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Path 2 Flashcards

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1
Q

What causes problems in babies in embryo?

A

Teratogens

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2
Q

Definition of teratogen:

A

Any agent that can disturb the development of an embryo or fetus. Teratogens may cause a birth defect in
the child. Or a teratogen may halt the pregnancy outright.

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3
Q

Muscular dystrophy:

A

group of muscle diseases that weaken the musculoskeletal system & hamper locomotion. Characterized by progressive
skeletal muscle weakness, defects in muscle proteins, and the death of muscle cells and tissue.
- Muscular dystrophy: muscle weakness, “long face” which is characterized by a lower vertical facial height and open bite/

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4
Q

Muscle dystrophy; after local anesthetic is most likely due to? Lidocaine toxicity, increase duration of action, increase onset, Can’t
be supine

A

Lidocaine toxicity,

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5
Q

QUESTION: Pt w/ muscular dystrophy condition:

A

lower face with open bite

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6
Q

What can be seen on a patient with muscle weakness of the face? Cross bite, buccal tilting of molars, long upper face, lower face
with open bite

A

lower face

with open bite

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7
Q

Considerations for muscular dystrophy: increase in dental disease if OHI is neglected, weakness of muscles of mastication

A

weakness of muscles of mastication

decrease biting force, open mouth breathing

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8
Q

Addison’s disease

A

primary adrenal insufficiency

chronic endocrine disorder, adrenal glands do not produce
enough steroid hormones (too little cortisol & sometimes, insufficient aldosterone).

  • Symptoms generally come slowly & include abdominal pain, weakness, skin darkening and weight loss.
  • Adrenal crisis may occur with low blood pressure, vomiting, lower back pain, and loss of consciousness. An adrenal crisis can be triggered
    by stress, such as from an injury, surgery, or infection.
  • Tx: give cortisol
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9
Q

Acute adrenal insufficiency:

A

hypotension

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10
Q

QUESTION: What Addison disease causes in mouth:

A

pigmentation of the mucosa

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11
Q

Pheochromocytoma:

A

neuroendocrine tumor in medulla of adrenal gland à excess catecholamines (ex. epi)

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12
Q

Cerebral palsy (CP):

A

group of permanent central motor/movement disorders that appear in early childhood, caused by abnormal development
or damage to the parts of the brain that control movement, balance, muscle tone, and posture. Signs and symptoms vary & include: poor
coordination, stiff muscles, weak muscles, and tremors. Other problems w/ sensation, vision, hearing, swallowing, and speaking.

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13
Q

QUESTION: CP patient - which is not true?

a. 95% have cognitive impairment
b. all bruxism
c. increase in periodontitis

A

c. increase in periodontitis

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14
Q

Cerebral palsy during treatment.

A

– patient will have spastic oral mucosa

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15
Q

Pt has involuntary uncoordinated movements with larynx problem?

A

Cerebral palsy

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16
Q

Common finding in a patient with cerebral athetoid palsy:

A

Anterior Teeth fracture

- cerebral athetoid palsy: damage to basal ganglia, has both hypertonia/hypotonia

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17
Q

Case: Black girl around 7 years old presents with unilateral cross bite; she had a cleft palate that was fixed. Palate in picture looks
like a triangle and laterals are towards the palate.
A) What is the pigmentation?
B) What is the most likely cause of the crossbite?

A

racial pigmentation

early loss of laterals, due to cleft palate

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18
Q

When does cleft lip and palate develop?

A

6-9 weeks in utero

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19
Q

QUESTION: Patients with cleft lip and palate, what occlusion is mostly seen?

A

class III malocclusion

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20
Q

QUESTION: Cleft lip is more common in ; cleft palate more common in .

A

boys

girls

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21
Q

QUESTION: Pt had cleft lip and palate. Later in life during ortho analysis, what do you see?

A

Deficient maxilla, normal mand

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22
Q

Most prevalent developmental deformity in Maxilla?

A

Cleft Palate

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23
Q 
What is more commonly seen?
o Amelogenesis imperfect
o Ectodermal dysplasia
o Dentinogenesis imperfect
o Cleft lip and palate
A

o Cleft lip and palate

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24
Q

What is cleft palate class III?

