Oral Pathology exam 3 (CH 8 AND 9)
Jaundice
- Excessive destruction of RBCs, the yellow substance builds up in the tissues of the body, causing the yellowing of the persons skin and mucus membranes.
Burkitt Lymphoma
-Aggressive form of non-Hodgkin lymphoma -Possibly most rapidly growing cancer known -Endemic and sporadic forms affect children and those under age 35 most often -90% are male
Osteoporosis: Primary Etiology
-Aging and loss of hormones -Unknown, many risk factors
Paget Disease:Perioral and intraoral characteristics
-Asymmetric enlargement of the skull -Neurological symptoms ->Headache ->Cranial nerve compression ->Dementia -Enlargement of the maxilla and/or the mandible ->Malocclusion ->TMD -Loss of lamina dura and PDL space -Hypercementosis
Peutz-Jeghers Syndrome: Etiology
-Autosomal dominant condition
Multiple Myeloma Etiology and transmission
-B-cell cancer (plasma cells) -Slight genetic tendency
Waste products converted to? Then goes where?
-Bilirubin -Then Transported to the liver and excreted in bile
Multiple Myeloma Perioral/intraoral Characteristics
-Bone lesions in skull and jaw bones ->Multiple, well-defined radiolucencies "punched out" ->Jaw lesions seen in the mandible more often than in the maxilla
Aplastic Anemia Pathogenesis
-Bone marrow stops producing cells. -Bone marrow replaced with fatty tissue.
Multiple Myeloma Extraoral Characteristics
-Bone pain, bone resorption, pathological fractures ->Vertebrae, ribs, skull, pelvis, and femur
Peutz-Jeghers Syndrome: Perioral and intraoral characteristics
-Brown or dark blue macules on lips and vermilion border, perinasal skin, and buccal mucosa
Hypochromic Anemia Extraoral characteristics
-Classic symptoms of hypoxia. -Skin and conjunctiva are pale.
Celiac Disease:Etiology
-Complex genetic disorder
Burning Mouth Syndrome (BMS): -Pathogenesis -Perioral and intraoral characteristics
-Deep burning pain without detectable pathology for at least 6 to 8 months -Less severe in the morning, increase as day progresses.
Osteoporosis: Pathogenesis
-Defective bone remodeling -Imbalance between bone resorption and formation creates a decrease in bone density.
Fibrous Dysplasia: Etiology
-Defective gene (GNAS1). -Not inherited or passed to children. -Mutation occurs after fertilization. -All exhibit mosaic karyotype accounting for the variation in severity seen among patients.
Aplastic Anemia signs and if left untreated
-Epistaxis -Untreated Fatal
Polycythemia
-Excess red blood cells in relationship to plasma (hematocrit greater than 48%) -Normal arm compared to arm of someone with polycythemia vera
Megaloblastic Anemia Perioral/intraoral characteristics
-Glossitis "Beefy red," smooth, sore
Celiac Disease:Perioral and intraoral characteristics
-Glossitis -Ulcers -Angular cheilitis -Enamel defects -Increased risk of adenocarcinoma of oropharynx and esophagus
Sickle Cell Disease is? and its Transmission
-Hemolytic anemia -Autosomal recessive inheritance -Heterozygous—sickle cell trait -Homozygous—sickle cell disease
Fibrous Dysplasia: Pathogenesis
-Higher than normal amount of a specific protein that enhances the action of osteoblasts and fibroblasts is produced. -Immature (woven) bone is formed from the fibrous tissue. ->Woven bone shows a "ground-glass" radiographic appearance
Anemia:
-Inadquate number of erthrocytes -Hemoglobin Inadequate amount Defective structure Inadequate or defective function
Hypochromic Anemia Vital signs
-Increased pulse and respirations
Peutz-Jeghers Syndrome: Extraoral characteristics
-Intestinal polyps and increased risk for GI cancers.
