OPTH727 - exam #4

Oral manifestations of HIV - all infectious agents go 'gangbuster' (8)

1) HHV 1 (and 2) - herpetic gingivostomatitis - much more severe 2) HHV8 - kaposi's sacroma 3) HPV 4) C. albicans - candidiasis 5) necrotizing gingivostomatitis - like what you might see in leukemia, neutropenia, agranulocytosis 6) more advanced periodontitis 7) oral hairy leukoplakia (EBV mediated) 8) CMV mediated disease

Main causes of immune compromise (7)

1) HIV/AIDS 2) certain blood cancer (leukemia) 3) other WBC disturbances (dyscrasias) 4) uncontrolled diabetes 5) medications 6) liver/spleen dysfunction - important 7) nutritional deficiencies - more common outside US

4 types of leukemia

1) acute lymphocytic leukemia - mostly kids.. one of most common childhood malignancies 2) acute myelogenous leukemia 3) chronic lymphocytic leukemia - most common type of leukemia overall - affects most adults 4) chronic myelogenous leukemia - associated w/ Philadelphia chromosome - translocation of genetic material btw chromosome 9 & 22 that produces oncogene

Rheumatoid arthritis 1) caused by? 2) key for diagnosis? 3) may be seen concurrently with?

1) autoantibodies against antigens w/in joint spaces 2) serological testing (for autoantibodies) 3) lupus, scleroderma, rheumatic fever (know this slide for exam)

Describe chrondroma (2)

1) benign neoplasm of cartilaginous origin 2) sinovial chrondromatosis - numerous benign cartilaginous tumors deposit in joints - usually elbow, knee, hip, & shoulder; TMJ may also be affected but rarely (know this slide for exam)

Describe osteoblastoma (2) aka osteoid osteoma

1) benign neoplasm of osteoblasts; may be destructive, but still benign 2) radiolucent or mixed radiopaque/radiolucent (know this slide for exam)

Hematologic disorders - tools of the trade (3)

1) blood testing - blood cell counts (CBC) - many, many more advanced tests 2) bone marrow biopsies 3) clinical/radiographic examination - splenomegaly - history

Commonalities of the 4 'deep' fungal infections (5)

1) causative fungal spores found in soils (often excrement of particular animals) - diseases are region specific 2) fungal spores usually enter body through inhalation - primary site of infection usually lungs 3) primary infection causes self-limiting flu-like disease or no disease at all 4) immunocompromise may lead to more serious disease - more severe respiratory disease or could lead to fungi entering blood stream (septicemia) or distribution to other tissues (dissemination) - dissemination to oral cavity or skin leads to oral blisters, ulcers, or swellings (may look similar to oral cancer) 5) granulomatous inflammation - histological presentation of disease that helps diagnosis

Multipotent hematopoietic stem cell = (2)

1) common myeloid progenitor 2) common lymphoid progenitor

Clinical & radiographic features of Pagets (5)

1) cotton wool appearance of bone radiographically 2) bone pain 3) bones become thickened, enlarged, weakened, & susceptible to fracture 4) pelvis, femur, lumbar vertebrae, & skull most affected - jaws 17% of cases 5) lab testing: elevated serum alkaline phosphatase levels

Cyclic neutropenia 1) describe 2) affects? 3) cycle? 4) leads to? 5) oral manifestations?

1) cyclic reduction of neutrophils 2) children 3) 21 day cycle, very low neutrophils for few days then back to normal 4) constant illness 5) same as generalized neutropenia (NUG)

General neutropenia 1) describe 2) causes? (3) 3) results in? 4) oral? (3)

1) decrease in # of circulating neutrophils 2) many causes - leukemia - chemotherapy - infections exacerbated by immune compromise 3) infections - fever, malaise - especially bacteria - often times, no abscess (need neutrophils for acute inflammation) 4) - frequently ulcerated gingiva (necrotizing ulcerative gingivostomatitis) - can see ulcers on tongue, buccal mucosa - early periodontal disease

Osteogenesis imperfecta - clinical features (3)

1) depending on severity: multiple bone fractures, growth impairment, bone deformities, hyperextensive joints - may see facial deformities 2) in some cases, blue sclera & hearing deficits seen 3) dental alterations may be present - will resemble dentinogenesis imperfecta = opalescent teeth, pulpal obliteration

Fibrous dysplasia 1) describe 2) caused by? 3) normal bone is replaced by? 4) what bones affected? 5) growths may present in? 6) growth replaces? 7) may involve?

