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NBDE II > Path 2 > Flashcards

Path 2 Flashcards

1
Q

What causes problems in babies in embryo?

A

Teratogens

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2
Q

Definition of teratogen:

A

Any agent that can disturb the development of an embryo or fetus. Teratogens may cause a birth defect in
the child. Or a teratogen may halt the pregnancy outright.

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3
Q

Muscular dystrophy:

A

group of muscle diseases that weaken the musculoskeletal system & hamper locomotion. Characterized by progressive
skeletal muscle weakness, defects in muscle proteins, and the death of muscle cells and tissue.
- Muscular dystrophy: muscle weakness, “long face” which is characterized by a lower vertical facial height and open bite/

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4
Q

Muscle dystrophy; after local anesthetic is most likely due to? Lidocaine toxicity, increase duration of action, increase onset, Can’t
be supine

A

Lidocaine toxicity,

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5
Q

QUESTION: Pt w/ muscular dystrophy condition:

A

lower face with open bite

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6
Q

What can be seen on a patient with muscle weakness of the face? Cross bite, buccal tilting of molars, long upper face, lower face
with open bite

A

lower face

with open bite

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7
Q

Considerations for muscular dystrophy: increase in dental disease if OHI is neglected, weakness of muscles of mastication

A

weakness of muscles of mastication

decrease biting force, open mouth breathing

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8
Q

Addison’s disease

A

primary adrenal insufficiency

chronic endocrine disorder, adrenal glands do not produce
enough steroid hormones (too little cortisol & sometimes, insufficient aldosterone).

  • Symptoms generally come slowly & include abdominal pain, weakness, skin darkening and weight loss.
  • Adrenal crisis may occur with low blood pressure, vomiting, lower back pain, and loss of consciousness. An adrenal crisis can be triggered
    by stress, such as from an injury, surgery, or infection.
  • Tx: give cortisol
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9
Q

Acute adrenal insufficiency:

A

hypotension

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10
Q

QUESTION: What Addison disease causes in mouth:

A

pigmentation of the mucosa

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11
Q

Pheochromocytoma:

A

neuroendocrine tumor in medulla of adrenal gland à excess catecholamines (ex. epi)

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12
Q

Cerebral palsy (CP):

A

group of permanent central motor/movement disorders that appear in early childhood, caused by abnormal development
or damage to the parts of the brain that control movement, balance, muscle tone, and posture. Signs and symptoms vary & include: poor
coordination, stiff muscles, weak muscles, and tremors. Other problems w/ sensation, vision, hearing, swallowing, and speaking.

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13
Q

QUESTION: CP patient - which is not true?

a. 95% have cognitive impairment
b. all bruxism
c. increase in periodontitis

A

c. increase in periodontitis

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14
Q

Cerebral palsy during treatment.

A

– patient will have spastic oral mucosa

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15
Q

Pt has involuntary uncoordinated movements with larynx problem?

A

Cerebral palsy

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16
Q

Common finding in a patient with cerebral athetoid palsy:

A

Anterior Teeth fracture

- cerebral athetoid palsy: damage to basal ganglia, has both hypertonia/hypotonia

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17
Q

Case: Black girl around 7 years old presents with unilateral cross bite; she had a cleft palate that was fixed. Palate in picture looks
like a triangle and laterals are towards the palate.
A) What is the pigmentation?
B) What is the most likely cause of the crossbite?

A

racial pigmentation

early loss of laterals, due to cleft palate

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18
Q

When does cleft lip and palate develop?

A

6-9 weeks in utero

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19
Q

QUESTION: Patients with cleft lip and palate, what occlusion is mostly seen?

A

class III malocclusion

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20
Q

QUESTION: Cleft lip is more common in ; cleft palate more common in .

A

boys

girls

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21
Q

QUESTION: Pt had cleft lip and palate. Later in life during ortho analysis, what do you see?

A

Deficient maxilla, normal mand

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22
Q

Most prevalent developmental deformity in Maxilla?

A

Cleft Palate

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23
Q 
What is more commonly seen?
o Amelogenesis imperfect
o Ectodermal dysplasia
o Dentinogenesis imperfect
o Cleft lip and palate
A

o Cleft lip and palate

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24
Q

What is cleft palate class III?

