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

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

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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
What is the ORAL manifestation of Paget's Disease of Bone?
generalized HYPERCEMENTOSIS
26
What is the most important complication of Paget's Disease of Bone? (what is a lesser concern?)
#1 OSTEOGENIC SARCOMA (maligant transformation) 2-fractures
27
Fibrous Dysplasia affects differentiation of What type of cell?
preosteoblasts
28
Which osteodysplasa is characterized by bones that become replaced with fibrous tissue and immature bone?
Fibrous Dysplasia
29
What % range of Fibrous Dysplasia is monOstotic?
80-85%
30
What are the distinuishing features of Fibrous Dystplasia-Jaffe-Lichtenstein Syndrome style?
Polyostotic with cafe au lait spots
31
What are the distinuishing features of Fibrous Dystplasia-McCune-Albright Syndrome style?
Polyostotic with cafe au lait AND endocrineopathy
32
Which flavor of Fibrous dysplasia is this describing? Polyostotic with café au lait AND endocrinopathy
McCune-Albright Syndrome
33
Which flavor of Fibrous dysplasia is this describing? Polyostotic with café au lait
Jaffe-Lichtenstein Syndrome
34
What is the typical age and sex of FIBROUS DYSPLASIA?
TEENAGE BOYS (1-2 decades...male)
35
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?
CROSSES SUTURE LINES!! (but its ONE lesion)...1/3 of cases affect craniofacial region
36
In craniofacial fibrous dysplasia VITAL structures can be compressed...for example this nerve can be compressed resulting in WHAT?
OPTIC nerve compressed resulting in blindness
37
What accounts for McCune-Albright Syndrome's clinical diversity?
Somatic MOSAICISM
38
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?
HYPER funciton of GONADS and THYROID
39
What is a common finding in girls with McCune-Albright syndrome?
increased gonad function causes sexual precocity
40
When do the cafe au lait spots appear in a person with McCune-Albright? What is unique about the margins?
within the first 2 years...irregular margins
41
In McCune-Albright Fibrous Dysplasia, it is polyostotic, more found in the long bones, but what are the chances it affects the craniofacial region?
1/4
42
In the 25% of patients with McCune-Albright Fibrous Dysplasia that affects the craniofacial region, which hormone is closely related with this situation?
increased GROWTH hormone
43
Which 3 osteodystrophies are associated with GROUND GLASS appearance in radiographs?
1.hyperparathyroidism 2.McCune-Albright Fibrous Dysplasia 3.renal osteodystrophy
44
Beyond ground glass appearance, what is another radiographic feature of fibrous dysplaisa?
There is cortical expansion
45
Histo of Fibrous Dysplasia: Prototype “________” lesion, bone produced in a fibrous stroma
“fibro-osseous”
46
Histo of Fibrous Dysplasia: Immature _______ of bone without significant _________ activity
trabeculae....osteoBLastic
47
Histo of Fibrous Dysplasia: LOL-Bone pattern has been compared to WHAT?
Chinese script writing
48
Histo of Fibrous Dysplasia: With CFFD bone can become _____ and lamellar, not often in other bones
MATURE
49
Fibrous Dysplasia stabalizes with skeletal _______
maturity
50
If the fibrous dysplasia is SMALL and LOCALIZED, what is the treatment?.....BUT if its LARGER what is the Tx?
smaller: it gets excised... larger: recontour with stabalization
51
If the patient with fibrous dysplasia is symptomatic and polyostotic, what drug may be Rx'd to them?
Bisphosphonates
52
WHAT IS THE MOST CONTRAINDICATED treatment for fibrous dysplasia?
Radiation (found to be oncogenic)
53
What is the typical age and sex of patients with Central Giant Cell Granulomas?
Young FEMALES (before age 30)
54
Which arch is favored for Central Giant Cell Granulomas? (what %?)
70% in the mandible
55
WHAT IS THE HALLMARK SIGN of a Central Giant Cell Granuloma? Where are they typically found?
CLASSICALLY crosses the midline...mostly in the anterior jaw
56
What other osteodysplasia is similar to a Central Giant Cell Granuloma?
hyperparathyroidism
57
What is the radiographic RED FLAG for the aggressive form of Central Giant Cell Granuloma?
root resorption
58
Radiographically, what are the margins of a Central Giant Cells Granuloma? What does this mean for the progression of the lesion?
non-coritcated...there can be coritcal perforation or expansion
59
Even though we can surgically remove Central Giant Cell Granulomas what can the recurrence rate of these get to?
50%
60
What are the alternative therapies for a Central Giant Cell Granuloma? (3 meds)
1.CorticoSteriods 2.Calcitonin 3.Interferon (denosumab)
61
This one sounds cool: An intraosseous accumulation of variable-sized, blood-filled spaces surrounded by cellular fibrous tissue with giant cells...
Aneurysmal Bone Cyst (ABC)
62
An Aneurysmal Bone Cyst (ABC) is an ________ accumulation of variable-sized, _____-filled spaces surrounded by cellular fibrous tissue with _____ cells
intraosseous...blood...giant
63
ABC's are most common in _____ bones or vertebrae, with ___% in jaws, and is more common in WHAT AGE RANGE?
LONG...2% in the jaws...kids and young adults
64
What is unique about the swelling involved in an ABC?
its RAPID swelling and there is pain associated
65
An ABC is unilocular or multilocular...are they opaque or lucent?
blood is lucent dawg.
66
What is typically done with an ABC before curettage/resection surgery?
Aspirate blood from the cyst
67
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????
Idiopathic OsteoSclerosis
68
What are the three most common ethnicities affected by idiopathic osteosclerosis? (although it does affect everyone)
Blacks, Chinese, Japanese
69
What is the gender predelection for idiopathic osteosclerosis?
none....affects males and females equally
70
Which arch and WHERE in the arch is an idiopathic osteosclerosis most common?
90% in the mandible and in the 1st molar region
71
What % of Idiopathic Osteosclerosis lesions CONTACT THE ROOT?
80%
72
Idiopathic osteosclerosis CHARACTERISTICALLY shows no sign of ______ or ________
pain or expansion
73
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????
Gardner's Syndrome
74
How often does root resorption occur in idiopathic osterosclerosis?
RARE
75
Athough YOU will never confuse this....Idiopathic Osteosclerosis can be easily confused with WHAT other type of lesion....what is the distinguishing factor?
condensing osteitis...but the tooth is VITAL in idiopathic osteosclerosis (non-vital in condensing osteitis)
76
Is an idiopathic osteitis radiopaque or lucent? What radiographic feature is MISSING, and therefore the lesion BLENDS?
RadiOPAQUE...NO HALO so the borders blend
77
In a 28 year study what % of idiopathic osteosclerotic lesions stayed stable? Got smaller? or grew larger?
86% stable, 10% smaller, 4% larger
78
A Focal Osteoporotic Bone Marrow Defect is defined as an ________ radio_____ lesion
asymptomatic...radioLUCENT
79
Which osteodysplasia is found most often in middle aged females??...One theory is this is secondary to low grade anemia
Focal Osteoporotic Bone Marrow Defect
80
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 ______
middle aged females...low grade anemia
81
What procedure commonly produces a focal osteoporotic bone marrow defect?
often at the site of a previous extraction
82
Which jaw is affected most and were in the jaw is it affected most by a focal osteoportotic bone marrow defect?
70% are in the POSTERIOR mandible
83
Radiographically, focal osteoporotic bone marrow defects present as a RADIOLUCENCY often with FINE internal _______
Trabeculation
84
How is a focal osteoportotic bone marrow defect diagnosed and treated?
biopsy and no Tx necessary

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