

Ludwig’s angina, Cavernoous sinus thrombosis

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41
Q

Ludwig’s Angina typically results from an abscess of what tooth?

involved rapid swelling of what 3 areas?

Which causes elevation of the tongue?

A

Mandibular molar

sublingual, submandibular, submental

sublingual

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42
Q

Cavernous sinus thrombosis typically results in an abscess of what teeth (2)?

What is the most common source of infection?

swelling involves what tissues?

A

Mx anterior, Premolar

Canine

periorbital (eyelids, conjunctiva), may also involve lateral nose/forehead

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43
Q

Possible sequelae to Cavernous Sinus Thrombosis:

A

protrusion/fixation of eye

pupil dialtion

lacrimation

meningitis

brain abscess/death

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44
Q

Decrease in hemoglobin resulting in inability to oxygenate tissue

A

Anemia

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45
Q

3 types of Anemia:

A

Iron deficiency: most common

Pernicious: loss of IF, can’t absorb B12

Sickle Cell: hemolytic

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46
Q

What is the most common type of Anemia?

Associated syndrome?

Oral consequence of syndrome?

A

Iron deficiency

Plummer-Vinson Syndrome

increases oral/esophageal carcinoma

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47
Q

Oral findings of Sickle Cell:

A

Pain and burning (glossodynia/glossopyrosis)

glossitis, angular chelitis, apthous ulcers

candidiosis

bone density loss

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48
Q

Uncontrolled overproduction of RBC’s, platelets, and WBC’s. Blood becomes viscous

A

Polycythemia vera

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49
Q

What are the oral findings of Polycythemia Vera?

A

Erythematous mucosa

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50
Q

2 General types of WBC disorders:

A

Leukopenia (decreased WBC)

Leukocytosis (increase WBC)

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51
Q

2 types of Leukopenia (decrease WBC):

A

Agranulocytosis (neutropenia) - decreased neutrophils

Lymphopenia - decrease in lymphocytes (immunosuppression)

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52
Q

Agranulocytosis (neutropenia) oral presentation:

Lymphopenia sequelae:

A

ragged non-healing oral ulceration

viral/fungal infections

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53
Q

Leukocytosis (increased WBC) can be due to what 2 conditions?

A

Physiologic (infection)

Leukemia (WBC malignancy)

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54
Q

Primary oral consequence of Leukemia:

secondary:

A

diffuse gingival hyperplasia, radiolucency

infection and bleeding

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55
Q

Poverty of thrombocytes

A

Thrombocytopenia

*no platelets

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56
Q

Thrombocytopenia can be primary (immune) or secondary to another condition like ________

A

leukemia (or drug use)

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57
Q

What are 3 oral manifestations of Thrombocytopenia?

A

petechiae (red spots)

ecchymosis

purpura around necks of teeth

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58
Q

Hemophilia is an ____ linked deficiency of clotting factor ______

*causes deep bleeding, joints, internal organs

A

x linked

VIII

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59
Q

Idiopathic facial paralysis:

What nerve affected?

this is a ______ neuropathy

describe onset:

Most have _____ recovery, but there should be a neurosurgical consultation

A

Bells Palsy

VII

postviral

abrupt, unilateral, middle age

complete

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60
Q

3 attributes of Melkersson-Rosenthal Syndrome:

A

cheilitis granulomatosis

fissured tongue

facial paralysis (this is NOT Bell’s palsy)

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61
Q

Tic Douloureux:

A

Trigeminal neuralgia

*V

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62
Q

Trigeminal neuralgia affects what age group most?

If under 30 suspect what?

A

45-55

MS (demyelinating plaques)

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63
Q

Trigeminal neuralgia is what kind of pain?

follows _____ zone manipulation

lasts seconds to a minute and is _______

affects any division of V

A

acute, excruciating, abrupt

trigger

unilateral

True

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64
Q

Trigeminal neuralgia may be caused by anatomic abnormalities in what?

A

Ganglion

65
Q

Tx Trigeminal neuralgia: ____% get relief from ______ (drug)

_______ radiofrequency trigeminal gangliolysis

_______ knife radiation

neurosurgical ________

A

75%, Tegretol (anticonvulsants)

percutaneous

Gamma

decompression

66
Q

Endocrine system produces hormones that are secreted directly where?

meaning there is no…

A

blood stream

duct system

67
Q

6 components of the Endocrine System:

A

Pituitary

Thyroid

Parathyroid

Adrenal (cortex and medulla)

Pancreas (langerhans)

Gonads

68
Q

Generally there area 2 diseases for every Endocrine Organ

A

True

*overproduction and underproduction

69
Q

Hyperfunction of an Endocrine Organ can be caused by what 3 things?

