Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Oral Path Exam 2 > 10: Epithelial Pathology > Flashcards

10: Epithelial Pathology Flashcards

1
Q

5 papillomas?

A

Squamous papilloma, Verruca vulgaris, Condyloma accuminatum, Verruciform Xanthoma, and Focal Epithelial hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Benign proliferation of stratified squamous epithelium thought to be virally induced (HPV), but not as infective?

A

Squamous papilloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Squamous papilloma character?

A

Soft painless usually pedunculated exophytic nodule with numerous fingerlike surface projections giving a cauliflower or wartlike look

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Squamous papilloma treatment?

A

Surgery. May remain same if untreated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

This is a benign, virus induced (HPV), focal hyperplasia of stratified squamous epithelium

A

Verruca Vulgaris (common wart)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Is verruca vulgaris contagious?

A

Yes, can spread by autoinoculation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Age Verruca vulgaris common in, and where is it rarely found

A

Children, mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Verruca Vulgaris treatment (4)? Which is used for oral warts?

A

Liquid nitrogen, Cryotherapy/Surgical laser (especially if oral), Salicylic or lactic acid (topical keratinolytic agents)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

If untreated, how long will it take for Verruca Vulgaris to resolve?

A

2 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Extreme accumulation of compact keratin resulting in hard surface projection several millimeters in height found in Verruca Vulgaris?

A

Cutaneous horn/Keratin horn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Virus induced (HPV) proliferation of stratified squamous epithelium of genitalia, perianal region, mouth, larynx?

A

Condyloma accuminatum (Venereal wart)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Condyloma acuminatum is considered what type of disease? When?

A

STD; several papillomas seen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Condyloma acuminatum age normally diagnosed?

A

Teenagers/young adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Condyloma acuminatum occur orally where?

A

labial mucosa, soft palate, lingual frenum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Histologic indication of Condyloma acuminatum

A

Koilocytes: acanthotic stratified squamous epithelium w/ cover having pynknotic nuclei surrounded by clear zone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which 2 HPV are associated with Cancer?

A

HPV 16, HPV 18. Present in urogenital condyloma acuminatum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Hyperplastic condition of epithelium of mouth, skin, and genitalia with a characteristic accumulation of lipid-laden histiocytes beneath the epithelium?

A

Verruciform Xanthoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Is Verruciform Xanthoma an HPV papilloma?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Gender, Age, race for Verruciform Xanthoma?

A

White, females, 40-70 yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the histology looking for when differentiating for a Verruciform Xanthoma?

A

Lipid laden histiocytes under the epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are two ways to differentiate verruciform xanthoma from other papillomas?

A

Faovr gingiva and alveolar mucosa (50%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How do we tx Verruciform xanthoma?

A

Conservative surgical tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

HPV 13 and HPV 32 induced localized proliferation of oral squamous epithelium?

A

Focal Epithelial Hyperplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Age Focal Epithelial Hyperplasia found

A

Childhood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Clinical appearance of Focal Epithelial Hyperplasia?

A

multiple flat or rounded papules which are clustered with normal color (not white)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the hallmark histo for Focal Epithelial Hyperplasia?

A

acanthosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is acanthosis (Wiki def)?

A

thickening upper layer of epithelium: diffuse epidermal hyperplasia, increases thickness of stratum spinosum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Treatment for Focal Epithelial Hyperplasia? Prognosis?

A

Conservative surgical for diagnosis or esthetics, but will regress spontaneously; spontaneous regression reported months to years later

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Common skin condition of elderly representing axquired benign proliferation of epidermal basal cells, associated with chronic sun exposure?

A

Seborrheic Keratosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Clinical appearance of Seborrheic Keratosis?

A

Brown plaque that grows up and appears to be stuck on skin (popcorn kernel)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is sebhorrheic keratosis identical to when it is a small macule (early stages)?

A

Actinic lentigenes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Form of Sebhorrheic keratosis in African Americans?

A

Dermatosis papulosa nigra

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Where is sebhorrheic keratosis normally found on body (3) and when first seen?

A

Face, trunk, and extremities during 4th decade and become more prevalent with each passing decade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Sudden appearance of numerous seborrheic keratoses with pruritis that is associated with internal malignancy?

A

Laser-Trelat sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Histo feature of Seborrheic Keratosis?