A

Soft & hard palate plus alveolar process

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25
What mostly gives cleft lip/palate? Genetic, autosomal dominant, autosomal recessive, environmental, multi-factorial
multi-factorial
26
All of the following are the reasons for closing a cleft lip except? Support the premax on a unilat cleft Help speech Support the ala of the nose.
Support the ala of the nose.
27
Speech problems associated with cleft lip and palate are usually the result of?
Inability of soft palate to close air flow into the nasal | area
28
QUESTION: A cleft lip occurs following the failure of permanent union between which of the following? A. The palatine processes B. The maxillary processes C. The palatine process with the frontonasal process D. The maxillary process with the palatine process E. The maxillary process with the frontonasal process
E. The maxillary process with the frontonasal process
29
Age for repair of cleft palate w/ normal canine eruption:
When canine tooth is 3⁄4 formed (8-9years old)
30
When correcting cleft problem, how do you end/finish?
Suturing lip
31
Percentage of cleft lip and cleft palate in Caucasians?
1/750 | - Asians = 1/500, Asians have it the most common
32
Incident of cleft palate & lip in US - 1 in ____ vs Incident of cleft palate w/out lip in US 1 in ____ –
palate & lip 1 in 1000 palate without lip 1/2000 (CDC 2012)
33
QUESTION: What surgery will a pt with cleft palate most likely need?
(mandibular set back) - Pt get cleft lip & palate surgery. This usually cases future Class III tissues so at later age, they need to come back to move the mandible to correct Class III (mandibular setback)
34
How does a kid with fetal alcohol syndrome present with? anencephaly, midface deficiency, cleft lip
midface deficiency
35
Treacher Collins inheritance
AUTOSOMAL DOMINANT midface deficienct weird ears aka mandibulofacial dysostosis downslanted eyes cleft palate, malocclusion, anterior open bite, enamel hypoplasia
36
Which disorder has the least developmental delay?
Treacher Collins syndrome
37
Treacher Collins has loss (hypoplasia) of _____. What do patients with cleidocranial dysplasia have?
Treacher Collins: zygomatic bone Cleidocranial: Loss of clavicle
38
Describes patient saying they have mandibular hypoplasia, malformed ear, lower eyelids, ear pinna –
Treacher Collins
39
Treacher Collins syndrome à
know pt's are not mentally retarded and they have ear abnormalities
40
Down's higher risk of
perio dz NOT CARIES
41
Down's which third of face is affected
midfacial hypoplasia
42
What orthomanifcastion does Turner syndrome and trisomy 21 associated with?
short midface
43
What is orbital hypertelorism?
Wide-set eyes (seen in Crouzon, Cleidocranial dysostotosis, GOrlin Syndrome, Down’s syndrome)
44
Hypertelorism definition:
Increased distance between eyes, or other body parts
45
Which does NOT result in delayed development? Trisomy 21, Trisomy 18, Hurler Syndrome, Cri du Chat
Trisomy 18 (Edward syndrome) - Edward’s syndrome: small head (microcephaly) accompanied by a prominent back portion of the head (occiput), low-set, malformed ears, abnormally small jaw (micrognathia), cleft lip/cleft palate, upturned nose, narrow eyelid folds (palpebral fissures), widely spaced eyes (ocular hypertelorism)
46
What resembles epiphyseal plate?
Synchondrosis - Synchondrosis: almost immovable joint between bones bound by layer of cartilage (ex. vertebra, epiphyseal growth plate)
47
What age does the mandibular symphysis close?
6-9 months | Symphysis: two flat bones grow together & join
48
Sphenooccipital closure, what kind of tissue fills it in?
Cartilage Interstitial growth – occurs by the mitotic division and deposition of more matrix around chondrocytes already established in the cartilage. - Ex – CONDYLE, nasal septum, and spheno-occipital snychondrosis
49
``` Which of these undergo suture closure latest? • sphenoethmoidal • Sphenoccipital • Intrasphenoid • Intraoccipital ```
Sphenoccipital
50
What is synostosis?
ABNORMAL FUSION OF BONES
51
What is craniosynostosis?
Early closure of suture between bones
52
Crouzon syndrome
Autosomal dominant, 1st branchial arch syndrome, mutation in fibroblast growth factor receptor II à fibrous joints between certain bones of the skull (cranial sutures) close prematurely (craniosynostosis).
53
characteristic x ray of Crouzon
beaten metal
54
how does crouzon present
Most notable characteristic of Crouzon syndrome is cranial synostosis, but it usually presents as brachycephaly, which results in the appearance of a short and broad head, exophthalmos or proptosis (bulging eyes due to shallow eye sockets after early fusion of surrounding bones), hypertelorism (greater than normal distance between the eyes), hypoplastic maxillary, & mandibular prognathism Fuzzy radiograph!
55
Synostosis – early/late closing of sutures - which syndrome
Crouzon syndrome
56
Patient w/ deficient mid-face, proptosis, etc?
Crouzon syndrome
57
``` Pt has ocular proptosis, maxillary hypoplasia, premature suture closing (synostosis)? treacher-collins Crouzon Pierre robin cleidocranial ```
Crouzon
58
Hurler and Hunter syndromes class
Both are lysosomal storage disease (MCUOPOLYSACCHARIDOSIS)
59
hurler inheritance
mucopolysacch type I, gargoylism Autosomal recessive buildup of GAGs deficienct of alpha-L heparin sulfate and dermatan sulfate