Temporomandibular Joint Dysfunction: Perioral and intraoral characteristics
-Joint pain ->Increases with function -Joint sounds (may be present with or without TMD) ->Pop or click ->Crepitus -Deviation/deflection -Limited opening < 40 mm -Locking -Bite irregularities -Masseter muscle hypertrophy -Radiographic evidence of joint changes may be seen
White Blood Cells have?
-Lymphoid stem cell Lymphocytes -Myeloid stem cell Monocytes Granulocytes
Osteoporosis: dental implications
-Medication-related osteonecrosis of the jaw (MRONJ) -> MINIMIZE SURGICAL Manipulation ->Osteonecrosis of the jaw
Crohn Disease: Etiology
-Multifactorial: strong genetic, environmental, and host factors
Trigeminal Neuralgia: Extraoral, perioral, and intraoral characteristics
-No clinically observable signs of the disorder -Pain described as lighting-like and debilitating
Temporomandibular Joint Dysfunction (TMD): -Etiology -Trauma
-Otherwise, unclear with multiple factors contributing -Inflammatory response—swelling, pain, warmth -Limited range of motion -Teeth might not occlude correctly
As part of the cascade, ________ IS THE IMPORTANT PART for________?
-POTASSIUM -coagulation
Rheumatoid Arthritis: Extraoral characteristics
-Pain, stiffness, swelling, deformed joints. -Accumulation of fluids around the joint. -Formation of rheumatoid nodules. -Deformities may cause nerve entrapment. ->Carpal tunnel syndrome -Other organ involvement ->Keratoconjunctivitis sicca (secondary Sjögren syndrome) ->Fluid accumulation around the heart and lungs
Bell Palsy: Pathogenesis
-Paralysis may result from demyelination of nerve sheath. -Necrosis of neurons -Partial or total paralysis
Dysphagia: Dental implications
-Patient positioning -Caries risk management -Home care modifications
Thrombocytopenia platelet count
-Platelet count below 150,000/mm3 blood
Hodgkin Lymphoma: Pathogenesis
-Presence of Reed-Sternberg cell is diagnostic (abnormal tumor cell)
Neutropenia dental implications:
-Prevent infections and preserving dentition because it will cause early loss of teeth and perio- disease
Sickle Cell Disease: Dental implications
-Prevent oral infections Education Appointment modification
Paget Disease:Extraoral characteristics
-Radiographic abnormalities ->Cotton-wool appearance
Polycythemia: 3 forms
-Relative—decrease in plasma fluid increases hematocrit (most common cause dehydration) -Primary (polycythemia vera)—increase in all formed blood products -Secondary (erythrocytosis)—increase in red cells in response to chronic hypoxia
Non-Hodgkin Lymphoma Epidemiology
-Risk of developing non-Hodgkin lymphoma is about 1 in 50.
Migraine Headache: Etiology
-Strong genetic component thought to be inherited as autosomal dominant trait.
anemia symptoms
-Tachycardia and palpitation -Dsynpnea
Osteoarthritis: Perioral and intraoral characteristics
-Temporomandibular joint dysfunction
Thalassemia Epidemiology
-The thalassemias are the most common inherited disorder worldwide.
Chronic lymphocytic leukemia (CLL) etiology
-Unknown Deletion of DNA from chromosomes 13, 11, and 17 Trisomy 12 Agent orange (herbicide) Family history of CLL
Hodgkin Lymphoma Etiology
-Unknown, risk factors include -Previous infection with Epstein-Barr virus (EBV) -Conditions associated with immunosuppression -Genetic predisposition
Crohn Disease: Extraoral characteristics
-Vitamin/mineral deficiencies -Blood loss from ulcers and anemia
Gastroesophageal Reflux Disease (GERD): Etiology
-Weak or transient relaxation of lower esophageal sphincter allows back flow of gastric acids into the esophagus.
when you see hair-On-End Effect. Think?
