Chapter 9 Oral manifestations of Systemic Diseases

  1. HYPERPITUITARISM is a disease in which there is _______ produced by the _______
    • too much growth hormone
    • anterior pituitary gland
  2. If HYPERPITUITARISM occurs during developmental years (childhood), ________ occurs
  3. If HYPERPITUITARISM occurs in adulthood, ________ occurs
  4. Enlargement of the jaws results in
    separation of the teeth
  5. In healthy people, the thyroid makes just the right amounts of two hormones, ___ and ____ , which have important actions throughout the body. These hormones _________.
    • T4 and T3
    • regulate many aspects of our metabolism
  6. HYPERTHYROIDISM is more common in ________. Several different causes but most common cause is _________
    • women than men
    • Graves’ disease
  7. Clinical features  of HYPERTHYROIDISM include ________. Oral manifestations in children lead to ________
    • exophthalmia (bulging eyeballs)
    • early loss of primary teeth and premature eruption of permanent teeth
  8. HYPOTHYROIDISM is characterized by _________
    In infancy and childhood, it is known as ________.
    In adults it is known as _______.
    • decreased output of thyroid hormone
    • cretinism
    • myxedema
  9. The parathyroid glands are _______ located on the ________ .
    • four pea-sized glands
    • thyroid gland in the neck
  10. The parathyroid glands secrete ________ which regulates _______
    parathyroid hormone (PTH)

    release of calcium from bone and absorption of calcium
  11. Hyperparathyroidism is characterized by elevated _______, lower levels of ________ and abnormal ________.
    • blood levels of calcium (hypercalcemia),
    • blood phosphate (hypophosphatemia)
    • bone metabolism
  12. 15% of HYPERPARATHYROIDISM may be caused by _______ or 85% _______
    • hyperplasia of parathyroid gland
    • a benign or malignant tumor
  13. Hyperparathyroidism that results from an abnormal enlargement of the hyperparathyroid is called ________ .
    primary hyperparathyroidism
  14. Hyperparathyroid due to the response caused by excessive calcium excretion so that calcium levels are continually low, is called ________.
    secondary hyperparathyroidism
  15. Primary hyperparathyroidism is the most common type T or F
  16. Oral manifestations of HYPERPARATHYROIDISM include changes in _______ which microscopically look like _______
    • mandible and maxilla with well-defined uni- or multilocular radiolucencies
    • central giant cell granulomas (due to loss of calcium in bone)
  17. Normal fasting blood glucose is under _____mg. A reading over ____
    is considered abnormal. _____ mg considered prediabetic
    • 100
    • 126
    • 100 – 125
  18. GTT blood glucose should be under ____mg within 2 hours after drinking the glucose. All readings should be under _____. ______ mg considered prediabetic.
    • 140
    • 200
    • 140- 199
  19. Blood sugar for type II diabetics fasting up to ____mg
    After meals less than ____ mg
    • 130
    • 180
  20. Symptoms of hypoglycemia
    • Trembling
    • Clamminess
    • Palpitations
    • Anxiety
    • Sweating
    • Brain dysfunction
  21. ADDISON’S DISEASE is characterized by insufficient production of ________ due to destruction of _______. As result of decrease in _______, there is an increase in _______.
    • adrenal steroids
    • adrenal cortex
    • adrenal steroids
    • ACTH (adrenocorticotropic hormone)
  22. Adrenal cortex produces _______, _______, and _______
    • Aldosterone – responsible for uptake of sodium and secretion of potassium (controls BP)
    • –Low blood pressure
    • Cortisol – (the stress hormone) responsible for production of glucose
    • –Problems especially under stress
    • Testosterone
  23. (ADDISON’S DISEASE) As a result of increase in ACTH, there is an increase in
    brown pigmentation resulting in bronzing of skin and possible oral pigmentation with melanotic macules (increase MSH)
  24. Anemia is the
    reduction in the oxygen-carrying capacity of the blood
  25. What are the causes of anemia
    • Nutrition Anemia
    • Suppression of bone marrow stem cells
  26. What are the Oral manifestations of Anemia
    • Skin and mucosal pallor
    • Angular cheilitis
    • Erythema and atrophy of oral mucosa
    • Loss of filiform and fungiform papillae on tongue
  27. The most common type of anemia in the U.S
    Iron deficiency anemia
  28. Plummer-Vinson Syndrome is due to
    long-standing iron deficiency
  29. Pernicious anemia caused by _______ which is needed for the ________
    • deficiency of intrinsic factor in the stomach
    • uptake of vitamin B12
  30. Thalassemia also known as ________. Hereditary disease resulting in ______
    Mediterranean or Cooley’s anemia

