F09 Oral Path 2a Flashcards

Erythema
Terms Definitions
Distodens
Fourth molar aka ____.
 
True or False?
 
HPV+ cancers have a better prognosis than HPV- ones.
 
True
HPV
___ infections show koilocytes microscopically.
 
Which multiple mucosal ulcer diseases are always Nikolsky sign positive?
 
Which are sometimes or rarely Nikolsky sign positive?
Always:                Pemphigus vulgaris
BMMP
Epidermolysis Bullosa
 
 
Sometimes:         Erosive Lichen Planus
Erythema Multiforme
Systemic Allergy
 
Sistrunk procedure
 removal of thyroglossal duct cyst
 
- cyst removed as well as midsegment of hyoid bone and musle along tract
 
- less than 10% recur
 
- rarely can transform into papillary adenocarcinoma
 
Order the following types of leukoplakia from unlikely malignant transformation to likely malignant transformation:
 
Granular/nodular
Speckled
Verrucous
Thin
Homogenous/thick
 
Thin
Homogenous/thick
Granular/nodular
Verrucous
Speckled
Parotid gland
Pleomorphic adenoma, wathin's tumor, basal cell adenoma, mucoepidermoid carcinoma, acinic cell carcinoma, adenoid cystic carcinoma and carcinoma ex pleomorphic adenoma are most commonly found in which gland?
actinomycosis
Sulfur granules are yellowish flecks found in ____.
Rubeola
___ = measles caused by paramyxovirus
#5
Gardner Syndrome is an autosomal dominant defect on chromosome ___.
 
Cheilitis granulomatosa is a component of Melkerson-Rosenthal syndrome. It presents clinically as firm swelling of the lip(s). What does it look like histologically?
 
typical granuloma morphology:
 
poorly-formed granulomas consisting of
- epithelioid cells
- multinucleate giant cells
- lymphocytes & macrophages
 
* no microorganisms or foreign material
 
 
What is the treatment for Herpes Simplex infections, or for Erythema Multiforme triggered by HSV infection?
 
acyclovir
Benign salivary gland tumors usually have well-defined borders, a slow growth rate, and are freely moveable.
 
Where in the mouth are they not freely moveable?
 
hard palate
Posterior palate (>75%)
Where is necrotizing sialometaplasia most commonly found?
penicillin
Treatment of choice for syphilis is ___.
AIDs-related complex
Oral candidiasis, herpes zoster and oral hair leukoplakia are clinical features of which disease?
Enamel hypoplasia
Rows of brown pits/grooves, larger areas of missing enamel, white spots or discoloration describe which developmental abnormality?
Pulpitis
___ appears as increased redness at the coronal aspect of the pulp chamber.
periapical cysts
Larger periapical lesions (>2cm) more likely to be ___ ___.
periapical inflammation
Toxic metabolites of degerating cells incite inflammation in ___ ___.
 
What disease am I?
 
defective desmosomes
skin papules
acantholytic dyskeratosis
Corps ronds
 
 
Keratosis Follicularis (Darier's Disease)
 
 
defective Ca pump gene: ATP2A2 on 12q23-24.1
treated with Vitamin A derivatives
 
The most common cause of recurrent erythema multiforme
 
HSV-1 infection
 
treatment and malignant transformation rate for
PLEOMORPHIC ADENOMAS
 
surgical excission must include rim of normal tissue
(these adenomas often poorly encapsulated and can extend beyond capsule)
 
- malignant transformation <5%
 
- recurrence more often for parotid gland than minor sg




l5%
What chronic blistering disease exhibits sub¬epithelial separation with positive direct immunofluorescence at the basement membrane?   
Benign mucous membrane pemphigoid
carcinoma ex pleomorphic adenoma
Which neoplasia arises from preexisting pleiomorphic adenoma?
Chronic atrophic candidasis
Patchy erythema or petecchiae usually seen in patients with dentures describes what?
MUMPS = parotitis
___ is a paramyxovirus infection primarily affecting salivary glands. It is transmitted through urine, saliva or respiratory droplets.
VSV = HHV-3
Varicella/Zoster is human herpes virus ___.
Hutchinson incisor
___ ___ caused by congenital syphilis are rounded, bulbous crowns with incisal edge notch.
Periapical granulomas
Widened PDL, resorption of lamina dura and possible root resorption are radiographic findings in ___ ___.
Ludwig Angina
___ ___ is an elevation, enlargement and protrusion of the tongue (woody tongue).
 
Cellulitis is an acute edematous inflammatory reaction which is rapidly spreading. S. pyogenes produces enzymes that allow rapid spread through tissues.
 
Name two types of cellulitis & characterize each.
Ludwig's Angina
- submandibular, sublingual, lat. pharyngeal spaces
- can originate from periapical infection of lower teeth
- clinically, area is brawny hard, fever, malaise
 
Erysipelas
- sharply demarcated, often due to trauma/S.pyogenes
- edematous hot shiny plaque, orange peel sometimes
- butterfly pattern seen when malar/face involved
- fever chills, malaise
 
What causes chronic sclerosing sialadenitis?
 
