Hematologic Disorders

Reactive enlargement of lymphoid tissue 
Can affect any lymphoid tissue (soft palate, floor of mouth, lateral and ventral tongue)
Caused by infections and inflammatory conditions

Swollen, soft, tender, freely moveable nodes describes what type reaction lymphandenopathy?

Persistent, non-tender, rubbery, freely movable nodes describe what type reaction lymphandenopathy?

What should be biopsied to rule out a lymphoma or mets cancer?

What does the histo look like for reactive lymphadenopathy

What is this?

Is this a reactive lymphandeopathy or some other pathology? (SCC, papilloma)

Deficiency of factor VIII is  ____

Deficiency of factor 9 is _____

Abnormal PTT (intrinsic clotting pathways) is present in what?

The disease presents as the following


Uncontrolled bleeding, hemarthrosis, pseudotumor
Oral: Hematomas following minor trauma

What should not be recommended for a patient with hemophilia?

disease of decreased platelets and orally presents as petechiae, ecchymoses, hematomas

As a dentist what should you do if a patient has thrombocytopenia?

reduction in the oxygen carrying ability of blood due to the reduction in number of circulating RBCs or in the concentration of hemoglobin

What are two oral sign of anemia?

Hereditary disorder of Beta-globin chain

what its the difference between sickle cell trait vs. sickle disease?

Four main side effects of sickle cell anemia

Why should you avoid epinephrine in patients with sickle cell anemia?

Disease that presents with severe anemia, infections, bone marrow hyperplasia (enlarged maxilla and frontal bossing), and hair on end appearance

failure of marrow stem cells and therefore a reduction in the numbers of all blood cells

What causes aplastic anemia (3)

what are the 4 oral signs and symptoms of aplastic anemia

Reduced number of neutrophils (<1500) and increased risk of infections

What differentiates neutropenia oral ulcers from aphthous ulcers?

What is the difference between aplastic anemia and leukemia

What do the oral lesions for agranulocytosis manifest as?

Agranulocytosis is a decrease in what 3 cells?

Mutation of neutrophil elastase gene

A disease that has episodes that last 3-5 days and reach every 18-21 days, affects children and presents as multiple ulcers and periodontal disease

a group of malignancies of stem cells that have either myeloid or lymphoid lineage

Most common leukemia in children

Disease that presents with the following clinical features:
Fatigue, SOB, bleeding, infections, hepatomegaly, splenomegaly, lymphandenopathy

The following are the oral lesions for which disease 

Petechiae
Spontaneous gingival hemorrhage
Deep ulcers
Infections (Candidiasis, HSV, Periodontal disease, loose teeth) 
Boggy swelling of gingival tissue
Chloroma

How does leukemia present on an a radiograph

Occurs when engrafted BONE MARROW cells perceive the host tissues as foreign

occurs within 100 days of transplant and presents as mild cutaneous rash to a severe sloughing

Occurs more than 100 days after the transplant 
Skin lesions may resemble lichen planus or systemic sclerosis

What do the oral lesions for GVHD look like?

Group of disorders characterized by monoclonal proliferation of Langerhans cells

What might the radiographic features of LCH mimic?

How do you differentiate between LCH and MM when you see punched out RL

Malignancy of Reed-Sternberg Cells and often involves cervical and supraclavicular lymph nodes 

presents as : persistant, enlarging, non-tender lymph nodes

With Hodgkin Lymphoma if there are nodes on both sides or organ involvement what does that mean?

T/F: oral lesions with hodgkins lymphoma is rare
True False

There are two common subtypes of Non-Hodkins lymphoma what are they and what is the most common subtype ?

Usually mass within lymph node(s)
25% are extranodal
Most oral lesions are seen in patients with disseminated disease
Non-tender, diffuse boggy swelling or tumor-like mass
May have pain or paresthesia
Ill-defined radiolucent lesion may be present

Which type of Burkitt's is 90% associated with EBV and has a predilection for the jaws and children

Which type of Burkitt's is 20% associated with EBV, predilection for the abdomen (but can involved the oral cavity) and has a broader age range and presents as a rapidly growing, destructive lesion of the jaws

A disease that primarily affects midline structures and presents as nasal stuffiness, nose bleeding and swelling of the palate following by deep, necrotic ulcer and eventual perforation

Which disease show destructive palatal lesions? (Along Came Three Wise Men)

Malignancy of the plasma cells
Presents as bone pain, pathological fracture, myelophtisic anemia in older males 
See punched out RL

What do you see in the urine of patients with MM?

What drugs are patients with MM placed on?

Solitary monoclonal lesion of plasma cells  that may be located in bone or soft tissues 
Tendency to progress to MM

What do you see in the oral cavity of MM patients?