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DH Path Exam 1
DH Path Exam 1 update
Question | Answer |
---|---|
Disease caused by a healthcare worker | Iatrogenic |
what is the scientific study of disease | Pathology |
Unknown cause | Idiopathic |
'5' Clinical signs of Inflammation | Redness, Heat Pain, Swelling loss of normal tissue functiom |
Systemic signs of Inflammation | Fever- pyrogen production Leukocytosis- more WBC in blood Lymphadenopathy- Hyperplasia & Hypertropy of Lymphocytes |
4 stages of Mitosis | Prophase, Metaphase, Anaphase, Telophase P M A T |
A complete 2nd set of chromosomes (92) incompatible with life | Euploid |
Larger than normal, extra segment is identical to a segment of the normal chromosome | Duplication |
Aneuploid | and extra number, but isn't an exact multiple of chromosomes |
The observable appearance of an individual | Phenotype |
Identical Allelic Genes(genes located same level/same function) | Homozygote i.e. Blood type AA |
Different Allelic Genes | Heterozygote |
The pathological wearing away of tooth structure from repetitive mechanical habit | Abrasion |
Wedge shaped lesion cervical areas of tooth weakened/fatigued structure=susceptibility | Abfraction |
70-75% of defense pool, major antibody in the blood serum Initial Defense, (Fetal-1st passive immunity)) | IgG (Immunoglobin or antibodies) |
Defends body fluids from microorganisms | IgA (Immunoglobin) |
Activation of B lymphocytes (along w/ IgD) involved in early immune response | IgM |
Activates of B lymphocytes | IgD |
Involved in hypersensitivity reactions- release histamines | IgE |
level of a specific antibody | Antibody Titer |
link between inflammatory & immune response, act as antigen presenting cells, amplifies the immune response phagocytosis does NOT have Memory | Macrophages |
develop from bone marrow stem cells, reside in lymphoid tissue. Produces plasma cells and B memory cells. | B lymphocytes |
Pin wheel shaped nucleus, visible cytoplasm. Produces antibody proteins or Immunoglobulins | Plasma Cells |
develop from bone marrow stem cells, mature in the Thymus. Memory Cells, T-helper cell (T4 marker, T-Cytotoxic cells (viral surveillance) & T supressor cells (turn off B lymphocites) T8 marker | T lymphocytes Cell Mediated Immunity |
'B' Lymphocytes primary role and the production of Antibodies | Humoral Immunity |
'T' Lymphocytes assisted by macrophages are the predominant role in: | (CMI) Cell Mediated Immunity |
Type I hypersensitivity | occurs within minutes IgE--> histamine release constricts smooth muscle in lungs swelling edema i.e. asthma, hay fever, anaphylaxis |
IgG and IgM antibodies combine with antigen. Tissue destruction where antigen is present | Type II hypersensitivity i.e. incompatible blood transfusions |
Immune complexes formed (microorganisms+antibody) deposit in circulation, Acute inflammatory response. neutrophils->phagocytosis-> lysosomal enzymes->Tissue destruction | Type III hypersensitivity (Auto Immune disease) |
Delayed hypersensitivity, Cell Mediated Immunity | Type IV hypersensitivity (i.e. Tuberculosis Dx, Organ Transplant rejection) |
What is Uticaria? | Hives, multiple well demarcated swelling w/ Itching |
Arthritis, Urethritis, Conjuctivitis Antigenic marker HLA-B27 Men 10:1 Oral ulcers & tongue depapillation. lower extremities affected (knees ankles) | Reiter Syndrome aka Reactive arthritis |
Histocytosis X Letter-Siwe disease- Hand Schuller Christian disease Eosinophilic Granuloma of bone | Langerhans Cell Disease Langerhans cell present (type of macrophage) |
Acute, rapid, children under 3yrs can be fatal, oral manifestations rare | Letter-Siwe disease (Langerhans) |
Chronic, multifocal, children under 5yrs 'punched out' skull radiolucencies mimics advanced perio disease | Hand Schuller Christian disease (Langerhans disease) |
Chronic. localized older children,young adults skull & mandible commonly involved eosinophilic granuloma males affected 2x as much | Solitary Eosinphilic Granuloma of the Bone (Langerhans) |
Combination of dry mouth and dry eyes | Sicca Syndrome |
Auto-immune, Just sicca=Primary w another auto immune disease= Secondary bilateral enlarged parotid glands Sicca and Raynaud's Syndrome (fingers and toe circulation) 90% positive reaction to Rheumatoid factor | Sjogren Syndrome |
