UCSF Pathology/Microbiology Flashcards
What type of virus is Hepatitis B?
DNA virus
Incubation time for Hepatitis B?
1-6 months
Describe symptoms of Hepatitis B
Jaundice
Fatigue
Flu-like symptoms
*30% of people have No symptoms with infection
What is commonly seen in patients with HBV?
No symptoms
What is the first detectable evidence of HBV?
HBsAg (Hep B Surface Antigen)
When does HBsAg appear?
appears within 3-4 weeks of exposure and 1-2 months prior to clinical disease
What does the presence of HBc IgM indicate?
Indicates acute infection
It takes time to develop the anti-HBs but anti HBc IgM develops initially.
What does the presence of HBeAg indicate?
May indicate viral replication. Presence associated with increased infectivity in association with HBsAg
What would the presence of Anti-HBe indicate?
This is a favorable sign in carriers, suggest that a low degree of infectivity is present
What would the presence of Anti-HBs indicate?
Indicates past infection and provided immunity. This appears after HBsAg disappears
What antibody is first to fight an acute infection?
IgM - also an indicator of current infection
What does IgG indicate?
Indicator of past or recent infection. Represents 75% of circulating antibodies
Define Paget’s Disease?
An uncommon fibro-osseous condition of unknown cause that produces ENLARGEMENT of the skull and jaws.
What are the 2 most common features or clinical signs of Paget’s Disease
- Distinctive radiographic appearance of Cotton Wool
- Increased alkaline phosphatase
Describe the prognosis of Paget’s Disease
Continual enlargement and weakening of bones
- Potential of undergoing malignant transformation
Describe clinical features of Cherubism
Cherub appearance due to bulging of the mandible
- multilocular cysts of both jaws
- giant cell tumors are wide spread
- premature tooth loss
A patient presents with symmetric bilateral enlargement in posterior areas of the mandible.
- Radiographs reveal large, multilocular radiolucencies
Most likely Cherubism (familial fibrous dysplasia)
How is Cherubism inherited?
Autosomal dominant
What is Eagle’s Syndrome
Elongation of the Styloid process and stylohyoid ligament calcification
Symptoms of Eagle’s syndrome
The tissues in the throat rub on the elongated styloid process during the act of swallowing. This results in pain along the glossopharyngeal nerve
- Also pain when turning head or extending the tongue
What is Osteopetrosis?
Inhibition of Bone Resorption
- Due to lack of osteoclasts activity. They are present but with no function
Describe the difference between Osteopetrosis seen in infants vs that seen in adults
Infantile: Autosomal recessive. Very severe with common fractures
Adult: Autosomal dominant. Milder form that starts off asymptomatic but progresses
What is the average age that an Odontogenic Keratocyst (OKC) is found?
20
WHere is the most common location of an OKC?
Mandibular ramus or third molar region
Describe radiographic appearance of an OKC
Unilocular or multilocular and well demarcated. It mostly displaces roots but can cause root resorption
What is an Ameloblastoma?
Uncommon benign jaw neoplasm of odontogenic epithelium.
What is the radiographic appearance of an Ameloblastoma?
Multilocular radiolucency.
- **Soap Bubble appearance
Expansive and destructive
Where are ameloblastomas commonly found?
Mandibular ramus
Often associated with boney impacted wisdom teeth
Where are Calcifying Epithelial Odontogenic Tumors commonly found?
Mandibular molar area
Describe characteristics of a Calcifying Epithelial Odontogenic Tumor?
Swelling, flecks of calcification, expansive
-**Driven snow appearance
What is Fibrous Dysplasia?
An asymptomatic regional alteration of bone in which normal architecture is replaced by fibrous tissue
Characteristics of Fibrous Dysplasia
Expansive, can cause externally visible deformities
**Ground Glass Appearance or **Orange Peel appearance
What is the most common location for a Central Giant Cell Granuloma?
In the mandibular anterior that often crosses the midline.