60
hunters syndrome inheritance
``` mucopoluysacch 2 X-linked recessive defect in achoring between epidermis and dermis friction and skin fragility iduronate-2-sulfatase --> GAG buildup ```
61
Hurler and Hunter’s syndromes, what do they have in common?
They both have mucopolysaccaridosis & buildup of GAGs
62
Cleidocranial dysostosis =
hereditary congenital disorder (usually autosomal dominant), where there is delayed ossification of midline structures. Bone defects usually involve clavicle (hypoplastic or aplastic clavicle) & skull. Short, big head, shoulders moved in. Dental – narrow high palate, increased rate of cleft palate, presence of many unerupted permanent, retained primary, & supranumery teeth w/ distorted crowns/root shape
63
What is the most significant finding in cleidocranial dysplasia? odontoma, supernumery teeth, sparse hair, multiple impacted teeth, retained teeth
supernumery teeth
64
Cleidocrainal dysplasis in mouth–
supernumerary teeth & problems with eruption
65
QUESTION: Cleidocranial syndrome: x ray with
absence of clavicle
66
Which will give you very narrow facial structures and delayed eruption of permanent teeth? * cleidocranial syndrome * downs syndrome
• cleidocranial syndrome
67
What allows for compression of skull during birth?
Fontanelles
68
What is the part of the infant’s head that allows it to change shape?
Fontanelles (enable the bony plates of the skull to flex - Fontanelles close anterior 12-18 months, posterior 3-4 months
69
What is the part of the infant’s head that allows it to change shape?
Fontanelles
70
Which structures in a baby allow the head to deform in the birth canal?
fontanelles
71
Papillon–Lefèvre syndrome (PLS) -
palmoplantar keratoderma w/ periodontitis. It’s an autosomal recessive disorder caused by a deficiency in cathepsin C. - Severe perio à early/young loss of primary & permanent teeth after eruption of 1st molar - Hyperkeratosis of palm & feet sole
72
15 yr. old w/ edentulous and keratosis on hands and feet. They gave ugly picture of thick soled feet. à
Papillon Lefevre syndrome
73
What is Papillon–Lefèvre syndrome?
You get periodontitis, keratosis on hands | and soles, and premature loss of primary teeth.
74
Hyperkeratosis in hands and feet –
Papillon-Lefevre Syndrome
75
Pierre Robin Syndrome:
Pierre Robin Syndrome:
76
Pt has glossoptosis, micrognathia, and cleft palate?
Pierre Robin syndrome | - Glossoptosis = refers to the downward displacement or retraction of the tongue
77
Sturge-Weber syndrome:
neurological disorder present at birth. Characterized by a port-wine stain on the face and brain or eye abnormalities due to overabundance of capillaries near skin surface. Sometimes seizures or neurological symptoms
78
Sturge-Weber syndrome?
vascular malformation, eye and hemangioma
79
Portwine stain
Sturge-Weber | Angiomatosis of leptomeninges
80
Pt has high cholesterol, hypertension and diabetes, metabolic problem, which does he have:
metabolic syndrome
81
Pt has BMI of 36, is overweight & has high cholesterol. What syndrome?
Metabolic Syndrome
82
QUESTION: What is the normal % fat intake per day-
30% | - Recommended daily dose of fat: 30% of total calorie and saturated fat is 10% of daily calorie intake
83
Which is not endocrine gland? Parathyroid, thyroid, adrenal, parotid
parotid
84
Which do you give a hyperparathyroid child for normal development of teeth?
Vitamin D (Brings in Ca+)
85
Thyrotoxicosis symptoms –
DIAPHORESIS (sweating), fever, hypertension and TACHYCARDIA | - thyroid storm is a severe version of thyrotoxicosis
86
Thyrotoxic pt. manifestation?
Tachycardia
87
QUESTION: LA with epinephrine contraindicated in? Uncontrolled Diabetes, hypothyroidism, hyperthyroidism
hyperthyroidism
88
Symptoms of hypothyroid attack:
loss of brain function due to severe, longstanding low levels of thyroid hormone in the blood (hypothyroidism) - Hypothyroidism primary symptoms are altered mental status & hypothermia. Hypoglycemia, hypotension, hyponatremia, hypercapnia, hypoxia, bradycardia, hypoventilation may also occur.
89
Myxedema is due to?
severe hypothyroidism | - Myxedema: swelling of skin, waxy consistency
90
With which endocrine systemic disease does thick hair become thin hair?
thyroid – hypothyroidism (cretinism in kids and | myxoedema in adults)
91
PT was gaining weight, has lower voice, fine hair, feels cold –
hypothyroidism | - symptoms of hypothyroidism: weight gain, bradycardia, cool to touch/cold, fatigue
92
QUESTION: Which thyroid drug doesn't let iodine bond to hormone?
Radiated Iodide (for hyperthyroidism)
93
QUESTION: Graves’ Disease
(Hyperthyroidism) - | exophthalmos
94
Thyroid hormone decrease, which drug do you give?
Levothyroxine (for hypothyroidism)
95
Hypophosphatasia -
metabolic bone disease, low alkaline phosphatase
96
Increase in alkaline phosphatase is related to?
Hyperparathyroidism
97
Decreased alkaline phosphatase is related to:
Hypophosphatasia
98
What disease causes decrease in alkaline phosphatase? Malnutrition, hypophosphatasia, hypothyroidism, pernicious anemia
hypophosphatasia
99
Central Giant Cell Granuloma is seen with pts with which condition?
Hyperparathyroidism
100
Osteoporosis is associated with which of the following diseases?
Hyperparathyroidism

NBDE II (12 decks)

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