-sickle cell anemia and Thalassemia
Erythrocytes: RBC's
1% destroyed and replaced each day Normal life span approximately 4 months/120 days RBCs released from bone marrow as Iron and amino acids recycled Waste products converted to
Microcytic red blood cells are characteristics of which one of the following?
Acute lymphoblastic
The Philedelphia chromosome is associated MOST often with which of the following?
Acute lymphocytic leukemia
Which of the following is the most common cause of agranulocytosis?
Adverse reaction to a drug
Which one of the following medications has been associated with osteonecrosis of the jaw?
Antiresorptive drugs
Pernicious anemia
Autoimmune conditon that is characterized as the inability of the gastric mucosa to produce intrinsic factors. -B 12 deficient, Megaloblastic anemia
Megaloblastic Anemia Transmission
Autoimmune pernicious anemia may follow an autosomal recessive inheritance pattern.
Rheumatoid Arthritis: Pathogenesis
Autoimmune reaction triggered in susceptible person -Inflammatory mediators -Rheumatoid factor Inflammation of the synovial membrane -Formation of scar tissue on opposing bony articular surfaces -Calcification of scar tissue ->Ankylosis and fusion of the bones causing deformity and loss of function Other organs/skin can be affected.
All of the following are truw about McCune-Albright syndrome EXCEPT one. Which ONE is the EXCEPTION?
Autosomal of weight-bearing bones
Sickle cell disease follows which of the following inheritance patterns?
Autosomal recessive
Front bossing is associated with which form of thalassemia?
B-thalassemia major
Which of the following malignancies is considered the most rapidly growing neoplasm?
Burkitt lymphoma
which one the the following is the most common etiology of aplastic anemia?
Chemical or environmental
which type of leuemia progresses through three distinct stages?
Chronic myeloid
Sickle Cell Disease Extraoral characteristics
Classic symptoms of anemia (severe) Jaundice from RBC hemolysis Multiple organ damage Chronic pain -heart diseases and enlarged heart
Leukemia Classified as?
Classified further as chronic (gradual) or acute(rapid)
Which of the following terms is associated with the characteristics sound the TMJ makes when the joint is affected by arthritis?
Crepitation
Apthous-like ulcers, glossitits, and cobblestoning of the buccal mucosa are characteristics of which of the following disorders?
Crohn disease
Which one of the following often results in premature loss of dentition?
Cyclic neutropenia
Reticulocytes
Damaged RBCs trapped by the spleen
Sickle Cell Disease Perioral/intraoral characteristics
Delayed eruption of primary and secondary teeth
oral manifestations of anemia are associated with which of the following?
Depressed growth of epithelial cells
Osteoarthritis: Pathogenesis
Destruction of cartilage Bone on bone function Cartilage breaks off and floats in joint space Formation of osteophytes Destruction of bone surface
Dysphagia
Difficulty swallowing
Which of the following is associated with gastroesophageal reflux disease?
Erosion
Barret esophagitis is associated with a higher risk for which of the following?
Esophogeal cancer
Hypochromic (Iron Deficiency) Anemia
Etiology: Inadequate dietary intake of iron Chronic blood loss Increased demand *Most common form of anemia worldwide**
Bell Palsy is associated with which of the following nerves?
Facial
von Willebrand disease is associated with decreased levels of von willenbrand factor and may also manifest with decreased levels of which of one of the other clotting factors?
Factor VIII (antihemophilic factor)
Which of the following is associated with an increased risk of cleft lip or palate?
Folic acid deficiency
Signs of a Systemic Condition
Gingival bleeding (excessive or spontaneous) Unexplained petechiae/ecchymoses Pale mucosal tissues Glossitis or glossodynia Nonhealing ulcers Recurrent fungal infections Exaggerated gingival response to local irritants
Small pea-sized areas of exotosis in the joints of the fingers are known as which one of the following?