A

Deep keratin filled invaginations that look cystic = horn cyst/pseudo-horn cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Common small hyperpigmented macule of skin that represents a region of increased melanin production? Prediliction?

A

Ephelis (Freckle); blond and red-heads

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

How do you prevent new ephelises and darkening of old ones?

A

Sunscreen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Benign brown macule that results from chronic UV light damage to skin. Not seen in mouth, but common on face.

A

Actinic lentigo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Layman’s term for Actinic Lentigo?

A

Age spots/liver spots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Demographics for Actinic Lentigo? What age group is rare to see it in?

A

Older whites >70 (90%); before age of 40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Does Actinic Lentigo undergo malignant transformation?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Actinic lentigo tx?

A

Topical retinoic acid can reduce intensity and completely destroyed with Q-switched ruby laser

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Diffuse hyperpigmentation of the facial skin in pregnant women?

A

Melasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Flat brown mucosal discoloration produced by focal increase in melanin deposition and possibly concomitant increase in number of melanocytes?

A

Oral Melanotic Macule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Prevention of melanoma?

A

Minimize sun exposure or don’t get pregnant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Is the oral melanotic macule related to sun exposure?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Demographics for Melanotic macule

A

2:1 Females, can be on vermillion border

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

6 causes/syndromes/demographics associated w/ melanin pigmentation?

A

Racial, Peutz-Jehgers, Addison’s disease, Neurofibromatosis (cafe au late), Chronic trauma, Smoker’s Melanosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What 4 drugs can cause melanin pigmentation?

A

Chloroquine/quinine derivatives, Phenolphthalein, Estrogen, and AIDS meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Benign acquired pigmentation characterized by dendritic macrophages dispersed throughout epithelium?

A

Oral Melanoacanthoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Oral Melanoacanthoma is found exclusively in what race, common site, and age? Tx?

A

Blacks w/ female predilection, Buccal mucosa, and 3rd-4th decade; biopsy to rule out melanoma and may resolve after biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Freckle like lesions of the hands, perioral skin, oral mucosa, in conjunction with intestinal polyps?

A

Peutz-Jeghers syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Benign, localized proliferation of cells from the neural crest called nevus cells. Represent the most commonly recognized nevus?

A

Acquired melanocytic nevus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Other name for Acquired Melanocytic Nevus?

A

Mole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Most common places to have an acquired

melanocytic nevus intraorally?

A

Palatal or gingivally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Melanoma transformation risk for Acquired melanocytic nevus?

A

1 in 1 million

57
Q

At what age do acquired melanocytic nevi normally present? Demographic?

A

Whites before 35

58
Q

What are the three types of moles? What is it generally based on?

A

Junctional, compound and intramucosal; location of growth compared to CT

59
Q

White lesion that does not rub off and cannot be characterized as any other disease?

A

Leukoplakia

60
Q

What are the four pathologies you must rule out first before diagnosing leukoplakia?

A

Leukoedema, lichen planus, candidiasis, linea alba

61
Q

What type of lesion is Leukoplakia considered?

A

Premalignant

62
Q

3 areas of high risk for Leukoplakia?

A

Floor of mouth, ventral tongue, soft palate

63
Q

1/3 of oral cancers have what in close proximity?

A

Leukoplakia

64
Q

Most common oral precancer?

A

Leukoplakia (85% of lesions)

65
Q

Most common etiology for Leukoplakia?

A

Tobacco

66
Q

What race and sex does leukoplakia affect more often?

A

Whites and males (70% of cases)

67
Q

If patient had UV radiation induced Leukoplakia, where would it appear orally?

A

Lower lip

68
Q

With Leukoplakia, which is worse: thick or thin? Homogenous or heterogenous?

A

Thick; homogenous

69
Q

High risk form of leukoplakia characterized by multiple keratotic plaques with roughened surface projections?

A

Proliferative Verrucous Leukoplakia (PVL)

70
Q

How many years after PVL diagnosis will pt likely receive squamous cell carcinoma?

A

8 years

71
Q

Leukoplakia that is red, representing sites in which epithelial cells are so immature or atrophic they no longer produce keratin?

A

Erythroplakia

72
Q

If have a mixed Leukoplakia/erythroplakia lesion, where do you biopsy?

A

Biopsy in the red

73
Q

4 grades of dysplasia?

A

Mild, moderate, severe, carcinoma in-situ

74
Q

What is carcinoma-in-situ?

