Oral Pathology exam 3 (CH 8 AND 9)

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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


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