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ORAL PATHOLOGY! > Exam 6-OsteoDystrophy-Metabolic, Unknown & Other Causes > Flashcards

Exam 6-OsteoDystrophy-Metabolic, Unknown & Other Causes Flashcards

1
Q

What is the term for a Vitamin D deficiency during INFANCY?

A

Rickets

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2
Q

What is the term for a VItamin D deficiency during ADULTHOOD?

A

OsteoMALACIA

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3
Q

Rickets in infancy presents with growth retardation, prominence of the costochondral junctions (rachitic _____),
_____ of the legs

A

rosary and bowing

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4
Q

Osteomalacia presents with weak bone, _______ , diffuse skeletal pain

A

fractures

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5
Q

What is culprit for 80-90% of Hyperparathyroidism cases?

A

a parathyroid adenoma

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6
Q

What age and sex presents with hyperparathyroidism most frequently?

A

Women over 60

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7
Q

The mechanism for Parathyroid Hormone is to increase blood calcium which causes bone ______

A

resorption

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8
Q

What is the typical cause of secondary hyperparathyroidism?

A

chronic renal disease

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9
Q

Mechanism for secondary hyperparathyroidism: vit D does not get activated by the ______, absorption of ______ does not happen in the intestine and PTH is increased

A

kidney…calcium

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10
Q

What is our cute little rhyme for the mainfestations of hyperparathyroidism?

A

Stones, bones, and abdominal groans (kidney stones, calcifications)

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11
Q

Oral Radio features of hyperparathyroidism: loss of _______, ________ trabecular pattern, _____ tumor (radiolucency)

A

lamina dura, ground glass, brown

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12
Q

Which metabolic osteodystropic disease is associated with BROWN tumors? What do they appear as in a radiograph?

A

hyperparathyroidism…radioLucent

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13
Q

What is the Histo of a BROWN tumor INDISTINGUISHABLE from?

A

a Giant cell granuloma

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14
Q

Renal osteodystrophy is a complication of ________ hyperparathyroidism in end stage renal disease

A

SECONDARY

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15
Q

What is the radiographic feature of renal osteodystrophy?

A

ground glass pattern

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16
Q

What is the oral manifestation of renal osteodystrophy?

A

enlargement of the jaws

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17
Q

What is the histology of a lesion assocuated with a renal osteodystrophy?

A

fibro-osseus lesion

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18
Q

Which form of osteodystrophy presents with accelerated resorption and deposition of bone, ultimately osteoblasts win and bones become sclerotic, larger and brittle?

A

Paget’s disease of bone

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19
Q

In Paget’s disease of bone: Accelerated resorption and deposition of bone, ultimately WHICH TYPE OF CELL wins?? and bones become sclerotic, larger and brittle

A

OSTEOBLASTS

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20
Q

What is the typical demographic for Paget’s disease of the bone?

A

White males over 40

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21
Q

Is Paget’s disease of bone typically associated with one bone affected or multiple bones affected?

A

PolyOstotic (multiple)

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22
Q

Paget’s disease of bone CAN be asymptomatic, but if it is showing symptoms it is most likely WHAT?

A

bone pain

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23
Q

What are the two etiologies associated with Paget’s Disease of Bone?

A

1.ParaMyxoVirus infection 2.genetic

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24
Q

Radiographically, Paget’s disease of bone can vary from well defined radiolucent to mixed radioluct/opaque to “________” type of Radiopaque

A

“Cotton Wool-like”

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25
Q

What is the ORAL manifestation of Paget’s Disease of Bone?

A

generalized HYPERCEMENTOSIS

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26
Q

What is the most important complication of Paget’s Disease of Bone? (what is a lesser concern?)

A

1 OSTEOGENIC SARCOMA (maligant transformation) 2-fractures

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27
Q

Fibrous Dysplasia affects differentiation of What type of cell?

A

preosteoblasts

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28
Q

Which osteodysplasa is characterized by bones that become replaced with fibrous tissue and immature bone?

A

Fibrous Dysplasia

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29
Q

What % range of Fibrous Dysplasia is monOstotic?

A

80-85%

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30
Q

What are the distinuishing features of Fibrous Dystplasia-Jaffe-Lichtenstein Syndrome style?