- 70% in the mandible
Central Giant Cell Granulomas mostly affect which gender? and what age?
Females
60% cases are before age 30
Where do Giant Cell Tumors commonly occur?
Most often in epiphyses of long bones
Can be in jaws
What is an Osteoblastoma?
Benign neoplasm of bone that arises from osteoblasts
Where do Osteoblastomas commonly occur
Mandible
What is the most common gender and age for Osteoblastomas
Male
85% before the age of 30
What is a Cementoblastoma
Odontogenic neoplasm of cementoblasts.
Where is the most common location for Cementoblastomas
Mandible with >90% being in the molar and premolar region
What gender and age are cementoblastomas most common?
Male, predominantly in children and young adults before the age of 25
Describe radiographic appearance of Cementoblastomas
Radiopaque mass fused to one or more tooth roots, surrounded by thin radiolucent rim
What is a Chondroma
Benign tumor composed of mature hyaline cartilage
What is an Osteosarcoma
Malignancy of mesenchymal cells that produces osteoid or immature bone
Although Osteosarcomas are uncommon in the jaw, describe where they would be found in both maxilla and mandible?
Maxilla - Inferior portion (alveolar ridge, sinus floor, & palate)
Mandible - Posterior body and horizontal ramus
What gender is more commonly found with Osteosarcomas
Males 2:1 to female
Describe what Condensing Osteitis is
A common condition without severe signs or symptoms recognized by a well-defined radiopacity at the apex of a non-vital toot
What is Addison’s Disease
Insufficiency of adrenal cortex
Hallmark clinical sign of Addison’s disease
Bronzing of the skin
Hypopituitarism may result in what?
A form of Dwarfism
What does Hyperpituitarism lead to?
Gigantism in children.
Acromegaly in Adults
What is Cushing’s Syndrome
Hyper function of the adrenal cortex
Hallmark clinical signs of Cushing’s Syndrome
Buffalo Hump
Moon Face
Hypothyroid leads to what diagnoses in adults and children?
Adults: Myxedema
Children: Cretinism
Cretinism is a common cause of what?
Delayed eruption of teeth
Hyperthyroidism leads to what disease?
Graves Disease
Graves Disease is related to what dental irregularity?
Increased eruption rate
What disorder is related with Older women with “stones, bones, moan and groans”
Hyperparathyroidism
Explain what happens to calcium in Hypoparathyroidism vs Hyper parathyroidism
Hypo: Decreased Ca++ excretion from bone
Hyper: Increased Ca++ out of bones and into serum
What is a Residual Cyst
True cyst inadvertently left behind during extraction of a tooth.
What is a Primordial Cyst
An epithelial-lined jaw cyst appearing as a radiolucency in the alveolar process unassociated with a tooth
Where are primoridal cysts most commonly found
area of the third molars
What is a Simple Bone Cyst
Benign, empty or fluid containing cavity inside bone
Unknown cause - maybe trauma
What is an Aneurysmal Bone Cyst
Intraosseous blood-filled spaces
Unknown cause
What is a Dentigerous Cyst
Cyst found between the crown and reduced enamel epithelium.
Associated with impacted teeth around CEJ area
What is a lateral cyst
Same as a periapical cyst but on the lateral aspect of the tooth
Develops from the rests of the dental lamina
What is a Globulomaxillary Cyst
Occurs between the maxillary lateral incisor and the canine
Often produces divergence of the roots
What is the most common Sialolithiasis?
Sublingual
Most common malignant bone tumor
Osteosarcoma or multiple myeloma
What does Multiple Myeloma look like on radiographs?
Punched out mandible
What is the blood glucose level in a patient with Diabetes
> 160 mg/dl
Rheumatic fever is caused by what?
Stretococcal bacteria
Subacute bacterial endocarditis is caused by waht?
Streptococcus Aureus
Most common oral manifestation of an HIV infection
Candidiasis
Osteomyelitis is caused by what?
Mycobacterium tuberculosis (MBT)