A

Soft & hard palate plus alveolar process

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25
Q

What mostly gives cleft lip/palate? Genetic, autosomal dominant, autosomal recessive, environmental, multi-factorial

A

multi-factorial

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26
Q

All of the following are the reasons for closing a cleft lip except?
Support the premax on a unilat cleft
Help speech
Support the ala of the nose.

A

Support the ala of the nose.

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27
Q

Speech problems associated with cleft lip and palate are usually the result of?

A

Inability of soft palate to close air flow into the nasal

area

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28
Q

QUESTION: A cleft lip occurs following the failure of permanent union between which of the following?
A. The palatine processes
B. The maxillary processes
C. The palatine process with the frontonasal process
D. The maxillary process with the palatine process
E. The maxillary process with the frontonasal process

A

E. The maxillary process with the frontonasal process

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29
Q

Age for repair of cleft palate w/ normal canine eruption:

A

When canine tooth is 3⁄4 formed (8-9years old)

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30
Q

When correcting cleft problem, how do you end/finish?

A

Suturing lip

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31
Q

Percentage of cleft lip and cleft palate in Caucasians?

A

1/750

- Asians = 1/500, Asians have it the most common

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32
Q

Incident of cleft palate & lip in US - 1 in ____ vs Incident of cleft palate w/out lip in US 1 in ____ –

A

palate & lip 1 in 1000

palate without lip 1/2000 (CDC 2012)

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33
Q

QUESTION: What surgery will a pt with cleft palate most likely need?

A

(mandibular set back)
- Pt get cleft lip & palate surgery. This usually cases future Class III tissues so at later age, they need to come back to move the mandible to
correct Class III (mandibular setback)

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34
Q

How does a kid with fetal alcohol syndrome present with? anencephaly, midface deficiency, cleft lip

A

midface deficiency

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35
Q

Treacher Collins inheritance

A

AUTOSOMAL DOMINANT

midface deficienct
weird ears

aka mandibulofacial dysostosis
downslanted eyes

cleft palate, malocclusion, anterior open bite, enamel hypoplasia

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36
Q

Which disorder has the least developmental delay?

A

Treacher Collins syndrome

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37
Q

Treacher Collins has loss (hypoplasia) of _____. What do patients with cleidocranial dysplasia have?

A

Treacher Collins: zygomatic bone

Cleidocranial: Loss of clavicle

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38
Q

Describes patient saying they have mandibular hypoplasia, malformed ear, lower eyelids, ear pinna –

A

Treacher Collins

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39
Q

Treacher Collins syndrome à

A

know pt’s are not mentally retarded and they have ear abnormalities

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40
Q

Down’s higher risk of

A

perio dz

NOT CARIES

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41
Q

Down’s which third of face is affected

A

midfacial hypoplasia

42
Q

What orthomanifcastion does Turner syndrome and trisomy 21 associated with?

A

short midface

43
Q

What is orbital hypertelorism?

A

Wide-set eyes (seen in Crouzon, Cleidocranial dysostotosis, GOrlin Syndrome, Down’s syndrome)

44
Q

Hypertelorism definition:

A

Increased distance between eyes, or other body parts

45
Q

Which does NOT result in delayed development? Trisomy 21, Trisomy 18, Hurler Syndrome, Cri du Chat

A

Trisomy 18 (Edward syndrome)

  • Edward’s syndrome: small head (microcephaly) accompanied by a prominent back portion of the head (occiput), low-set, malformed ears,
    abnormally small jaw (micrognathia), cleft lip/cleft palate, upturned nose, narrow eyelid folds (palpebral fissures), widely spaced eyes
    (ocular hypertelorism)
46
Q

What resembles epiphyseal plate?

A

Synchondrosis
- Synchondrosis: almost immovable joint between bones bound by layer of cartilage (ex. vertebra,
epiphyseal growth plate)

47
Q

What age does the mandibular symphysis close?

A

6-9 months

Symphysis: two flat bones grow together & join

48
Q

Sphenooccipital closure, what kind of tissue fills it in?