How is it characterized histologically?
 
long-term obstruction of the salivary gland without infection
 
 
- characterized by acinar atrophy, chronic inflammation and marked fibrosis --> loss of function
- occasionally entire gland becomes calcified
 
smokers have an increased risk for this benign salivary gland tumor
 
WARTHIN'S TUMOR
(papillary cystadenoma lymphomatosum)
 
- asymptomatic swelling in lower pole of parotid
- unilateral or bilateral
- fluctuant
- in males >50 yrs old
What blistering disease can cause scarring and fusion of the digits and may cause death at an early age?       
Epidermolysis Bullosa (dystrophic, recessive type)     Fusion of digits = “mitten-like” deformity; may also have esophageal strictures
What techniques/medicines help relieve the symptoms of burning mouth syndrome?   
Anti-anxiety meds (e.g., clonazepam)     Fight fire w/ fire → tobasco sauce or capsaicin cream      Correct underlying condition     Supportive techniques if idiopathic type
2ndary syphilis
___ syphilis presents with a skin rash and is contagious, 1/3 resolve w/o tx
Verruca vulgaris
___ ___ is the common wart. Sessile, hairy-looking white lesion.
Oligodontia
____ is the failure of 6+ teeth to develop.
True! Masses of neutrophils, histiocytes with foci of necrosis, chronic inflammatory cells and fibrosis peripherally
T/F: Irreversible pulpitis, partial necrosis and necrosis have similar histologic features.
 
Which type of pneumonia was at one time very rare, but is seen as an opportunistic infection in about half of all AIDS patients?
 
Pneumocystitis carinii pneumonia
 
Name 2 proteins that are commonly overexpressed in oral cancers, causing, or as a result of, p53 inactivation.
 
MDM2 protein (inhibits p53)
 
Cyclin D1 protein (p53 activates CDK inhibitors)
Which odontogenic cyst exhibits ghost cells?
Calcifying Odontogenic Cyst (Gorlin cyst)     Ghost cell = loss of nuclear staining; become calcified with time          Unilocular, mixed RL/RO (scattered calcifications)          Two types: Type 1 (cystic) & Type 2 (solid = odontogenic ghost cell tumor
Chelitis glandularis
A 45 year old man presents with the chief complaint of swelling and eversion of the lower lip. His history is significant for excessive sun exposure and he is also a chain smoker. What is most likely the diagnosis?
verruca, condyloma, papilloma
___ looks like an upside-down V, ___ is a sideways C, ___ is pedunculated like P.
Permanent mandibular premolars / maxillary incisors
Where is Turner hypoplasia most commonly found?
Acute apical abscess
___ ___ ___ comes with pus, severe pain to pressure/percussion, but usually not thermal sensitivity since pulp is necrotic.
Give the more common name for each disease:
 
Scleroderma
Cancrum oris
Hansen's Disease
Stomatitis venenata
Darier's Disease
Cannon's Disease
Von Recklinghausen's Disease
Sutton's Disease
 
Scleroderma aka Systemic sclerosis
Cancrum oris aka NOMA or Necrotizing stomatitis
Hansen's Disease aka Leprosy
Stomatitis venenata aka Allergic contact stomatitis
Darier's Disease aka Keratosis Follicularis
Cannon's Disease aka White sponge nevus
Von Recklinghausesn's Disease aka Neurofibromatosis 1
Sutton's Disease aka Major apthous stomatitis
 
 
This represents more than 90% of oral cancers
 
Squamous Cell Carcinoma of the oral mucosa
 Blistering of non-lesional skin or mucosa from lateral pressure is known as?
Positive Nikolsky sign; seen in pemphigus vulgaris, benign mucous membrane pemphigoid (cicatricial pemphigoid)
D. All of the above!
Which of the following statements is true about Sjogren's syndrome:a. Main oral symptoms is xerostomiab. Lymphatic infiltration of the glands with destructionc. Biopsy of the minor salivary glands of lower lip confirms the diagnosisd. All of the above
False! Hyperdontia = males > females, hypodontia = females > males
T/F: Hyperdontia, like hypodontia, occurs more frequently in males than females.
You see a microscopic tissue sample that included Schaumann bodies (laminated basophilic calcifications) and asteroid bodies (stellate cellular inclusions).
 
What tissue should you biopsy?
What skin test could you expect to test positive?
What would
 
biopsy superficial lobe of parotid gland
(93% success rate for Sarcoidosis)
 
Positive Kveim skin test
(4-6 weeks, 50-85% accuracy)
 
Chest film would show hilar lymphadenopathy
 
Xeroderma Pigmentosum is an AR condition that predisposes people to what type of oral cancer?
 
cancer of skin, lower lip, and tongue tip
 
- can include SCC, BCC, melanoma
What are the gross, microscopic and radiographic features of an adenomatoid odontogenic cyst/tumor?
   associated with an impacted tooth, esp. the ant. maxilla (e.g. canine) of     teenage females; expansive but             painless     Gross: very thick capsule Radiographic: well circumscribed RL w/ increasing RO over time of scattered calcifications; surrounds     crown & portion of the root, adjacent roots may be displaced Histo: duct-like appearing odontogenic structures, thick fibrous capsule, amyloid deposition rarely but not     as frequent as Pindborg tumor Tx: enucleation only (b/c thick capsule); no recurrence
3rd molars, 2nd premolars, lateral incisors -- females > males
What are the three most commonly missing teeth, and does it affect males or females more often?
. What disease advances its course by deposition of dense collagen in tissues and organs?  
Scleroderma (PSS); leads to mask-like facies, loss of ala of nose, and fibrosis of vital organs (fatal)
parotid gland -- it has a better prognosis than other tumors
Where is Acinic cell adenocarcinoma found most commonly?
False! Porphyrin staining is worse in decidious teeth because they are in enamel/dentin, and only in dentin of permanent teeth.
T/F: Porphyrins staining is worse in permanent teeth because they are in dentin and enamel.
What is Gorlin's sign and what is it associated with?          
 Hypermotility of tongue seen in Ehlers-Danlos syndromes - - touch the tip of the nose with the tip of the     tongue.
heck's disease focal epithelial hyperplasia
___ ___ is caused by HPV 13, 32 and is found especially in native people, usually multiple lesions found on buccal/labial mucosa appearing as sessile, pink or white.
A RANULA may be mistaken for a dermoid cyst in the FOM.
A ___ may be mistaken for a dermoid cyst in the FOM.
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