A

Entire thickness of epithelium involved. At basement membrane but not through

75
Q

7 precancerous changes in erythroplakia or leukoplakia?

A

Enlarged hyperchromatic nuceli, increased nuclear-to-cytoplasm, plemorphic nuclei, increased mitotic activity, dyskeratosis/keratin pearls, loss of epithelial cohesiveness, bulbous rete ridges

76
Q

What must be breached to diagnose cancer?

A

Basement membrane

77
Q

What is the histology of leukoplakia?

A

Hyperkeratosis (thickened keratin layer of surface epithelium), which can be hyperparakeratinized or hyperorthokeratinized. May or may not have thickened spinous layer (acanthosis)

78
Q

What is orthokeratin versus parakeratin?

A

Parakeratin has nuclei in top layer

79
Q

What is the malignant/premalignant risk for

Erythroplakia?

A

80-90%

80
Q

Soft fissured gray white lesion of lower labial mucosa located in the area of chronic snuff placement?

A

Tobacco pouch keratosis

81
Q

What is first oral lesion you get with dip? first thing you get with chew?

A

Dip get recession; Chew get root caries

82
Q

What is the Indian form of dip or chew? How much greater risk over tobacco?

A

Betal quid; 10x

83
Q

How long will tobacco pouch keratosis remain if dipping ceases?

A

Disappear in 2-6 weeks, >6 weeks biopsy

84
Q

Is there pain involved precancerous epithelial changes with smokeless tobacco or dip?

A

No

85
Q

What is the appearance of the tobacco pouch lesion? Does it extend past where the tobacco touches?

A

Confined to areas in direct contact with tobacco; thin gray or gray-white plaque with a border that blends gradually into the surrounding mucosa

86
Q

Chronic, progressive, scarring high-risk precancerous oral condition seen primarily in India due to betel quid/paan?

A

Oral Submucous Fibrosis

87
Q

Oral Submucous Fibrosis clinical appearance?

A

Feel the fibrous bands with blotchy, marble-like pallor and progressive stiffness of subepithelial tissues. Can be brownish red

88
Q

Does oral submucous fibrosis have a high malignant transformation rate?

A

Yes

89
Q

What is quid?

A

Areca nut and slaked lime, usually with sweeteners and condiments wrapped in a betal leaf (chew 16+ hours)

90
Q

What are the symptoms of oral sub mucous fibrosis?

A

Mucosal rigidity, trismus and mucosal pain when eating spicy foods; Tongue immobile if involved

91
Q

Common premalignant alteration of the lower lip vermillion that results from long-term or excessive exposure to UV component of sunlight?

A

Actinic Cheilosis (Actinic Cheilitis)

92
Q

Gender predilection for Actinic Cheilosis

A

Males 10:1

93
Q

Approximately 94% of all oral malignancies are…

A

Squamous cell carcinoma

94
Q

When are white men at greatest risk for squamous cell carcinoma?

A

> 65 yo

95
Q

In middle age, what race is at greatest risk for squamous cell carcinoma?

A

Blacks

96
Q

What may patients with actinic cheiolosis say they have?

A

Scaly material that can be peeled off with some difficulty, only to reform in a few days

97
Q

Smoking increases lung cancer, but what increases oral cancer? What aspect of the wood industry increases SCC?

A

Smoking + alcohol; phenols (may also cause nasal/nasopharyngeal cancers)

98
Q

Most common site for intraoral carcinoma?

A

tongue, posterior lateral and ventral surfaces most common

99
Q

How does squamous cell carcinoma etiology differ between sexes?

A

Older males due to smoking; non-smokers are young females (mutation in p53 chromosome)

100
Q

What human papilloma virus is associated with intraoral cancers?

A

HPV 16

101
Q

Is there a link between Herpes Type I and oral cancer?

A

No

102
Q

What is the most common site for Squamous Cell

Carcinoma on the floor of the mouth?

A

Midline near frenum. Most often ass’d with development of a secondary primary malignancy

103
Q

What are six other potential causes of SCC?

A

Radiation, iron defiency, Vitamin A deficiency, syphilis, candidal infection, immunosupression

104
Q

What iron-defiency syndrome may also be ass’d with SCC?

A

Plummer-Vinson

105
Q

How long does it typically take before an older man will seek professional help for oral alterations?