Heberden nodes
The use of aspirin-containing analgesics is contraindicated in which one of the following disorders?
Hemophilia
Sickle Cell Disease: management
Hydroxyurea Penicillin prophylaxis and pneumococcal vaccinations Pain control Maintain hydration and oxygenation Manage complications of disease Avoid crisis triggers Transfusions
Which one of the following is a characteristic manifestation of polycythemia vera?
Hypercoagulation
eyrthocytes have a shorter than normal life span in all of the following conditions EXCEPT one. Which ONE is the EXCEPTION?
Hypochronic anemia
Cardiac irregularities, tachycardia, and palpitations associated with anemia are the result of which of the following?
Hypoxia
A diagnosis of burning mouth syndrome is associated with which of the following etiologies?
Idiopathic
Which of the following is a side effects of major concern associated with diease-modifying antirheumaic drugs?
Immunosuppresion
All of the folowing manifestations are associated with Bell Palsy EXCEPT one. Which ONE is the EXCEPTION?
Increased gag reflex
All forms of leukemia:
Increased periodontal infections Unexplained petechiae/purpura in oral soft tissues Gingival enlargement (most often in CML
Sickle Cell Disease: Bone trabecular changes
Increased radiolucency Thickening of lamina dura Periapical "step-ladder" trabecular pattern between posterior teeth Skull "hair-on-end"
The severe pain characteristic of sickle cell crisis is caused by which of the following?
Infarcts due to thrombi
Thalassemia Radiographic bone changes
Jaw bones: More radiolucent Honeycomb trabecular pattern Skull: Hair-on-end trabecular pattern
Osteoarthritis: Extra oral characteristics
Joints most often affected -Weight bearing ->Knee, hip, cervical and lumbar spine -Fingers Pain -Deep, achy increases with the use of the joint Heberden nodes -Exostosis in joints of fingers -Seen more in women than in men
Which of the following organs is responsible for regulating the process of eyrthopoiesis?
Kidney
Which of the following is NOT a risk factor for osteoporosis?
Large bone structure
Bleeding Disorders: Acquired types
Liver disease -Coagulation factors produced in the liver Vitamin K deficiency -Inadequate dietary intake -Malabsorption syndromes -Long-term broad-spectrum antibiotic therapy
Which of the following would be contraindicatedwhen treating a patient with sickle cell disease?
Local anethesia with epi
All of the following are manifestations associated with Paget disease EXCEPT one. Which ONE is the EXCEPTION?
Macroglossia
Sickle Cell Disease Epidemiology
Most common inherited blood disorder in the United States.
Osteoarthritis: Etiology
Multifactorial degenerative disease -Genetic and environmental factors -Risk factors
Macroglossia due to anyloid accumlation is associated with which of the following conditions?
Multiple myeloma
Desmopressin acetate mimica the action of eyrthopoietin BECAUSE it stimulates release of factor VIII from the kidneys.
NEITHER the statement NOR the reason is correct.
Plummer-Vinson syndrome is associated with an increased risk of which of the following?
Oralpharyngeal cancer
The formation of osteophytes is associated with which of the following conditions?
Osteoarthritis
An increased rate of periodontal bone loss is associated with which one of the following?
Osteopororis
Which one of the following medications has been associated with osteonecrosis of the jaw?
Osteoporosis
Elevated levels of alkaline phosphatase are diagnostic of which of the following?
Paget disease
Hypochromic Anemia Perioral/intraoral characteristics
Pale membranes Glossitis Angular cheilitis Ulcers Burning sensations Dysphagia (severe case)
Megaloblastic Anemia Neurologic symptoms
Paresthesia: numb Loss of proprioception : function but a little issue iwht coordination with spacial awareness Ataxia : more spazztic movements
Oral and perioal dark brown or blue macules are characteristics of which one of the following disease?
Peutz-Jeghers syndrome
Which of the following disorders is associated with gastrointestinal complications and the potential for cancers starting as early as age 8?
