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Question Answer
libman-sacks endocarditis (non-bacterial verrucous endocarditis)SLE (lupus), can present with lichenoid lesions
virus associated with Lichen PlanusHep C
KoebnerizationLichen Planus
Wickham's StriaeReticular/Papular form of Lichen Planus
saw-tooth rete ridgesLichen Planus
autoantibodies against BP180/BP2 (components of hemidesmosomes)Pemphigoid
subepithelial clefting with preservation of basal cell layerPemphigoid
Desquamative Gingivitis associated with what?Pemphigoid 68%, Lichen Planus 28%, Pemphigus 3%
positive Nikolsky's signLichen planus, Pemphigoid, Pemphigus Vulgaris, Erythema Multiforme
opthalmologic eval needed for what disease?Pemphigoid
autoantibodies against Desmoglein 1 & 3 (intercellular cementing protein, components of desmosomes)Pemphigus
suprabasal epithelial separation, acatholysis, vesicle formationPemphigus
genetic susceptibility (associated with HLA-DRB1)Pemphigus
IgG deposition in FISHNET-LIKE patternPemphigus
basal cells adherent to connective tissue in TOMBSTONE patternPemphigus
Ashkenazi-Jewish middle-agedPemphigus vulgaris (oral findings present in 100%)
target, bulls-eye, iris lesionsErythema Multiforme (EM)
usually spares gingivaErythema Multiforme
Steven Johnson syndromeEyrthema multiforme oral lesions + Eye lesions (symblepheron) + Genital lesions
tx of EMmajority are self-limiting, eliminate precipitating factor, Acyclovir for herpes infection, antihistamines, steroids
CREST syndromeProgressive Systemic Sclerosis (Scleroderma)
en coup de sabre (morphea)localized form of scleroderma
esophageal stricturesProgressive Systemic Sclerosis (Scleroderma)
mask-like faceProgressive Systemic Sclerosis (Scleroderma) -- dysphagia, xerostomia, periodontitis, erosion of mandibular angles, TMJ, widening of PDL, Reynauds, telangiectasia
PAVMs"pulmonary arteriovenous malformations" - occur in 50% of pts with Hereditary Hemorhagic Telangiectasia (Osler-Weber-Rendu syndrome)
Hereditary Hemorhagic Telangiectasia (Osler-Weber-Rendu syndrome)nosebleeds, telangiectasia, anemia, blaching red mucosal papules, bacteriemia --> brain abscess --> fistulas, so USE ANTIBIOTIC PROPHY
INRnormalized PT scores (ideal is <3 or 3.5 48 hrs before procedure)
most common clotting disorderVon Willebrands (1%), autosomal dominant, gingival bleeding in 1/3, epistaxis, ecchymosis and hematomas, joint bleeding, menorrhagia
koilonychiasbrittle/concave fingernails due to hypoxia - common to all anemias
most common type of anemiairon deficiency anemia/chronic blood loss anemia
5-50% risk of SCC (esophagus, oral, pharyngeal)Plummer-Vinson syndrome- anemia, glossitis, dysphagia, Northern European woman
most common cause of severe b12 deficiencyatrophic gastritis (autoimmune disease)- pernicious anemia
demyelination, hypersegmented neutrophils, paresthesiaMegaloblastic anemia
frontal bossing, hair on end calvaria, honeycomb, enlarged jawThalassemia
hair on end calvaria, delayed dental eruption, dental hypoplasia, ischemic necrosis, reduced trabeculation, neuropathySickle cell anemia
fatal form of thalassemiahydrops fetalis (alpha thalassemia)
sickle cell crisislasts 3-10 days, hemolysis --> anemia and jaundice --> bone pain, strokes, acute chest syndrome --> cor pulmonale --> sequestration crisis --> splenomegaly --> autosplenectomy --> increased infections. With autosplenectomy, may need to prescribe antibiotic prophy before invasive procedures
causes of neutropeniachemotherapeutics, antibiotics (Clindamycin), phenothiazines, diuretics, tranquilizers, HAV, HBV, rubella, measles, varicella, HIV, TB, osteoporosis, bone malignancies
benign ethnic neutropeniaMediterranean, Africans
neutropenia makes you more susceptible to bacterial infectionsstaph aureus, oral cavity lesions (crater-like), middle ear infections, perirectal lesions