1) developmental tumor-like condition 2) genetic mutation of GNAS gene - mutations usually sporadic & post-zygotic (not inherited from parents) 3) mix of fibrous CT & immature bone 4) many different bones - craniofacial bones, ribs, femur, tibia 5) childhood & continue into adulthood 6) normal bone continues growing & produces enlargement (swelling) & 'ground glass' radiographic appearance 7) one bone (monostotic) or several bones (polyostotic)

Osteogenesis imperfecta 1) describe 2) incidence 3) numerous? 4) large?

1) diverse group of genetic diseases all characterized (in general) by osteopenia & bone fragility 2) rare ~1:10,000 3) different mutations in many different genes all cause similar clinical presentation - most cases exhibit mutations in type 1 collagen genes; COL1A1 or COL1A2 4) large diversity in clinical severity

Non-hodgkin's lymphoma 1) what is it? 2) clinical behavior? 3) origin? 4) characterized based on? (3) 5) usually arises in? 6) presentation?

1) diverse group of lymphocytic malignancies (nearly 100 subtypes) 2) highly variable clinical behavior - some indolent & some extremely aggressive 3) may be B-cell or T-cell origin 4) - histomorphology of lymphocytes - cell surface antigen profile - genetic modifications 5) lymph nodes - grow as solid masses 6) can have 'extra-nodal' presentation (I.e found outside lymphoid tissues - bone or soft tissues) - oral lymphoma

Fibro-osseous lesions 1) describe 2) how many entities that affect the jaws exist? 3) what are they?

1) diverse group of processes that are characterized by replacement of normal bone by mix of fibrous CT that is partially calcified 2) 3 3) - fibrous dysplasia - cemento-osseous dysplasia (somewhat common condition, found in tooth bearing areas of jaws) - ossifying fibroma (potentially aggressive tumor of jaws; obviously not all cases are aggressive)

Bleeding disturbances (too much bleeding bc of insufficient clotting) 1) most often clotting 'issues' are __ related 2) acquired conditions (3) 3) inherited (3)

1) drug related - use of anti-clotting medications - when blood too 'thin,' hemorrhage more easily 2) - thrombocytopenia - not enough platelets generated - vitamin K deficiency - liver disease - many clotting factors produced in liver 3) - von willebrand's disease - affects both males & females - hemophilia A - males only - hemophilia B - males only

Osteoradionecrosis (ORN) 1) describe 2) far more common in? 3) presents?

1) exposed, non-vital bone following radiation (cancer therapy) - many head & neck cancers treated partly by radiation 2) mandible than maxilla 3) similarly to MRONJ - exposed, non-vital bone

Psoriatic arthritis 1) describe 2) thought to be?

1) found in pts w/ psoriasis (red patches of skin topped w/ silverly scales) 2) autoimmune, but diagnosis based on concurrent skin lesions, not serology (know this slide for exam)

Bone fracture 1) most common bone pathology? 2) fracture may be? 3) common symptoms of fracture? 4) most commonly due to? 5) fracture may occur?

1) fracture (break in continuity of bone) 2) partial or complete 3) pain & swelling 4) trauma (break leg while skiing) - usually substantial amount of force required to cause fracture 5) either spontaneously or w/ very minor trauma to bones already weakened by disease = pathological fracture (know this slide for exam)

Osteomyelitis 1) describe 2) types? 3) most serious cases involve? 4) often associated with? 5) may also result from?

1) general term to indicate infection of bone 2) many types exist - some mild - some severe - some acute infections containing pus, some chronic 3) medulla of bone 4) systemic disease - immune compromised - serious infection from another part of body spreads to bone (via septicemia) eg tuberculosis 5) direct access of bacteria via open wound - could be fracture (pathological or traumatic) or other bone injury - jaws unique bc house teeth.. teeth provide open access from oral cavity (filled w/ bacteria) to bone (know this slide for exam)

Oral manifestations of HIV - in addition (5)

1) generalized lymphadenopathy (cervical) 2) osteomyelitis 3) increased cancer rate - lymphoma (may types virally mediated - EBV) - squamous cell carcinoma 4) deep fungal infections 5) molluschi contagiosum (poxvirus)

Agranulocytosis 1) describe 2) clinical manifestations? 3) causes?

1) granulocytes severely lowered (granulocytes = neutrophils, basophils, eosinophils) 2) very similar to neutropenia - increased infections including oral infections 3) often drug-induced, chemotherapy

'Deep' fungal infections w/ commonalities (4)

1) histoplasmosis 2) blastomycosis 3) paracoccidomycosis 4) coccidomycosis HB PC

Deep fungal infections (7)

1) histoplasmosis 2) blastomycosis 3) paracoccidomycosis 4) coccidomycosis 5) cryptococcus 6) mucoromycosis (mucor) 7) aspergillosis CC MA HB P

Arthritis 1) describe 2) symptoms 3) what joints affected? 4) types (4)

1) inflammation of joints & subsequent destruction of cartilage 2) pain, reduced range of motion, & stiffness 3) any joint 4) osteoarthritis, rheumatoid arthritis, psoriatic arthritis, gout (know this slide for exam)

Von Willebrands disease 1) cause? 2) far more common than? 3) usually __ bleeding disease 4) describe

1) inherited (genetic) - autosomal dominant, males & females affected (hemophilia is X-linked recessive, males more affected) 2) hemophilia 3) mild 4) abnormal VW factor - VW factor aids platelet adhesion at bleeding site

Why are jaws unique bones? (2) - for these reasons, jaws have?

1) jaws only bones that have other organs growing w/in them (teeth) 2) teeth exposed to outside world w/ bad things trying to harm them (bacteria) - compromise in tooth structure provides direct conduit for bacteria to reach bone - several unique pathological entities (far more susceptible to infection/inflammation)

Vitamin D-dependent rickets 1) due to? 2) inheritance? 3) symptoms?

1) lack of 1-alpha-hydroxylase that converts vitD to active form 2) autosomal recessive 3) similar to rickets

Examples of hematopoietic neoplasia (6) *which may be highly aggressive

1) leukemia* 2) lymphoma* - hodgkins - non-hodgkins 3) multiple myeloma* 4) myelodysplasia 5) langerhans cell histiocytosis 6) polycythemia vera LLL MMP

Why palpate head & neck during exams? (2)

1) look for enlarged lymph nodes - regular sized nodes not palpable - lymphadenopathy = enlarged nodes sometimes enlarged nodes = very bad things (I.e metastatic disease or primary cancers) 2) look for other swellings/asymmetries - any # of pathologic entities may present in head & neck area: epidermoid cysts, lipomas, developmental cysts, etc

Leukemia 1) what is it? 2) results from? 3) what cells are created? 4) normal blood cells? 5) that^ may lead to? (3) 6) treated with? 7) what happens if cells spill out in circulation?

1) malignancy of bone marrow stem cells 2) uncontrollable cell division inside bone marrow 3) non-functional immune cells created 4) displaced by malignant cells 5) - anemia due to fewer RBCs - increased infections due to fewer WBCs - reduced clotting ability due to fewer platelets (thrombocytopenia) 6) chemotherapy - may further diminish blood counts - bone marrow transplant can replenish bone marrow stem cells destroyed by chemotherapy 7) produce tumor-like masses - in oral cavity, gingival enlargement can be seen

Hodgkins disease (Hodgkins lymphoma) 1) what is it? 2) malignant cells are? 3) most common sites? 4) __ age peak 5) many __

1) malignancy of lymph nodes (& spleen) 2) reed-sternberg cells 3) cervical & supraclavicular nodes 4) bimodal - peak #1 btw 15-35 - peak #2 older than 50 5) many subtypes - all carry different prognosis, treatment regimens 'owl-shaped eyes'

Multiple myeloma 1) describe 2) presents in? 3) often? 4) almost always in? 5) radiographically? 6) characterized by?

1) malignancy of plasma cell origin 2) bone 3) multifocal 4) adults 5) multiple, well-defined, 'punched out' radiolucencies 6) presence of bence-jones proteins in urine or serum

Thrombocytopenia 1) describe 2) when would you might see symptoms? 3) causes (4)

1) marked decreased in circulating platelets (normal is 150-400 k/uL) 2) platelet count <100 3) - leukemia - reduces # of platelets produced - chemotherapy - reduces # of platelets produced - drug rxn (heparin) - causes immune-mediated destruction of platelets - diseases that cause splenomegaly = portal hypertension secondary to liver disease, leukemia

Common causes of bone ischemia/necrosis (5)

1) medications 2) radiation therapy 3) ostemyelitis 4) tumors 5) pathological fracture # of factors that causes bone ischemia/necrosis

Metastatic disease to bone 1) most common form of cancer affecting bone? 2) common sites of metastasis? 3) are jaw metastases common? 4) common site of metastatic disease in jaw? 5) most common symptoms?

1) metastatic disease 2) vertebrae, ribs, pelvis, & skull 3) rare (but definitely occur) 4) posterior mandible 5) pain, dysesthesia, and/or swelling (know this slide for exam)

Fibrous dysplasia cont 1) polyostotic types are? 2) polyostotic types are more associated with? (3)

1) more rare & severe 2) some multi-organ syndromes - Jaffe-Lichenstein syndrome = polystotic FD & cafe-au-lait pigmentations - McCune-Albright syndrome = polystotic FD & multiple endocrinopathies (know this slide for exam)

What infections include -mycosis but are not fungal infections? (2)

1) mycosis fungoides - T-cell lymphoma found on skin 2) actinomycosis - bacterial infection - actinomycetes (bacteria) look like fungus when clumped together

Acquired anemia 1) most common cause worldwide? 2) other causes? (4)

1) nutritional deficiencies (iron, B12, folate) 2) - inflammatory diseases, chronic infections, liver or kidney disease - diseases of spleen (splenomegaly) - blood cancers (leukemia), cancer treatment (chemotherapy) - internal bleeding (know this slide for exam)

Odontogenic cysts (3)

1) odontogenic keratocyst (more aggressive) 2) radicular cyst - inflammation from necrotic tooth pulp travels to bone & causes cystification of remanent epithelial cells 3) dentigerous cyst - common cyst always associated w/ impacted tooth - when tooth impacted, tooth organ less likely to resolve; epithelial cells more likely to be present & cystify (know this slide for exam)

Paget disease of bone 1) aka 2) describe 3) results in? 4) cause? 5) who is affected?

1) osteitis deformans 2) abnormal, haphazard deposition of bone 3) skeletal distortion & weakening 4) unknown - some cases, genetic cause identified, but most causes, no genetic cause identified 5) primarily ppl of Anglo-Saxon descent (high rates in UK, New Zealand, Australian); ~1% of ppl in USA are affected - adult onset, usually over 40

Primary bone neoplasms - entities (6)

1) osteoma 2) osteoblastoma aka osteoid osteoma 3) osteosacroma 4) chrondrosacroma 5) chondroma 6) ewing sacroma (know this slide for exam) OOO CCE

Osteoarthritis 1) incidence? 2) caused by? (4) 3) symptoms?

1) overwhelmingly most common - affects tens of millions of ppl 2) aging, abnormal joint loading, crystal deposition, constant wear & tear 3) pain/dysfunction usually constant (know this slide for exam)

Gout 1) describe 2) produces? 3) what contributes to propensity for gout?