Peutz-Jeghers syndrome
Which of the following is associated with an increased risk of developing cancers of the stomach, pancreas, breast, ovary, and testes?
Peutz-Jeghers syndrome
Multiple myeloma is cancer of which of the following cell types?
Plasma cells
Hematopoiesis
RBC and WBC are being produced
Which of the following types of cells is found in Hodgkins Lymphoma?
Reed-Sternberg
Blastic
Refers to cells that fail to mature
The presence of disorders that cause the bone marrow to produce inadequate or excessive numbers of red cells can be suspected if blood tests find abnormally high number of which of the following?
Reticulocytes
From the following list, select TWO disorders that present with "hair-on-end" radiographic findings.
Sickle cell anemia and B-Thalassemia disorder
Hypoxia is a trigger for which of the following?
Sickle cell crisis
Chronic leukemia (CLL and CML) extra oral characteristics
Symptoms not apparent at diagnosis, appear gradually Anemia, neutropenia, thrombocytopenia Infections (repeated), fatigue, lymphadenopathy, bleeding tendencies, bone pain
Dental implication associated with migraine headaches focus on managing the side effects of medications used to control migraines BECAUSE all of the medications can cause nausea and vomiting.
The statement and the reason are correct but NOT related.
Pernicious anemia is associated with a deficiency in the intrinsic factor BECAUSE folic acid cannot be transported across the intestinal musosa.
The statement and the reason are correct but NOT related.
Patients with hemophilia may need to be consideredfor antibiotic premed prior to dental care BECAUSE their immune system is compromised by the production of too many eyrthrocytes.
The statement is correct, but the reason is NOT
Symptoms affecting the peripheal nervous system are seen in folic acid deficiency BECAUSE folic acid is required for the synthesis of DNA and RNA.
The statement is correct, but the reason is NOT.
Rhematoid arthritis causes joint deformity BECAUSE the joints become permanently dislocated.
The statement is correct, but the reason is not
Burkitt Lymphoma: 3 forms
Three forms: Endemic Sporadic Immune deficiency associated
Oral manifestations of non-hodgkins lymphoma are uncommon, but when present, they can be found most often in which of the following areas?
Tonsils
The topical use of which of the following could control postoperative bleeding after dental procedure for someone with a bleeding disorder?
Tranexamic acid
Chronic lightening-like pain manifesting after light contact with the upper lip might indicate which of the following disorders?
Trigeiminal neurlgia
Acute lymphocytic leukemia (ALL) Etiology
Unknown Translocation of DNA between chromosomes 9 and 22 produces "Philadelphia chromosome." Inherited syndromes.
Non-Hodgkin Lymphoma Etiology
Unknown but seems to be associated with changes in the chromosome structure
Megaloblastic Anemia
Vitamin B12 deficiency (pernicious anemia) -Folic acid deficiency
Which of the following vitamins is essential for the production and action of many of the clotting factors?
Vitamin K
All of the following are risk factors for non-Hodgkins Lymphoma EXCEPT one. Which ONE is the EXCEPTION?
Young age
Hematuria
blood in the urine
Hemarthrosis
blood within a joint, after age of 4 a lot red bone marrow has shrunken
Dysphagia may result in aspiration pneumonia BECAUSE the individual may not be able to safely swallow food.
both the statement and the reason are correct and related
Which gastrointestinal disorder is associated with enamel defects?
celiac disease
Pluripotent STEM CELL can perform?
many different types of cells
The characteristic of "pop" or "click" heard or felt in many TMJ disorders is caused by which one of the following?
misplaced articular disk
Epistaxis
nose bleed
Hematocrit
percentage of blood volume occupied by red blood cells
Which of the following is the best treatment for pernicious anemia?
percutaneaous injection of vitamin B12
Erythrocytes
red blood cells
Leukocytes
white blood cells