agranulocytosisWBC < 200/uL, severe neutropenia, resembles ANUG (do biopsy to rule out), resembles Aplastic Anemia (but without reduced platelet count), infections of oral cavity, perirectal, middle ear
hodgkin lymphoma5 types (most common are Nodular Sclerosis, Mixed Cellularity), 1/3 of all lymphomas, young adults/teens, mainly seen in LYMPH NODES, most common initial presentation is enlarged cervical/supraclavicular LNs (70-75%)
reed-sternberg cells, popcorn cellsHodgkin lymphoma
non-Hodgkin lymphoma (NHL)adults, most common in oral cavity is B-Cell Lymphoma; EBV and AIDs, present in LNs and outside of lymph nodes, bony lesions look like PARLs
high grade NHLBurkitt Lymphoma, B-cell lymphoma of CHILDHOOD, endemic/African type always associated with EBV
starry sky histopathologyBurkitt lymphoma (high-grade NHL)
moth-eaten and poorly defined radiolucencies, which lymphoma?diffuse large B-cell lymphoma (intermediate grade NHL)
t/f? • No benign neoplasms of lymphocytes or monocytes existTRUE
bence-jones proteins, hypercalcemia, bone pain, pathologic fractures, amyloid deposits, punched out radiolucenciesMultiple myeloma
ALLacute lymphoid leukemia, CHILDREN, good prognosis for children (50-70% cure), worse prognosis for adults (20% cure rate)
AMLacute myeloid leukemia, ADULTS AND CHILDREN, Signs of anemia, bleeding, GINGIVAL ENLARGEMENT, poor prognosis for all (1-2 year survival rates, 10-30% cure rate)
Langerhans Cell disease/Histiocytosis Xassociated with lymphoma (small focus within or adjacent to lymphoma), >50% are <10 yrs of age (aka majority are CHILDREN, jaw lesions in 10-20%, alveolar bone destruction causes LOOSE TEETH (resembles severe perio disease), ulcer and/or soft tissue proliferation over bone lesion
Birbeck granulesLangerhans Cell disease/Histiocytosis X
"interface inflammation"Lichen Planus (lymphocytic infiltration at junction between epithelium + connective tissue)
upper lip lesionlupus erythematosus (Discoid lupus is localized on skin and mouth)
post-inflammatory melanosisLichaen Planus
subepithelial T-cell infiltration that leads to destruction of basal cell layerLichen Planus
hyperorthokeratosis/hyperparakeratosisLichen Planus
fibrinogen deposits, but no IgsLichen Planus
oral lichen planus is found in ___% of the population2% skin and mouth- 40%, skin-35%, mouth- 25%
linear IgG deposits at basement membrane zonePemphigoid
transport mediumMichel's solution
large bleedsClotting factor deficiencies (Von Willebrands, Hemophilia A, Hemophilia B)
eosinophilic granulomasubtype of Langerhans cell disease/Histiocytosis X- one or more bone lesions
Hand-Schuller-Christiansubtype of Langerhans cell disease/Histiocytosis X- multifocial (skull, pituitary, orbit)
Letterer-Siwesubtype of Langerhans cell disease/Histiocytosis X- disseminated with skin, bone and internal organ involvement; can resemble ACUTE LEUKEMIA
ANA, anti-phospholipids, anti-dsDNASLE
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numbers

Question Answer
normal thrombocytes/platelets 150k - 450k/uL
excessive bleeding from surgery/trauma20k - 50k platelets
spontaneous bleeding (especially gingiva)<20k platelets
increased risk of intracranial bleeds<10k platelets
<500 granulocytesmore susceptible to infections, decreased neutrophils
normal RBC3.5-6 x 10^6/uL, men have somewhat higher counts
normal Hb12-18 g/dL
normal Hct37-54%
normal leukocytes/WBCs4,000 - 10,000/uL
leukocyte compositionneutrophils (40-74%), lymphocytes (14-46%), monocytes (4-13%), eosinophils, basophils
normal range of vitamin b12220-1130 pg/mL
Aplastic anemia<500 granulocytes/mL, <20,000 platelets, <10,000 reticulocytes
Agranulocytosis<200 granulocytes
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