1) particular type of arthritis in which uric acid crystals deposit in joints 2) episodic, severe pain - redness, swelling, & pain often on big toe - joint discomfort may last few days to few weeks 3) dietary factors & systemic diseases (know this slide for exam)

Describe osteomas (4)

1) proliferation of mature, lamellar bone 2) example = tori 3) common, not destructive (some argue if real neoplasms) 4) radiopaque (know this slide for exam)

Aplastic anemia 1) common? 2) causes? (2) 3) describe 4) oral manifestations?

1) rare & life-threatening 2) environmental toxins & antibiotic chloramphenicol 3) failure of bone marrow to produce all blood cells (RBCs, WBCs, platelets) 4) similar to neutropenia

Vitamin D deficiency 1) common in US? 2) in young children/infants? 3) in adults?

1) rare bc of fortification of milk & cereal w/ vitamin D 2) rickets - growth impairment - bowing of long bones (legs) occurs bc of loading of weak bones - hypomineralization of teeth - weak overall bone structure - susceptible to pathological fracture 3) osteomalacia - weak overall bone structure, susceptible to pathological fracture - no tooth abnormalities.. dentition already developed

Vitamin D-resistant (independent) rickets 1) describe 2) inheritance? 3) will supplementation w/ vitamin D mitigate symptoms?

1) rare condition producing similar symptoms as vit D dependent rickets - growth impairment, bowed long bones - vit D independent does not have tooth abnormalities 2) X-linked dominant trait (not a lot of these) - males more severely affected, but females too - mutation in zinc metalloproteinase gene 3) no

Osteopetrosis 1) describe 2) what does it lead to? 3) ^why? 4) general characteristics? (3)

1) rare group of hereditary skeletal disorders characterized by markedly increased bone density 2) increased bone density does not lead to stronger bones; more susceptible to fracture 3) strong bone cortex & spongy medulla allow great resistance to traumatic force; osteopetrosis = marrow spaces filled w/ bone, so bone weaker & more susceptible to fracture 4) - numerous types of disease w/ spectrum - some clinical features: reduced hematopoiesis bc bone grows into marrow spaces increased fractures & osteomyelitis - mutations in one of several genes cause disease (know this slide for exam)

Hypophosphatasia 1) describe 2) characterized by? 3) one of first presenting signs of disease? 4) clinical manifestation?

1) rare metabolic bone disease - many types, variable severity 2) deficiency of alkaline phosphatase 3) premature loss of primary teeth - tooth loss caused by lack of cementum on root surfaces 4) similar to rickets - growth impairment - bowing of bones - weak bones due to poor mineralization of skeleton

Describe ewing sacroma (2)

1) rare, aggressive, malignant tumor of mesenchymal stem cell origin 2) mostly children & adolescents (know this slide for exam)

Langerhan cell histiocytosis cont 1) appearance when alveolar bone is destroyed? 2) may look like? 3) __ appearance 4) could be in what position? 5) disease can?

1) scooped out appearance 2) severe perio disease 3) 'teeth floating in air' 4) periapical position - may look like periapical pathology (cyst or granulation tissue associated w/ dental infection) 5) break out of bone & into gingiva & create soft tissue mass

Hemophilia 1) clinically? 2) treatment? (3) 3) dental implications?

1) similar to thrombocytopenia - hematoma, ecchymoses, purpura; uncontrolled bleeding in severe cases 2) - clotting factor replacement therapy (as needed) - mild hemophiliacs - may need clotting factor supplementation when undergoing surgery - severe hemophiliacs - take clotting factors replacement regularly = may have bleeding into joints = hemarthrosis 3) be very careful - get med consult for pts w/ clotting diseases (thrombocytopenia, von willebrands, hemophilia, liver diseases, pts on anti-clotting meds)

Inherited anemia 1) what diseases? (2) 2) defects (or polymorphisms) in? 3) hence called?