A

Hyperplasia

Functional neoplasia

Loss of negative feedback signal

70
Q

Hypofunction of Endocrine Organ is usually caused by what 2 things?

A

Destruction

Loss of positive signal

71
Q

Signs/symptoms of Endocrine diseases tend to be _________

A

multifocal

*not local

72
Q

You are unlikely to diagnose an Endocrine disorder by looking in the mouth

A

True

*oral manifestations uncommon

73
Q

The pituitary gland is in the Sella Turcica below what?

A

hypothalamus

74
Q

The Anterior Lobe of the Pituitary, aka…

derived from what?

A

adenohypophysis

Rathke’s Pouch (oral mucosa)

75
Q

6 hormones secreted by the Anterior Pituitary

1 by the Pars Intermedia:

2 by the Posterior Lobe:

A

GH, ACTH, TSH, FSH, LH, LTH

MSH

ADH, Oxytocin

76
Q

What is unique about the Posterior Lobe of the Pituitary?

A

Neurohypophysis

*extension of the CNS

77
Q

GH, 2 Hyperfunction:

1 Hypofunction:

A

Giantism, Acromegaly

Dwarfism (normal proportions)

78
Q

Gigantism onset:

_____ pts have ______ syndrome

2 oral manifestations:

A

pre-pubertal

1/5, McCune-Albright

macrodontia (!), Mn enlargement/prognathism

79
Q

Giantism onset

Acromegaly onset

A

pre-pubertal

post pubertal

80
Q

4 Oral manifestations of Acromegaly:

A

Skull/jaw enlargement

Mn prognathism

Diastemas

Macroglossia

81
Q

Giantism, big

Acromegaly, big

*orally

A

teeth

tongue

82
Q

Acromegaly has Mn prognathism, often with what?

A

Anterior Open Bite

83
Q

4 Oral manifestations of Dwarfism (GH hypofunction):

A

delayed eruption, deciduous retention

microdontia

no 3rd molars

crowding

84
Q

Hyperfunction ADH:

Hypofunction ADH:

A

lots of ADH, no oral manifestations

Diabetes insipidus, no oral manifestations

85
Q

Thyroid gland located just below what?

Primarily regulates what?

2 hormones produced?

A

laryngeal prominence

cellular metabolism

thyroxine, Calcitonin

86
Q

Thyroid Hyperfunction (2):

Thyroid Hypofunction (2):

A

Grave’s, Multinodular Goiter

Cretinism (congenital), Myxedema (acquired)

87
Q

3 Oral manifestations of Hyperthyroidism:

potential complication dental Tx:

A

U shaped mass in neck, burning tongue, tremor of tongue

Thyroid Storm

88
Q

3 Oral manifestations of Cretinism (congenital hypothyroidism)

A

Large protruding tongue

Delayed development/eruption

Caries/Perio secondary to Retardation

89
Q

2 Oral manifestations Myxedema (acquired hypothyroidism)

A

Enlarged tongue

Lingual thyroid nodule

90
Q

Calcitonin is secreted by what?

A

Parathyroid

91
Q

How many Parathyroid glands are there?

Where located?

regulates what?

What hormone?

A

4-6

anterior neck (often in Thyroid gland)

Calcium

PTH

92
Q

What are 3 Oral Manifestations of Hyperparathyroidism?

A

Jaw radiolucencies

Loss of trabecular pattern “Ground Glass”

Loss of Lamina Dura

93
Q

What are 3 Oral Manifestations of Hypoparathyroidism?

A

Partial anodontia

Malfomed/hypoplastic teeth

Increased candidiasis

94
Q

Adrenal Cortex responsible for what?

Hormones produced:

A

Electrolyte/fluid balance, stress management, inflammatory response

Mineralcorticoids (Aldosterone) and Glucocorticoids (Cortisol)

95
Q

Where are Mineralcorticoids and Glucocorticoids produced?

Example of each:

A

Adrenal Cortex

Aldosterone (mineralcorticoid)

Cortisol (glucocorticoid)

96
Q

The Adrenal Medulla is responsible for the regulation of ________ and _______

Produces what 2 hormones?

A

cardiac output, blood pressure

epinephrine, norepinephrine

97
Q

Hyperfunction of the Adrenal Cortical hormones produces what Syndrome?

2 Oral manifestations of said syndrome:

A

Cushing’s

Moon face, decreased tongue/masticatory muscle mobility

98
Q

Hypofunction of Adrenal Cortical hormones produces what 2 diseases?