A

Cartilage

Interstitial growth – occurs by the mitotic division and deposition of more matrix around chondrocytes already established in the
cartilage.
- Ex – CONDYLE, nasal septum, and spheno-occipital snychondrosis

49
Q 
Which of these undergo suture closure latest?
• sphenoethmoidal
• Sphenoccipital
• Intrasphenoid
• Intraoccipital
A

Sphenoccipital

50
Q

What is synostosis?

A

ABNORMAL FUSION OF BONES

51
Q

What is craniosynostosis?

A

Early closure of suture between bones

52
Q

Crouzon syndrome

A

Autosomal dominant, 1st branchial arch syndrome, mutation in fibroblast growth factor
receptor II à fibrous joints between certain bones of the skull (cranial sutures) close prematurely (craniosynostosis).

53
Q

characteristic x ray of Crouzon

A

beaten metal

54
Q

how does crouzon present

A

Most notable characteristic of Crouzon syndrome is cranial synostosis, but it usually presents as
brachycephaly, which results in the appearance of a short and broad head, exophthalmos or
proptosis (bulging eyes due to shallow eye sockets after early fusion of surrounding bones),
hypertelorism (greater than normal distance between the eyes), hypoplastic maxillary, & mandibular
prognathism
Fuzzy radiograph!

55
Q

Synostosis – early/late closing of sutures - which syndrome

A

Crouzon syndrome

56
Q

Patient w/ deficient mid-face, proptosis, etc?

A

Crouzon syndrome

57
Q 
Pt has ocular proptosis, maxillary hypoplasia, premature suture closing (synostosis)?
treacher-collins
Crouzon
Pierre robin
cleidocranial
A

Crouzon

58
Q

Hurler and Hunter syndromes class

A

Both are lysosomal storage disease (MCUOPOLYSACCHARIDOSIS)

59
Q

hurler inheritance

A

mucopolysacch type I, gargoylism
Autosomal recessive
buildup of GAGs
deficienct of alpha-L

heparin sulfate and dermatan sulfate

60
Q

hunters syndrome inheritance

A 
mucopoluysacch 2
X-linked recessive
defect in achoring between epidermis and dermis
friction and skin fragility
iduronate-2-sulfatase --> GAG buildup
61
Q

Hurler and Hunter’s syndromes, what do they have in common?

A

They both have mucopolysaccaridosis & buildup of GAGs

62
Q

Cleidocranial dysostosis =

A

hereditary congenital disorder (usually
autosomal dominant), where there is delayed ossification of midline
structures. Bone defects usually involve clavicle (hypoplastic or aplastic clavicle) & skull. Short, big head, shoulders moved in.

Dental – narrow high palate, increased rate of cleft palate, presence of many unerupted permanent, retained primary, & supranumery
teeth w/ distorted crowns/root shape

63
Q

What is the most significant finding in cleidocranial dysplasia? odontoma, supernumery teeth, sparse hair, multiple impacted teeth,
retained teeth

A

supernumery teeth

64
Q

Cleidocrainal dysplasis in mouth–

A

supernumerary teeth & problems with eruption

65
Q

QUESTION: Cleidocranial syndrome: x ray with

A

absence of clavicle

66
Q

Which will give you very narrow facial structures and delayed eruption of permanent teeth?

  • cleidocranial syndrome
  • downs syndrome
A

• cleidocranial syndrome

67
Q

What allows for compression of skull during birth?

A

Fontanelles

68
Q

What is the part of the infant’s head that allows it to change shape?

A

Fontanelles (enable
the bony plates of the skull to flex
- Fontanelles close anterior 12-18 months, posterior 3-4 months

69
Q

What is the part of the infant’s head that allows it to change shape?

A

Fontanelles

70
Q

Which structures in a baby allow the head to deform in the birth canal?

A

fontanelles

71
Q

Papillon–Lefèvre syndrome (PLS) -

A

palmoplantar keratoderma w/ periodontitis. It’s an
autosomal recessive disorder caused by a deficiency in cathepsin C.
- Severe perio à early/young loss of primary & permanent teeth after eruption of 1st
molar
- Hyperkeratosis of palm & feet sole

72
Q

15 yr. old w/ edentulous and keratosis on hands and feet. They gave ugly
picture of thick soled feet. à

A

Papillon Lefevre syndrome

73
Q

What is Papillon–Lefèvre syndrome?