85% sin lesions (butterfly rash) Oral Lesions 25%, Raynaund 15% arthritis, arthralgis, kidneys possible sjorgen's present (bloodwork before dental work may need to pre-med) | SLE Systemic Lupus Erythematous |
confined to skin & mucous membranes mildest form: | DLE Discoid Lupus Erythematous |
Severe, progressive auto-immune disease affecting skin and mucous membranes.50% 1st sign in oral cavity Nikolsky's sign: gentle pressure on mucosa form bulla Epithelial cell destruction | Pemphigus Vulgaris mortality now 8-10% Corticosteroids |
Acantholytic or Tzanck cells- | detached epithelial cells (rounded appearance)biopsy to confirm |
Cicatrical Pemphigoid aka(benign) Mucous membrane pemphigoid | Gingiva-most common site affects oral & genital mucosa, skin, conjuctiva Cicatrical- 'healing w/ scarring' severe eye lesions may occur desquamative gingivitis. Nikolsky's sign hard to control. corticosteroids periods of exacerberation-> remission |
60yrs + lesions more extensive, painful anti-inflammatory, corticosteroids | Bullous Pemphigoid |
Chronic, recurrent, autoimmune disease. Avg age 30yrs, must have 2 of 3 lesions present Oral, Genital, Eye lesions, (Skin) | Behcet Syndrome |
60-70% of entire WBC population 1st wbc recruited by chemotaxis Main Function: Phagocytosis | Neutrophils (PMN) |
3-8% of entire wbc pop. 2nd to injury site longer lifespan than neutrophil function: phagocytosis, and immune response | Monocyte becomes MACROPHAGE |
Non specific response to injury, occurs in the same manner regardless of the nature of the injury | Inflammation |
Arterioles, capillaries, venules | (MC) Microcirculation Constricts than Dilates during inflammation |
Salivary gland stone formed by calcium salts around a central core (major and minor glands) | Sialolith |
Unilateral 'frog-pouch' mucocele-like lesion sublingual and submandibular glands duct obstruction likely cause | Ranula |
Radicular or Periapical cyst | True cyst (lined w/ epithelium) most commonly occuring oral cyst epi rest of Malassez proliferation usually asymptomatic |
Alveolar Osteitis | 'Dry Socket' lost blood clot after tooth extraction bone surface exposed. Painful, but no inflammation because no infection exists |
Trisomy 21 (Down Syndrome) | most common abnormality in humans fissured/pebbly tongue, Macroglossia w/ protrusion, High arch palate, Enamel hypoplasia, microdontia, >90% Perio disease |
Trisomy 13 | 70% live to 7mos only Bilateral cleft lip and palate small/No eyes micro/anophthalmia, supernumerary digits |
Missing an 'X' chromosome short,neck webbing, hands &feet edema, broad chest, genital underdeveloped, lack the 'Barr bodies' | Turner Syndrome |
XXY, male phenotype Taller, wide hips, female pubic hair, >50% breasts Maxilla slighty hypoplastic, detected after puberty 1 barr body for each extra x | Klinefelter Syndrome |
Caused by deletions on the short arm of CH5 Mental retardation, (No Oral abnormalities) 'catlike cry' | Cri du Chat Syndrome |
Wolf-Hirschhorn Syndrome | Deletion on CH4 Cleft Palate IQ > 30 |
Autosomal(non-sex chromosomes) dominant,cyclic decrease in Neutrophils 21-27dys intervals, lasting 2-3dys, Oral ulcers G-CSF Tx | Cyclic neutropenia Chronic= Kotsmann Syndrome |
Autosomal Recessice Inheritance Periodontal destruction, perm. tooth loss before age 14, Palmer & Plantar hyperkeratosis (retinoid Tx) | Papillon-Lefevre Syndrome |
Gingival Hyperkeratosis | band-like, few mm in width, Free gingiva not affected |
Gingival Hypertrophy, Very firm, corrugated, paler, lips may protrude | Gingival Fibromatosis |
Laband Syndrome | Gingival Fibromatosis, nail loss,malformed nose & ears, enlarged liver & spleen, fingers/toes frog-like appearance |
'Soap bubble' radiographic jaw appearance, eyes far apart, delayed eruption=pseudoanodontia Fibrous CT | Cherubism |
Ellis-Van Creveld Syndrome | affects dwarfs, Polydactyl, toenails missing, 50% heart defects, and present natal teeth, no anterior Max. Vestibule, Conical tooth shape |
> size of mand. teeth, supernumerary teeth,missing/minimal clavicles skull defects, open fontanelles | Cleidocranial Dysplasia |