A

Waterhouse-Fridrichsen’s (acute)

Addison’s (chronic)

99
Q

Describe Waterhouse-Friderichsen’s Disease onset:

oral manifestations:

*remember, this is Acute Adrenocortical Insufficiency

A

sudden, death w/in 3 days

none

100
Q

Addison’s disease major potential dental complication:

2 Oral manifestations:

A

Addisonian crisis

Bronzing, macular pigment oral mucosa

101
Q

Adrenal medulla hyperfunction:

hypofunction:

A

100% pheochromocytoma

none ever

102
Q

Endocrine Pancreas scattered w/in the parenchyma of the exocrine pancreas:

A

Islets of Langerhans

103
Q

Islets of Langerhans 4 cell types

what do each secrete?

A

Alpha Cells - glucagon

Beta Cells - Insulin

Delta Cells - Somatostatin

PP cells - pancreatic polypeptide

104
Q

Somatostatin is produced by _____ cells and counteracts ________

A

Delta

GH

105
Q

Hyperfunction insulin:

Hypofunction glucagon:

A

hypoglycemia (no oral manifestations)

Diabetes mellitus

106
Q

Inadequate insulin can lead to what complication of dental Tx?

3 Oral manifestations:

A

Diabetic coma

delayed healing, infection, perio

107
Q

Puberty, Pregnancy, Menopause

A

Gonadal endocrine system

108
Q

2 sites of Gonadal Endocrine in Males:

2 sites in Females:

A

Testes, Adrenal cortex (weak)

Ovaries, Adrenal cortex (small quantities)

109
Q

Hyperfunction of Gonadal Endocrine:

Hypofunction:

A

gingival hyperplasia

oral pigmentation

110
Q

Hypofunction of Gonadal Endocrine can lead to oral pigmentations due to concomitant secretion of _______ from ______

A

MSH

pituitary gland

111
Q

The oral lesions seen in AIDS pts are similar to other immunosuppressive states/autoimmune disorders such as what 3 medically induces states?

A

Chemo

Anti-rejection meds

Marrow transplant pts

112
Q

The more complete the immune deficiency the more florid the manifestations and accelerated the clinical course, less effective the Tx

A

True

113
Q

Oral sequelae is seen in ___% of AIDS/pre-AIDS pts

A

70%

114
Q

Oral sequelae in AIDS pts include viral/bacterial/funga infections and ______

A

neoplastic disease

115
Q

The most important Tx planning considerations in pre-AIDS pts are ________ and ________

*also recognition/management oral manifestations

A

time interval for Tx completion

preparation for immunodeficient state

116
Q

3 herpes infections seen in HIV

2 HPV in HIV

A

simplex, varicella zoster, EBV

Papilloma, condyloma acuminata

117
Q

Herpes simplex in HIV are recurrent labialis and intraoral

Lesions begin as…

lesions increase in number, size, duration

Tx:

A

True

vescicles

True

Antiviral therapy, fluids, analgesics

118
Q

Varicella-zoster begin as _____

progress to ______

_____ lesions often accompany oral lesions

can manifest as more _____

A

vescicles

ulcerations

skin

florid (red)

119
Q

Tx Varicella-zoster

*remember, this relates to HIV

A

Antiviral

Topical ointment for skin lesions

120
Q

What virus is an etiologic factor in Oral Hairy Leukoplakia?

A

EBV

121
Q

Papilloma clinical presentation:

Tx:

A

cauliflower, pedunculated, normal to pink,

antiviral, surgical excision

122
Q

Condyloma acuminata clinical presentation:

Tx:

A

caulliflower, papillary, NOT pedunculated (wide base), white

antiviral of LITTLE VALUE, Surgical excision

123
Q

What oral indicator is a predictor for the progression of full blown AIDS?

positive association with…

2 possible co-factors:

A

Oral hairy leukoplakia

EBV (HHV 4)

papilloma virus, candidiasis mediated

124
Q

Clinical presentation Oral hairy leukoplakia:

A

lateral border of tongue

bilateral

asymptomatic (pts unaware)

125
Q

A white, non-wipeable plaque in a vertical/linear pattern with a shaggy surface (although sometimes smooth) that may spread to other areas

A

oral Hairy Leukoplakia

126
Q

Is Oral Hairy Leukoplakia treated in association with HIV?

Lesions may regress w/ what?

A

maybe?

anti-AIDS regimen

127
Q

4 HIV associated perio diseases:

A

Linear Gingival Erythema

NUG

NUP

Necrotising Stomatitis

128
Q

3 bacteria that rarely cause oral manifestations in AIDS pts:

A

Mycobacterium avium intercellulare

Klebsiella pneumonia

Enterobacter cloacae

129
Q

3 bacterial species increased in HIV perio pts

A

Eikenella

Wolinella

Bacteroides

130
Q

HIV associated perio disease is Candidiasis mediated

A

False

but maybe???

131
Q

HIV associated perio resembles what?

does it respond to conventional perio therapy?

A

ANUG

no - even w/ good plaque control

132
Q

Tx HIV perio:

A

difficult

*plaque control, debridement, SRP, CHX

133
Q

Previously called HIV associated gingivitis:

A soft tissue necrosis that is _______

progression:

A

Linear Gingival Erythema

very painful

to more severe in short period

134
Q

NUG in HIV, often a transitional between _______ and more severe forms of involvement

Usually affects where?

A

Linear Gingival Erythema

focal, interdental papilla, bone destruction

135
Q

NUP in HIV, severe loss of what?

Minimal _____

Interproximal ______

Loss of _____ and severe _____

A

PDL attachment

pocket formation

cratering

bone, pain

136
Q

HIV Necrotizing Ulcerative Stomatitis is _____ with spread to _______

A

NUP

soft tissue/bone OUTSIDE alveolar ridge areas

*most severe form of disease

137
Q

3 fungal infections associated with HIV:

A

Candidiasis

Histoplasmosis

Cryptococcosis

138
Q

What are the 4 Clinical Presentations of Candidiasis?

A

Pseudomembranous

Hyperkeratotic (hyperplastic)

Erythmatous (atrophic)

Angular chelitis

139
Q

Candidiasis is due to immune deficiency and is seen in ___% of AIDS/pre-AIDS pts

symptoms are variable

Tx:

A

75%

True

Anti-fungals (longer/more potent)

140
Q

Clinical presentation Pseudomembranous candidiasis:

A

Creamy white

non-wipeable

milk curd

erythematous background

141
Q

4 commonly affected areas of Pseudomembranous candidiasis (HIV related):

A

Palate

Buccal/Labial mucosa

Dorsum of Tongue

142
Q

Clinical presentation Hyperkeratotic (hyperplastic) candidiasis: 3 things

*what area is commonly affected?

A

White plaque (irregular)

non-wipe

normal colored mucosa in background

*Buccal mucosa

143
Q

Erythematous (atrophic) candidiasis clinical presentation: color:

area:

texture:

3 commonly affected areas:

A

red to pink

diffuse involvement

velvety

Palate, Buccal Mucosa, Dorsum of Tongue

144
Q

Angular chelitis Clinical presentation: May spread to skin/lip ______ areas

_______ Background

cracking, crusting, and _______ on opening movements

often accompanied by other candidiasis

A

vermillion

Diffuse Erythematous

bleeding

True

145
Q

2 most common Fungal oral infections (w/ HIV)

A

Histoplasmosis

Cryptococcosis

146
Q

Oral fungal lesions in HIV usually accompany widespread involvement

A

True

147
Q

3 neoplasms associated with HIV

A

Kaposi’s sarcoma

Non-Hodgkin’s lymphoma

Squamous cell carcinoma

148
Q

2nd most common malignancy of AIDS

when AIDS pt contracts, what is the course?

A

Non-Hodgkin’s lymphoma

aggressive, survival a few months

149
Q

Clinical presentation Non-Hodgkin’s Lymphoma (AIDS): tissue:

most commonly affected site (though can occur anywhere):

palpation:

pain:

Ulceration due to _____ often seen

May be the 1st presentation of ______ disease

A

soft tissue enlargement

Palate/Gingiva

Firm

Painless

Trauma

Systemic

150
Q

Squamous Cell Carcinoma is increased in HIV pts

A

False

*questionable

151
Q

Kaposi’s sarcoma may or may not be a real neoplasm and is diffuse, uncontrolled _______ in an immune deficient patient

A

angiogenesis

152
Q

Kaposi’s sarcoma associated with what virus?

Is the initial manifestation in ___% of AIDS pts

A

HHV VIII

30%

153
Q

Kaposi’s sarcoma is more common in what 2 demographics?

A

whites, homos

154
Q

What comes first in Kaposi’s sarcoma, oral or skin lesions?

% w/ only oral?

% KS w/ oral lesions?

% w/ skin lesions that have oral lesions

A

Oral often 1st

10%

54%

50%

155
Q

HIV KS often shows _____ clinical course

Often _____ to therapy

Less commonly seed in what demographic?

A

aggressive

resistant

pediatric

156
Q

Clinical prez, KS: _____ colored lesions

_____ to slightly raised Nodular lesions

May show _____ in Nodular phase

Solitary/multiple/diffuse

A

red to purple

macular (distinct spots)

ulceration

True

157
Q

HIV KS most has a preference for what tissue?

What 2 areas specifically?

*remember, can be anywhere

A

keratinized mucosa

Hard palate, Gingiva

158
Q

Tx KS from HIV

A

Excision for isolated lesions

Laser larger areas

Tim's Cards (140 decks)

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