1) thalassemia & sickle cell disease 2) genes that produce hemoglobin 3) hemoglobinopathies (know this slide for exam)

Potential board question: which diseases lead to granulomatous inflammation? (5)

1) tuberculosis (caseating) 2) Crohn's disease 3) sarcoidosis 4) deep fungal infections 5) foreign body reactions & few others

Langerhans cell histiocytosis 1) describe 2) histological? 3) involvement? 4) age range? 5) what is often affected?

1) tumor of histiocytic cells 2) proliferation of histiocytes & eosinophils 3) single or multi-organ involvement 4) wide age range - high % of cases found in kids under 15 y/o 5) jaws

Polycythemia vera 1) describe 2) almost always in? 3) problems?

1) uncontrolled proliferation of RBCs - often has concurrent proliferation of platelets also 2) adults 3) greater propensity for thrombus formation - excess cells thicken blood - slows down flow - leads to increased propensity for thrombus formation

Kaposi's sacroma 1) describe 2) clinical manifestation 3) __ associated 4) associated with?

1) unusual vascular neoplasm 2) purple nodules, papules, macules 3) HHV8 4) immune compromise - HIV/AIDS - organ transplant pts - immunosenescence - seen in elderly & Italian or mediterranean men

Burkitt lymphoma 1) describe 2) tends to involve? 3) often? 4) usually seen in? 5) histological appearance

1) very aggressive lymphoma (initially described in Africa) - associated w/ EBV 2) jaws 3) multifocal 4) young children 5) 'starry night sky'

Osteoporosis 1) describe 2) makes patient susceptible to? 3) term 'osteoporosis' really more of? 4) what may cause osteoporosis?

1) very common condition that results in reduced bone density 2) reduced bone density makes pt more susceptible to pathological fracture 3) sign than a disease itself (similar to anemia) 4) many diseases/conditions; hormone disturbances, malnutrition, metastatic disease, other systemic diseases (know this slide for exam)

Where do we see lymphoid hyperplasia intraorally? (3)

1) waldeyer's ring - lymphoid tissue in oropharynx - tonsils - filled w/ lymphoid tissue; pharyngeal, palatine, lingual - soft palate 2) floor of mouth 3) posteriolateral tongue

What is anemia? 1) most often? 2) often seen in? 3) main symptoms are? 4) most anemias are?

low blood concentration of hemoglobin (<13 g/dl) 1) sign/symptom of another underlying disease 2) elderly - but not due 'old age;' usually another reason 3) weakness & fatigue - due to less oxygen 4) acquired (not inherited) (know this slide for exam)

One common cause of osteoporosis

lower levels of sex hormones (particular estrogen) in old age - therefore, osteoporosis most often affects elderly - females more affected than males bc of severe reduction of estrogens post menopause (know this slide for exam)

Describe chondrosacroma

malignant neoplasm of chondroblastic origin (know this slide for exam)

Describe osteosacroma

malignant neoplasm of osteoblastic origin (know this slide for exam)

Why might there be a wide range of clinical presentation of hemophilia?

many different genetic mutations

Is osteomyelitis common in jaw?

uncommon - but probably more common in jaw than most other bones bc of proximity/communication w/ oral cavity (due to diseases teeth or following extractions) (know this slide for exam)

How is leukemia classified? (2)

based on clinical behavior & histogenesis 1) acute vs chronic - acute leukemias are usually aggressive while chronic are indolent 2) lymphocytic vs myelogenous (myelocytic, myeloid)

-mycosis usually means?

fungal infection.. but not always

Side effect of bisphophonate drugs

MRONJ (medication related osteonecrosis of jaw) - most cases of MRONJ are bc of higher dose of bisphosphonates used to treat cancer not osteoporosis (know this slide for exam)

Most common causes of immune compromise are?

acquired (not inherited)

What is a Philadelphia chromosome?

translocation of genetic material from chromosome 9 to 22 - chromosomal translocation leads to fusion of 2 genes = uncontrolled expression of cell-cycle gene that leads to non-stop cell division = tumor formation

Where do we see lymphoid hyperplasia?