A

Polyostotic with cafe au lait spots

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31
Q

What are the distinuishing features of Fibrous Dystplasia-McCune-Albright Syndrome style?

A

Polyostotic with cafe au lait AND endocrineopathy

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32
Q

Which flavor of Fibrous dysplasia is this describing? Polyostotic with café au lait AND endocrinopathy

A

McCune-Albright Syndrome

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33
Q

Which flavor of Fibrous dysplasia is this describing? Polyostotic with café au lait

A

Jaffe-Lichtenstein Syndrome

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34
Q

What is the typical age and sex of FIBROUS DYSPLASIA?

A

TEENAGE BOYS (1-2 decades…male)

35
Q

In Fibrous Dysplasia long bones can have pain and fracture but what is the HALLMARK feature if it affects the craniofacial region? How often is this region affected?

A

CROSSES SUTURE LINES!! (but its ONE lesion)…1/3 of cases affect craniofacial region

36
Q

In craniofacial fibrous dysplasia VITAL structures can be compressed…for example this nerve can be compressed resulting in WHAT?

A

OPTIC nerve compressed resulting in blindness

37
Q

What accounts for McCune-Albright Syndrome’s clinical diversity?

A

Somatic MOSAICISM

38
Q

Since we all know that McCune-Albright effect the endocrine system, which to organs show abnormal function? IS this abnormal function hyper or hypo funciton?

A

HYPER funciton of GONADS and THYROID

39
Q

What is a common finding in girls with McCune-Albright syndrome?

A

increased gonad function causes sexual precocity

40
Q

When do the cafe au lait spots appear in a person with McCune-Albright? What is unique about the margins?

A

within the first 2 years…irregular margins

41
Q

In McCune-Albright Fibrous Dysplasia, it is polyostotic, more found in the long bones, but what are the chances it affects the craniofacial region?

A

1/4

42
Q

In the 25% of patients with McCune-Albright Fibrous Dysplasia that affects the craniofacial region, which hormone is closely related with this situation?

A

increased GROWTH hormone

43
Q

Which 3 osteodystrophies are associated with GROUND GLASS appearance in radiographs?

A

1.hyperparathyroidism 2.McCune-Albright Fibrous Dysplasia 3.renal osteodystrophy

44
Q

Beyond ground glass appearance, what is another radiographic feature of fibrous dysplaisa?

A

There is cortical expansion

45
Q

Histo of Fibrous Dysplasia: Prototype “________” lesion, bone produced in a fibrous stroma

A

“fibro-osseous”

46
Q

Histo of Fibrous Dysplasia: Immature _______ of bone without significant _________ activity

A

trabeculae….osteoBLastic

47
Q

Histo of Fibrous Dysplasia: LOL-Bone pattern has been compared to WHAT?

A

Chinese script writing

48
Q

Histo of Fibrous Dysplasia: With CFFD bone can become _____ and lamellar, not often in other bones

A

MATURE

49
Q

Fibrous Dysplasia stabalizes with skeletal _______

A

maturity

50
Q

If the fibrous dysplasia is SMALL and LOCALIZED, what is the treatment?…..BUT if its LARGER what is the Tx?

A

smaller: it gets excised… larger: recontour with stabalization

51
Q

If the patient with fibrous dysplasia is symptomatic and polyostotic, what drug may be Rx’d to them?

A

Bisphosphonates

52
Q

WHAT IS THE MOST CONTRAINDICATED treatment for fibrous dysplasia?

A

Radiation (found to be oncogenic)

53
Q

What is the typical age and sex of patients with Central Giant Cell Granulomas?

A

Young FEMALES (before age 30)

54
Q

Which arch is favored for Central Giant Cell Granulomas? (what %?)

A

70% in the mandible

55
Q

WHAT IS THE HALLMARK SIGN of a Central Giant Cell Granuloma? Where are they typically found?

A

CLASSICALLY crosses the midline…mostly in the anterior jaw

56
Q

What other osteodysplasia is similar to a Central Giant Cell Granuloma?

A

hyperparathyroidism

57
Q

What is the radiographic RED FLAG for the aggressive form of Central Giant Cell Granuloma?

A

root resorption

58
Q

Radiographically, what are the margins of a Central Giant Cells Granuloma? What does this mean for the progression of the lesion?

A

non-coritcated…there can be coritcal perforation or expansion

59
Q

Even though we can surgically remove Central Giant Cell Granulomas what can the recurrence rate of these get to?

A

50%

60
Q

What are the alternative therapies for a Central Giant Cell Granuloma? (3 meds)

A

1.CorticoSteriods 2.Calcitonin 3.Interferon (denosumab)

61
Q

This one sounds cool: An intraosseous accumulation of variable-sized, blood-filled spaces surrounded by cellular fibrous tissue with giant cells…

A

Aneurysmal Bone Cyst (ABC)

62
Q

An Aneurysmal Bone Cyst (ABC) is an ________ accumulation of variable-sized, _____-filled spaces surrounded by cellular fibrous tissue with _____ cells

A

intraosseous…blood…giant

63
Q

ABC’s are most common in _____ bones or vertebrae, with ___% in jaws, and is more common in WHAT AGE RANGE?

A

LONG…2% in the jaws…kids and young adults

64
Q

What is unique about the swelling involved in an ABC?

A

its RAPID swelling and there is pain associated

65
Q

An ABC is unilocular or multilocular…are they opaque or lucent?

A

blood is lucent dawg.

66
Q

What is typically done with an ABC before curettage/resection surgery?

A

Aspirate blood from the cyst

67
Q

What is the one osteodysplasia Dr. W said EVERY DENTIST needs to know it, it will be one of the most common lesions we will see????

A

Idiopathic OsteoSclerosis

68
Q

What are the three most common ethnicities affected by idiopathic osteosclerosis? (although it does affect everyone)

A

Blacks, Chinese, Japanese

69
Q

What is the gender predelection for idiopathic osteosclerosis?

A

none….affects males and females equally

70
Q

Which arch and WHERE in the arch is an idiopathic osteosclerosis most common?

A

90% in the mandible and in the 1st molar region

71
Q

What % of Idiopathic Osteosclerosis lesions CONTACT THE ROOT?

A

80%

72
Q

Idiopathic osteosclerosis CHARACTERISTICALLY shows no sign of ______ or ________

A

pain or expansion

73
Q

This is important: our DUTY as GUARDIANS OF THE ORAL CAVITY and therefore the BODY: less than 5% of patients will show MULTIPLE idiopathic osteosclerosis lesions. WHAT syndrome is associated with this finding????

A

Gardner’s Syndrome

74
Q

How often does root resorption occur in idiopathic osterosclerosis?

A

RARE

75
Q

Athough YOU will never confuse this….Idiopathic Osteosclerosis can be easily confused with WHAT other type of lesion….what is the distinguishing factor?

A

condensing osteitis…but the tooth is VITAL in idiopathic osteosclerosis (non-vital in condensing osteitis)

76
Q

Is an idiopathic osteitis radiopaque or lucent? What radiographic feature is MISSING, and therefore the lesion BLENDS?

A

RadiOPAQUE…NO HALO so the borders blend

77
Q

In a 28 year study what % of idiopathic osteosclerotic lesions stayed stable? Got smaller? or grew larger?

A

86% stable, 10% smaller, 4% larger

78
Q

A Focal Osteoporotic Bone Marrow Defect is defined as an ________ radio_____ lesion

A

asymptomatic…radioLUCENT

79
Q

Which osteodysplasia is found most often in middle aged females??…One theory is this is secondary to low grade anemia

A

Focal Osteoporotic Bone Marrow Defect

80
Q

In a Focal Osteoportotic Bone Marrow Defect, it is found most often in WHAT AGE AND SEX?…One theory is this is secondary to low grade ______

A

middle aged females…low grade anemia

81
Q

What procedure commonly produces a focal osteoporotic bone marrow defect?

A

often at the site of a previous extraction

82
Q

Which jaw is affected most and were in the jaw is it affected most by a focal osteoportotic bone marrow defect?

A

70% are in the POSTERIOR mandible

83
Q

Radiographically, focal osteoporotic bone marrow defects present as a RADIOLUCENCY often with FINE internal _______

A

Trabeculation

84
Q

How is a focal osteoportotic bone marrow defect diagnosed and treated?

A

biopsy and no Tx necessary

ORAL PATHOLOGY! (40 decks)

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