Gardner Syndrome | Osteomas (jaw,skull,long bones) and Odontaomas, Intestinal Polyps become malignant age 30+ |
Mandibulofacial Dysostosis (Assoc. w/ Treacher's Collins Syndrome) | 'fish-like' commisures Deafness Hypoplastic mandible, Open bite, 30% high palate or cleft |
Nevoid Basal Cell Carcinoma Syndrome (Gorlin Syndrome) | wide spaced eyes, Jaw cysts, basal cell carcinomas,Nevi: pigmented skin lesions |
Osteogenesis Imperfecta | 30% W/ Family Hx, brittle bones Dentinogenesis imperfecta (dentin can't suppoprt enamel) 80% Primary teeth affected. 35% Permanent |
Tori | Mandibular: rare before age 15 smooth or lobulated Palate: mucosa thin, trauma easy 2:1 women > Native Americans Rare younger than 14yrs |
Ehlers-Danlos Syndrome | Collagen & CT defect, very elastic, joint hypermobility |
Cleft palate/lip | 1 in 800 births cogenital lip pits midline of lower lip vermillion border |
Hereditary Hemorrhagic Telangiectasia | Serious Nosebleeds (Note in DX Tx) Pinpoint/spider-like red lesions lips,eyelids,nose Tip Anterior Dorsom tongue |
Multiple Mucosal Neuroma Syndrome MEN2 B | Thyroid Carcinoma 75%, early Dx can become malignant oral neuromas, tip of tongue Pt: tall, large thick lips, everted eyelids |
Von Recklinghausen Disease | Neurofibromatosis of CNS, eyelids, nasoloabial fold (hearing/visual) Cafe au lait 105 Oral involvment |
Peutz-Jeghers syndrome | 98% lip & buccal mucosa lesions multiple melanin macules skin and mucosa, diminish w age GI Polyposis (rarely malignant) |
White Sponge Nevus | birth or after puberty white, corrugated, soft mucosa Always the buccal, never free gingiva, usually bilateral Keratin desquamates- raw mucosa |
Amolgenesis Imperfecta 4 TYPES | HYPO:(1)Plastic-irregular thickness,pitted(2)Calcified,yelloworange,chips easily-openbite? 3)Maturation-i.e. snowcap,soft enamel (4)Plastic-Maturation- yellow,brown pitted ALL teeth, Severe Sensitivity |
Dentinogenesis Imperfecta | most common AKA Hereditary Opalescent Dentin dentin soft (restorations fail), enamel chips-Attrition, NO PULP CHAMBERS, Roots are short blunt |
Dentin Dysplasia Type I RADICULAR | Normal crowns, Short roots-early exfoliation. half moon pulp chamber appearance. Disturbance in Hertwig's epi root sheath |
Dentin Dysplasia Type II CORONAL | pulp stones, Translucent/amber primary teeth Permanent: Normal crown/color, small roots no pulp chambers shown radiographically |
Hypohydrotic ectodermal Dysplasia | X linked recessive less hair,sweat hypo or anodontia, alveolar ridge-only if teeth present no minor salivary glands or respiratory tract mucosa soft,dry skin incisors,canines small conical |
Hypophosphatasia | decrease in serum alkaline phosphates (calcifies bone and cementum) bow-legged, fractures no pdl, spontaneous loss of primary teeth |
Hypophosphatemic Vitamin D resistant rickets | Large pulp chambers, gingival abscesses, pulpal disease, Dentin cracks, bowlegged low phosphorous serum levels |
Pegged/Absent Max. Laterals | primary and Secondary dentition 1-3% white 7% Asian Premolars missing 10-20% |
Taurodontism | Large, Pyramid Molars Large Pulp chambers, furcations, freq found in Klinefelter (XXY) Syndrome |
Giant Cell Granuloma | CENTRAL_Within bone, multi-nucleated giant cells only in jaw PERIPHERAL- Outside bone, Dk red, on gingiva or alveolar mucosa |
Pyogenic Granuloma | No pus, response to injury pregnant, teenagers, young adults |
Chronic Hyperplastic Pulpitis | Granulation tissue fill caries void |
Increased dilation of blood vessels | Kinin System |
c-Reactive protein | produced in liver acute & chronic > 10mg is high |
Parenteral | Injection |
Serum sickness Drug Hypersensitivity | Type III allergy i.e. horse anti-toxin (no longer done) for immunity penicillin, barbituates |
Lichen Planus | 1% pop almost always bilateral Wickham's Striae benign, chronic skin(lumbar), oral mucosa (buccal) desquamative gingivitis basal cell layer degeneration |
Dental or Periapical granuloma | painful, localized slightly extruded from socket opening in pulp canal (apex usually) thickened PDL (slight) |
Focal Sclerosing Osteomyelitis aka condensing osteomitis | change in bone, near apex (usually Mand 1st Molar) usually reaction to infection, asymptomatic, no tx |