    damage to red blood cell membranes and destruction of RBC’s
  31. Clinical manifestation of Thalassemia
    yellowish skin, enlarged liver and spleen
  32. Sickle Cell Anemia is an inherited disorder found predominantly in ________ and disease presents ______ and is more common in ______
    • black people and people of Mediterranean origin
    • before age 30
    • women
  33. Clinical manifestations of Sickle Cell Anemia  include _______
    Oral manifestations show up on X-Ray as having _______
    • weakness, shortness of breath, fatigue
    • large marrow spaces with irregular trabeculae
  34. Aplastic Anemia is a _______ because of a _________
    • decrease in all circulating blood cells
    • severe depression of bone marrow activity
  35. Primary Aplastic Anemia is caused by  ________
    Secondary is due to _________
    • unknown cause (possible autoimmune)
    • chemotherapy or radiation therapy, virus, drugs
  36. Polycythemia is an
    abnormal increase in the number of circulating red blood cells
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  38. Polycythemia Vera (primary polycthemia) is the ________ and caused by ________
    • neoplastic proliferation of bone marrow stem cells resulting in a high number of red blood cells (rare)
    • unknown
  39. Secondary Polycythemia is an ________ caused by ________
    increase in RBC’s due to a decrease in oxygen

    • –due to lung or heart disease
    • –or living at high altitude
  40. Relative Polycythemia is an increase in RBC’s due to
    decrease in plasma volume
  41. Agranulocytosis is characterized by a _______ and the most common cause is _______
    marked reduction in neutrophils (neutropenia) due to either increased destruction of PMN’s or decrease in production

  42. Clinical manifestations of Agranulocytosis
    oral infection, ANUG, bleeding gums, rapid destruction of alveolar bone
  43. Cyclic Neutropenia is a
    form of agranulocytosis in which there is a severe depression of PMN’s which occurs at periodic intervals
  44. Leukemia is a malignant neoplasms of the 
    _______ resulting in _______
    • blood-forming stem cells in the bone marrow
    • dramatic increases in circulating white blood cells
  45. Chronic lymphocytic leukemia
    shows an _______, has a _____ onset and
    mainly found in people _____
    • increase in lymphocytes
    • slow
    • over 50
  46. _________ is the most common leukemia in children
    Acute lymphoblastic leukemia
  47. Chronic myeloid leukemia is a
    Increase in myeloid cells (PMN’s, eosinophils, basophils)
  48. Acute Leukemia is characterized by
    presence of immature cells (blast cells) and rapidly fatal if not treated
  49. Chronic Leukemia is a _______ usually found in ________. Oral manifestations is _____
    • slow onset form of leukemia
    • adults in 40’s-50’s

    pallor of lips and gingiva, gingival enlargement, petechiae, gingival bleeding, periodontal disease
  50. Platelet count are normally _______/mm
    Counts less than 100,000/mm are considered
    • 150,000 to 400,000
    • thrombocytopenia (decrease in platelets)
  51. Normal INR is
    1 to 1.5
  52. –Prothrombin time (PT) – normal range of ________
    –(Measures the patient’s ability to form a clot when _______ are added to the blood)
    • 11 to 16 seconds (abnormal if 1 ½ times this range)
    • calcium and a tissue factor
  53. –Partial thromboplastin time (PTT) – normal range of _______
    –Measures the patient’s ability to form a clot when _______ are added to patient’s plasma
    • 25 to 40 seconds
    • kaolin and cephalin
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  56. Ingestion of aspirin can result in impaired platelet function for up to ______ days as can NSAID’
  57. HEMOPHILIA is caused by a
    deficiency in a plasma protein necessary for conversion of fibrinogen to fibrin
  58. Are routine dental procedures contraindicated for patients on Coumadin therapy

    Contraindicated to discontinue antithrombotic medication
  59. Primary immunodeficiency is of ______ origin (SCID)
    Secondary immunodeficiency is due to _______
    • genetic
    • some other underlying disorder
  60. A patient is diagnosed with AIDS if they have
    HIV infection with CD4 lymphocyte count of less than 200 per microliter of blood

    Presence of opportunistic infections including Pneumocystic pneumonia, esophageal candidiasis, Kaposi’s sarcoma, pulmonary TB, cervical cancer
  61. As the immune system fails, HIV/AIDS patients develop _______ including ________
    ARC (AIDS related complex)

    oral candidiasis, fatigue, weight loss, lymphadenopathy
  62. Tests are used to measure the amount of HIV circulating in the blood and is called the _______ (desired is less than ___ copies/ml)
    viral load

  63. What is the most common problem following radiation
  64. Radiation caries is usually in the ________ of the teeth
    cervical area
  65. After radiation there is a significant shift in the oral microflora to a predominance of ________ along with the decrease in salivary flow
    strep mutans and lactobacilli
Card Set
Chapter 9 Oral manifestations of Systemic Diseases
Chapter 9 Oral manifestations of Systemic Diseases