A

You get periodontitis, keratosis on hands

and soles, and premature loss of primary teeth.

74
Q

Hyperkeratosis in hands and feet –

A

Papillon-Lefevre Syndrome

75
Q

Pierre Robin Syndrome:

A

Pierre Robin Syndrome:

76
Q

Pt has glossoptosis, micrognathia, and cleft palate?

A

Pierre Robin syndrome

- Glossoptosis = refers to the downward displacement or retraction of the tongue

77
Q

Sturge-Weber syndrome:

A

neurological disorder present at birth. Characterized by a port-wine stain on the face and
brain or eye abnormalities due to overabundance of capillaries near skin surface. Sometimes seizures or neurological
symptoms

78
Q

Sturge-Weber syndrome?

A

vascular malformation, eye and hemangioma

79
Q

Portwine stain

A

Sturge-Weber

Angiomatosis of leptomeninges

80
Q

Pt has high cholesterol, hypertension and diabetes, metabolic problem, which does he have:

A

metabolic syndrome

81
Q

Pt has BMI of 36, is overweight & has high cholesterol. What syndrome?

A

Metabolic Syndrome

82
Q

QUESTION: What is the normal % fat intake per day-

A

30%

- Recommended daily dose of fat: 30% of total calorie and saturated fat is 10% of daily calorie intake

83
Q

Which is not endocrine gland? Parathyroid, thyroid, adrenal, parotid

A

parotid

84
Q

Which do you give a hyperparathyroid child for normal development of teeth?

A

Vitamin D (Brings in Ca+)

85
Q

Thyrotoxicosis symptoms –

A

DIAPHORESIS (sweating), fever, hypertension and TACHYCARDIA

- thyroid storm is a severe version of thyrotoxicosis

86
Q

Thyrotoxic pt. manifestation?

A

Tachycardia

87
Q

QUESTION: LA with epinephrine contraindicated in? Uncontrolled Diabetes, hypothyroidism, hyperthyroidism

A

hyperthyroidism

88
Q

Symptoms of hypothyroid attack:

A

loss of brain function due to severe, longstanding low levels of thyroid hormone in the blood
(hypothyroidism)
- Hypothyroidism primary symptoms are altered mental status & hypothermia. Hypoglycemia, hypotension, hyponatremia, hypercapnia,
hypoxia, bradycardia, hypoventilation may also occur.

89
Q

Myxedema is due to?

A

severe hypothyroidism

- Myxedema: swelling of skin, waxy consistency

90
Q

With which endocrine systemic disease does thick hair become thin hair?

A

thyroid – hypothyroidism (cretinism in kids and

myxoedema in adults)

91
Q

PT was gaining weight, has lower voice, fine hair, feels cold –

A

hypothyroidism

- symptoms of hypothyroidism: weight gain, bradycardia, cool to touch/cold, fatigue

92
Q

QUESTION: Which thyroid drug doesn’t let iodine bond to hormone?

A

Radiated Iodide (for hyperthyroidism)

93
Q

QUESTION: Graves’ Disease

A

(Hyperthyroidism) -

exophthalmos

94
Q

Thyroid hormone decrease, which drug do you give?

A

Levothyroxine (for hypothyroidism)

95
Q

Hypophosphatasia -

A

metabolic bone disease, low alkaline phosphatase

96
Q

Increase in alkaline phosphatase is related to?

A

Hyperparathyroidism

97
Q

Decreased alkaline phosphatase is related to:

A

Hypophosphatasia

98
Q

What disease causes decrease in alkaline phosphatase? Malnutrition, hypophosphatasia, hypothyroidism, pernicious anemia

A

hypophosphatasia

99
Q

Central Giant Cell Granuloma is seen with pts with which condition?

A

Hyperparathyroidism

100
Q

Osteoporosis is associated with which of the following diseases?

A

Hyperparathyroidism

NBDE II (12 decks)

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