Lecture Summary: Systemic Disorders

Question 1

a clump of platelets that covers the hole through which you’re bleeding

Answer 1

platelet plug

Question 2

a protein made by a complicated pathway called the coagulation cascade

Answer 2

fibrin

Question 3

normal hemostasis steps (2)

Answer 3

1. make a platelet plug

2. seal up the plug with fibrin

Question 4

most bleeding disorders are caused by 1 of 2 things

Answer 4

• something wrong with platelets (not enough, not working right)
• something wrong with coagulation (not enough of 1 or more coagulation factors)

Question 5

clinical symptoms of platelet bleeding disorders

Answer 5

• mild
• bleeding into skin mucous membranes
• spontaneous/without preceding trauma

Question 6

examples of platelet bleeding

Answer 6

petechiae in skin, nosebleeds, heavy periods

Question 7

clinical symptoms of factor bleeding

Answer 7

• more massive
• involves deep joints
• related to preceding trauma

Question 8

example of location for factor bleedings

Answer 8

knee

Question 9

lab tests to evaluate bleeding disorders

Answer 9

• platelet count
• bleeding time
• coagulation test

Question 10

x-linked recessive genetic bleeding disorder

Answer 10

hemophilia

Question 11

hemophilia is caused by a problem in the ________ (deficiency of ________)

Answer 11

coagulation cascade (deficiency of factor VIII or IX)

Question 12

clinical bleeding of hemophilia

Answer 12

• can be mild, moderate, severe
• bleeding preceded by injury
• deep bleeds
• excessive bleeding after dental procedures

Question 13

disorder in which patient has a low platelet count

Answer 13

thrombocytopenia

Question 14

in thrombocytopenia, without enough platelets to make _____, patient can not make ____, and will ____ as a result

Answer 14

platelet plugs, clots, bleed more

Question 15

causes of thrombocytopenia (many are possible)

Answer 15

• splenic sequestration
• aplastic anemia
• certain drugs

Question 16

in thrombocytopenia, bleeding tends to be ______ and is located in ________

Answer 16

spontaneous, skin/mucous membranes (petechiae, pinpoint bleeding into the skin)

Question 17

a below-normal amount of hemoglobin

Answer 17

anemia

Question 18

three ways one can become anemic

Answer 18

1. massive blood loss
2. destroy too many RBCs
3. make too few RBCs

Question 19

general symptoms of anemia

Answer 19

• weakness/tiredness
• increased HR and RR
• pale skin and mucous membrane

Question 20

most common type of anemia

Answer 20

iron-deficient anemia (IDA)

Question 21

iron-deficient anemia is due to a lack of _____ either from _____ or _____

Answer 21

iron, chronic blood loss, poor nutrition

Question 22

genetic disease (autosomal recessive) in which patient makes abnormal beta globin chain

Answer 22

sickle cell anemia

Question 23

in sickle cell anemia, RBCs become “____” or ____ shaped, which makes red cells ________

Answer 23

sickle, curved, fragile and sticky

Question 24

in sickle cell anemia, blocked BV caused ______

Answer 24

ischemia

Question 25

clinical symptoms of sickle cell anemia

Answer 25

- extreme pain where tissue is damaged | - regular anemia symptoms

Question 26

radiographic findings of sickle cell anemia

Answer 26

-reduced trabeculation of mandible, "hair on end" appearance of skull

Question 27

white blood cell disorders can be _______

Answer 27

benign or malignant

Question 28

common finding in WBC disorders is _____, meaning ____

Answer 28

lymphadenopathy, enlarged lymph nodes

Question 29

most common cause of lymphadenopathy

Answer 29

infection

Question 30

enlargement of lymphoid tissue (big lymph nodes and enlargement of non-lymph-node-associated lymphoid tissue...tonsils, lymphoid tissue under the mouth mucosa)

Answer 30

lymphoid hyperplasia

Question 31

Malignancy of white blood cells that starts in the bone marrow and blood, but can involve other tissues as well.

Answer 31

leukemia

Question 32

oral manifestations of leukemia

Answer 32

- enlargement of gingiva | - petechiae

Question 33

Malignancy of white blood cells that starts in lymph nodes, but can sometimes affect other tissues as well.

Answer 33

lymphoma

Question 34

two categories of lymphoma

Answer 34

non-Hodgkin lymphoma, Hodgkin lymphoma

Question 35

type of lymphoma with a variable prognoses, with overall good prognoses, and has a few subtypes

Answer 35

non-Hodgkin lymphoma

Question 36

non-Hodgkin lymphoma oral manifestations

Answer 36

- oral lesions (red, purple, yellow lesions on buccal mucosa/gingiva/palate) - diffuse gingival swelling

Question 37

Hodgkin lymphoma ____ manifests in the mouth

Answer 37

rarely

Question 38

oral findings in Vitamin B2 (riboflavin) deficiency

Answer 38

- glossitis | - angular cheilitis

Question 39

oral findings in Vitamin B3 (niacin) deficiency

Answer 39

- fiery red painful mucosa - profuse salivation - in some areas, mucosa loses uppermost layer/desquamation - may develop acute necrotizing ulcerative gingivitis

Question 40

ANUG stands for...

Answer 40

acute necrotizing ulcerative gingivitis

Question 41

ANUG presents as...

Answer 41

- painful bleeding gums | - punched out looking ulcers in interdental papillae

Question 42

oral findings in Vitamin C deficiency

Answer 42

- spontaneous hemorrhage - ulceration - severe periodontal disease

Question 43

Vitamin C is required for ______ and ____ surrounds vessels. If there isn't enough Vitamin C, vascular walls are _______

Answer 43

collagen, collagen, weakened and likely to break

Question 44

early diabetes oral manifestations

Answer 44

burning tongue, sensitive gingiva

Question 45

later diabetes oral manifestations

Answer 45

fulminating periodontitis, bleeding gums

Question 46

end stage diabetes oral manifestations

Answer 46

can develop mucormycosis

Question 47

a dangerous fungal infection of the sinuses that | can invade directly into the brain

Answer 47

mucormycosis

Question 48

adrenal glands are destroyed levels of adrenal cortex hormones become so low that the patient develops symptoms

Answer 48

Addison disease

Question 49

symptoms of Addison disease (remember that Addison disease symptoms can be slow to manifest)

Answer 49

- flu-like symptoms - severe hypotension - skin bronzing

Question 50

pathway for skin bronzing

Answer 50

POMC ---> melanocyte-stimulating hormone (MSH) --> bronze skin excess ACTH = excess MSH ---> bronze skin