A

4-8 months (8-24 months for lower SEC)

106
Q

Location of 3/4 Oropharyngeal carcinomas

A

Tonsillar area or soft palate

107
Q

What accounts for 50% of intraoral lesions?

A

Carcinoma of the tongue

108
Q

Where are the most common locations on tongue?

A

2/3 posterior lateral border and ventral tongue

109
Q

If lesions is <2cm, what is the likelihood of metastases based on location of tongue?

A

Anterior: 20% metastasized
Posterior: 80% metastasized

110
Q

What SCC most likely comes from pre-existing leuko- or erythroplakia?

A

Carcinoma of the floor of the mouth

111
Q

What is the 5-year survival rate of carcinoma of lip?

A

95%

112
Q

How do we stage cancer?

A

T = size of primary tumor, M = distant metastasis, N= nodal involvement

113
Q

If you see a lesion on the the lateral border of the tongue, then feel it and it is not indurated (hard), but soft, what is it likely?

A

Normal Folliate papillae

114
Q

Have cancer survival rates increased for whites? Blacks? Why?

A

Whites yes, blacks, no; lack of education in lower incomes

115
Q

Carcinoma lesion, frequently associated with snuff, appearing as a well demarcated, painless, thick plaque with papillary or verruciform surface projections?

A

Verrucous Carcinoma

116
Q

Is verrucous carcinoma more or less aggressive than squamous cell carcinoma?

A

Less aggressive

117
Q

Maxillary sinus carcinomas are classified as?

A

Squamous cell carcinoma

118
Q

What are four clinical symptoms?

A

Unilateral stuffiness, mass of hard palate/alveolar bone, teeth in area are loosened/moth-eaten radiographically, superior displacement may cause protrusion of the eyeball

119
Q

What is the most common skin cancer and most common of all cancers?

A

Basal cell carcinoma

120
Q

Locally invasive, slowly spreading, primary epithelial malignancy that arises from the basal cell layer of the skin?

A

Basal cell carcinoma

121
Q

Basal cell carcinoma is a disease of whom?

A

White adults with fair complexion

122
Q

Does Basal Cell Carcinoma metastasize?

A

No

123
Q

What syndrome has many basal cell carcinomas that develop over a relatively short period of time?

A

Nevoid basal cell carcinoma syndrome

124
Q

Malignant neoplasm of melanocytic origin that arises from a benign melanocytic lesion?

A

Melanoma

125
Q

4 risks for melanoma?

A

Red hair, fair skin, blue eyes, sun

126
Q

Most common from of oral melanoma?

A

Actinic lentiginous melanoma

127
Q

In what two cancers is sun damage most important?

A

Basal cell carcinoma and squamous cell carcinoma (not melanoma)

128
Q

For melanoma, which is more important: acute or chronic sun exposure?

A

Acute (e.g. really bad sunburn)

129
Q

What are four types of melanoma and which is most common?

A

Superficial spreading melanoma (most common), nodular melanoma, lentigo malignant melanoma, acral elntiginous melanoma

130
Q

Where on the body is superficial spreading melanoma most commonly found?

A

Interscapular region in males and back of legs in females

131
Q

Majority of oral melanomas are found where?

A

Hard palate or maxillary aveolus

132
Q

3 most common skin cancers in order?

A

basal cell, SCC, melanoma

133
Q

Melanoma that begins almost immediately in vertical growth phase (poor prognosis) and are typically amelanotic?

A

Nodular melanoma

134
Q

Develops from precursor lesion called Lentigo maligna/Hutchinson’s freckle arising in the midface region of older adults and is a melanoma in situ in purely radial growth phase for first 15 years?

A

Lentigo malignant melanoma

135
Q

Melanoma found on palms of hands, soles of feet, subungual areas and mucous membranes?

A

Acral lentiginous melanoma

136
Q

What are the four criteria for classification of melanoma?

A

ABCDE:

Asymmetry, border irregularity, color variegation, diameter (>6mm)

137
Q

Prognosis for oral melanoma?

A

Poor- 20-45% 5-year survival rate

138
Q

Worse prognosis locations for melanoma?

A

BANS: Back, posterior upper Arm, posterior and lateral Neck, and Scalp

139
Q

What are the variations of color you need to be wary of when diagnosing melanoma?

A

Black, brown, red, white and blue (or no color)

Oral Path Exam 2 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions