Professional Documents
Culture Documents
Diseases (II)
Dr. Suhail S. Kishawi
Consultant in Endocrinology and Diabetes
Blood Disorders
Bleeding Disorders
Blood Disorders
Pernicious Anemia
Thalassemia
Celiac Sprue
Aplastic Anemia
Polycythemia
Normal CBC
Anemia
Nutritional anemias
Symptoms
Irritability
Lack of
Concentration
Fatigue
Infection
Palpitation
Weakness
Dizziness
Clinical Features
Pallor of skin
Soft ejection
And m/m
systolic murmur
Edema
Signs
Tachycardia
Koilonychia
Glossitis
Stomatitis
Anemia
Clinical features
Angular cheilitis
May occur as a result of deficient iron intake, blood loss from heavy
menstrual bleeding or chronic gastrointestinal bleeding, poor iron
absorption, or an increased requirement for iron in situations such as
pregnancy or infancy
Pernicious Anemia
Vitamin B12
There are a number of key steps in the absorption of Vitamin B12. The two key locations
are the stomach and the terminal ilium. Dietary vitamin B12 binds with intrinsic factor
(IF) in the stomach, a transport protein produced by gastric parietal cells. The B12-IF
complex then travels through the small intestine and is absorbed by special receptors in
the distal ileum. This pathway is important when considering possible causes of Vitamin
B12 deficiency.
Oesophagus
Causes of
vitamin B12
deficiency
Stomach
IF Intrinsic factor
1. Pernicious
anaemia
2. Inadequate
intake
3. Poor
absorption
Vitamin B12
ingested
Pernicious anaemia:
the leading cause of
B12 deficiency. IgG
autoantibodies
Distal ileum
Site of B12
absorption
Thalassemia
(Mediterranean Anemia)
Radiographic
Celiac Sprue
Aplastic Anemia
Aplastic Anemia
Polycythemia
Polycythemia Vera
Secondary Polycythemia
Relative Polycythemia
Unknown cause
More common in men than in women
Age of onset usually between 40 and 60 years of age
Clinical features
Secondary Polycythemia
Relative Polycythemia
Agranulocytosis
Leukemia
Granulocytes
Neutrophils (PMNs), eosinophils, and basophils
Lymphocytes
Monocytes
Agranulocytosis
Agranulocytosis
Oral infection
AGRANULOCYTOSIS
(White Blood Cell disorder)
Necrotizing ulcerations
Excessive bleeding from the gingiva
Rapid destruction of supporting tissue of the teeth
Regional lymphadenopathy
Necrotizing ulcerations
Regional lymphadenopathy
Leukemia
Acute Leukemias
Gingival enlargement
Oral infection
Chronic Leukemias
Slow onset
Bleeding Disorders
Hemostasis
Purpura
Hemophilia
Hemostasis
A cessation of bleeding
Hemostasis
Coagulation Cascade
(aPTT)
(PT)
Hemostasis
Platelet Count
Bleeding Time
Purpura
Thrombocytopenic Purpura
Immune thrombocytopenia
Nonthrombocytopenic Purpura
Hemophilia
Types of Hemophilia
Type A
Type B
Christmas disease
Less common, the clotting defect is plasma thromboplastin or
factor IX
Immunodeficiency
Divided into
Primary Immunodeficiencies
Of genetic origin
Very rare
Secondary Immunodeficiencies
Secondary Immunodeficiencies
Radiation Therapy
Chemotherapy
Radiation Therapy
Radiation Therapy
Radiation Therapy
Fluoride application
Patient education
Frequent follow-up appointments
Chemotherapy
Hematologic diseases
Leukemia
Gingival hypertrophy
Petechiae
Mucosal ulcers
Hemorrhage
Treatment of leukemia
Reactivation of herpes simplex virus oral mucosistis
Angular cheilitis
Iron-deficiency anemia
Intraoral burning
Iron-deficiency anemia
Pernicious anemia
Hemorrhage
Scurvy
Ulcerative colitis
Aphthous ulcers
Crohn's disease
Pernicious anemia
Ulcerative colitis
Candidiasis
Crohn's disease (steriod therapy)
Iron-deficiency anemia
Pyostomatitis vegetans (steriod
therapy)
Ulcerative colitis (steroid therapy
Glossitis
Crohn's disease
Iron-deficiency anemia
Pernicious anemia
Ulcerative colitis
Ulcerations and erosions
Crohn's disease
Iron-deficiency anemia
Pernicious anemia
Ulcerative colitis
Connective-tissue diseases
Sjgren syndrome
autoimmune disease
men : women - 1 : 9, 50 years and older
Main signs
sicca syndrome
keratoconjuctivitis sicca
xerostomia
Oral signs
decrease in saliva
xerostomia
dry, red, wrinkled mucosa
difficulty in swalloving and eating
disturbance in taste and speech
increased dental caries
infections
atrophy of the papilae
candidiasis
Connective-tissue diseases
Kawasaki disease
Oral signs
swelling of papilae on the surface of the
tongue (strawbery tongue)
intense erythema of the mucosal surfaces
cracked, cherry red, swolen and hemorrhagic
lips
Connective-tissue diseases
Scleroderma
Oral signs
pursed lips dificult to open the mouth
esophafeal sclerosis
gastroesophageal reflux damage of
enamel
pale, rigid mucosa
teleangiectasias
decreased mobility of tongue
salivary hypofunction
Gingival retraction
Connective-tissue diseases
Lupus erythematosus
autoimmune disease
Oral signs
ulcerations
oral lesions of lichen planus
petechiae
damage of salivary glands - xerostomia
ulcer
Behcets Disease
genital
similar in appearance
Behcets Disease
occular
uveitis, iritis
hypopyon
healing in days to
weeks some scarring
symptoms
simultaneously,
months apart
Pulmonary diseases
Cystic fibrosis
Oral signs
disorder of salivary
glands
swelling lips
gingivitis
dryness
Sarcoidosis
Sarcoidosis, also called sarcoid (from the Greek 'sark' and 'oid' meaning
"flesh-like")
The clinical course varies and ranges from asymptomatic disease that
resolves spontaneously to a debilitating chronic condition that may lead to
death.
Pulmonary Sarcoidosis
Oral signs
Cutaneous diseases
Psoriasis
Oral signs
Fissured tongue
Small white papules
Red and white plagues
Bright red patches
Acantosis nigricans
Hyperpigmentation, papillomatosis
Oral signs
Gingival hyperplasia
Gingiva, tongue, lips - papilomas
Discussion Questions
THANK YOU