anywhere there is collection of lymphoid tissue.. tonsils, spleen, lymph nodes, MALT (mucosa associated lymphoid tissue)

Define hemarthrosis

bleeding into joints

In general, osteoporosis occurs when? 1) what is often used to treat osteoporosis? 2) what is used to treat some cancers?

body makes too little bone (dysfunction of osteoblasts) or too much bone resorption (overactivity of osteoclasts) - sometimes combo of both 1) osteoclast inhibitors (usually bisphosphonate drugs) 2) bisphophonates (know this slide for exam)

Which cancers most often metastasize to jaw? - what is most common cancer overall?

breast, lung, thyroid, colon, prostate, & kidney cancers (BLT w/ cold kosher pickle; most common (non-skin) cancers) - non-melanoma skin cancer - but low metastatic potential (know this slide for exam)

Oral manifestations of leukemia =

cells may spill out in circulation & produce tumor-like masses = gingival enlargement

Why is important to study bone pathology?

dentists deal extensively w/ bone - no other medical specialty (besides orthopedics) that deals w/ bone as much - therefore all diseases described in bone pathology are important (some rare, but if any medical professional needs to know them, its us)

Hemoglobin levels; normal vs anemic - do not need to know for exam

do not need to know for exam

Why would splenomegaly cause thrombocytopenia?

enlarged spleen = dysfunctional spleen - spleen stores platelets.. when spleen enlarges, blood supply/drainage compromised & platelets not available for body to use for clotting (ecchymoses & hematoma in pic)

What does not go away when teeth are completed?

epithelial cells that produce teeth - remanent epithelial cells may proliferate & cystify producing jaw cysts cyst = epithelial-lined, fluid filled cavity (know this slide for exam)

What is done about a persistently enlarged lymph nodes?

evaluate for malignancy

What are bence-jones proteins?

immunoglobulin light chains remember: plasma cells produce antibodies.. so, neoplasia of plasma cell will produce A LOT of circulating antibodies

Why do we call deep fungal infections 'deep?'

more common fungal infections affect superficial tissues (I.e skin - athletes foot, jock itch, etc) or mucous membranes (candidiasis aka yeast infections) - deep fungal infections have primary infection sites 'deeper' = usually respiratory system (lungs or nasal cavity)

What is hemophilia caused by? 1) hemophilia A 2) hemophilia B 3) both are? 4) highly variable?

mutations in clotting factor genes 1) clotting factor 8 deficiency - far more common than hemophilia B 2) clotting factor 9 deficiency 3) X-linked recessive - only males have disease & females are carriers 4) clinical presentation - not all hemophiliacs 'bleed out' - some have very mild disease (clinically insignificant); 25% of clotting factor is enough for normal function - 1% have very severe disease

Common sequela of immune compromise?

necrotizing ulcerative gingivitis why is gingiva so commonly affected? bc lots of bacteria surround teeth

Describe myelodysplasia

not leukemia perse, but considered to be low-grade malignancy - abnormal growth/maturation in bone marrow

Enlarged lymph nodes usually a response to infection - not on exam

not on exam

What is the 2nd most common malignancy in oral cavity? - #1?

oral lymphoma - squamous cell carcinoma

Leukemia =

proliferating cells crowd out normal marrow

What is lymphoid hyperplasia?

proliferation of lymphoid tissue in response to insult (usually infection) remember hyperplasia is not cancer - it is not a neoplasm

How does radiation therapy leads to osteoradionecrosis (ORN)? 1) what might happen to bone following a tooth extraction in pt who has received radiation therapy? 2) for that^ reason, what is done? 3) bone can become? 4) radiation therapy also leads to?

radiation therapy leads to reduction of blood supply & ischemia of bone 1) bone may become further necrotic 2) questionable teeth are extracted/treated prior to radiation therapy 3) necrotic even in absence of extraction or dental treatment 4) salivary gland hypofunction & increased caries risk

Remnant epithelial cells can also grow as?

solid tumor = odontogenic tumor - ameloblastoma = common odontogenic tumor (know this slide for exam)