Boards

Question 1

Hereditary angioedema is the result of:

Answer 1

C1-INH esterase deficiency

Question 2

Chipmunk facies

Answer 2

Beta thalassemia

Question 3

Name the procedure for removing thyroglossal duct cyst

Answer 3

sistrunk procedure

Question 4

DX?

Syndromic association?

Answer 4

Hollman miller sign: Anterior bowing of the posterior wall of the maxillary sinus that occurs as a result of nasopharyngeal angiofibroma

Can be associated with Gardner’s syndrome

Question 5

Conditions that cause elevated vanillylmandelic acid (VMA) (3)

Answer 5

*note ALL neuroectodermally derived 1. Melanotic neuroectodermal tumor of infancy 2. Olfactory neuroblastoma 3. Pheochromocytoma

Question 6

Burton line

Answer 6

Bluish pigmentation of the marginal gingiva that results from lead poisoning

Question 7

3 Fun facts about chordomas

Answer 7

1. most often seen involving the clivus
2. contains physaliferous cells
3. stains positive with brachyury

Question 8

Dermatofibroma staining vs dermatofibrosarcoma protuberans (DFSP)

Answer 8

DF: CD34- F13A+ DFSP: CD34+ F13A -

Question 9

Intestinal type sinonasal adenocarcinoma is associated with what professions

Answer 9

leather and woodworking

Question 10

What are 4 risk factors of sinonasal adenocarcinoma (not intestinal type)

Answer 10

1. Southeast Asia
2. EBV infection
3. high salt fish diet (chinese male population greatly affected)
4. vitamin C deficiency

Question 11

Warthin-Finkeldey giant cells are seen in what 5 conditions?

Answer 11

1. measles
2. lymphoma
3. Kimura disease
4. AIDs associated lymphoproliferative disorders
5. Lupus erythematosus

Question 12

DX?

Name the two cell types indicated by the arrows

What is the causitive organism?

Answer 12

Rhinoscleroma caused by : Klebsiella rhinoscleromatis (gram negative bacteria)

Mikulicz cells(foamy histiocyte), Russell bodies (eosinophilic inclusions in plasma cells)

Question 13

Depicted entity:

• Chronic and localized infection of the mucus membranes
• Lesions present clinically as polypoid, soft masses (sometimes pedunculated) of the nose, throat, ear, and even the genitalia in both sexes.

What is the infectous organism?

Answer 13

Rhinosporiodosis- caused by Rhinosporidium seeberi (seems to be a fungus when you google it) -clinical presentation is an enlarged nostril/end of the nose

Question 14

Ascher syndrome features (3)

Answer 14

1. Double lip 2. Goiter 3. upper eyelid edema (blepharochalasia)

Question 15

Paramedian lip pit associated syndromes (3)

Answer 15

1. Van der woude syndrome 2. Kabuki syndrome 3. Popliteal pterygium syndrome

Question 16

Premature exfoliation of the mandibular incisors may be seen in

Answer 16

hypophosphatasia

Question 17

Beaten metal/copper skull is seen in which 3 conditions?

Answer 17

-Crouzan Syndrome (beaten-metal) -Apert syndrome (beaten metal) -Hypophosphatasia (beaten-copper)

Question 18

“Teeth floating in air” + skin plantar/palmar hyperkeratosis

Answer 18

Papilon-Lefevre syndrome

Question 19

Name that condition: Vertical bone trabeculae, Missing premolar, Retained primary molar

-List 2 other clinical findings

Answer 19

Segmental odontomaxillary dysplasia

Gingival overgrowth in the area of missing teeth

Becker nevus: hyperpigmentation with hypertrichosis

Question 20

Ghost teeth on radiology enameloid conglomerates on histo

Answer 20

regional odontodysplasia

Question 21

Black coated tongue cause

Answer 21

Bismuth staining

Question 22

Skull radiology: best diagnosis for punched out radiolucent lesions in a child vs an older adult

Answer 22

child: LCH adult: multiple myeloma

Question 23

Answer 23

Hydroxychloroquine pigmentation (antimalarial medication also given to lupus patients)

Question 24

Lateral Calcifications seen on PAN DDX (5)

Answer 24

1. tonsilith
2. sialolith
3. phlebolith
4. dystrophic acne
5. calcified lymph node

Question 25

Globodontia (aka globe shaped teeth), hearing loss, and ocular colobomas are classic of what syndrome?

Answer 25

otodental syndrome

Question 26

Papillary lesion of the soft palate DDX

Answer 26

1. squamous papilloma 2. verruciform xanthoma 3. Giant cell fibroma 4. Sialadenoma papilliferum

Question 27

Munro's abscesses

Answer 27

psoriasis

Question 28

Pautriers abscesses

Answer 28

Mycosis Fungoides

Question 29

HLA-Cw6

Answer 29

psoriasis

Question 30

Tissue culture pattern on histology

Answer 30

nodular fasciitis

Question 31

DDX for mixed radiolucent-radiopaque lesion (6) (of course site and appearance play a factor)

Answer 31

CEOT Ossifying fibroma COC odontoma ameloblastic fibro-odontoma AOT

Question 32

Late stage florid COD- how do you rule out Pagets disease?

Answer 32

There should be no expansion in COD and ALK phos levels are normal (elevated in Pagets)

Question 33

variant of ameloblastoma with mixed radiolucent/radiopaque appearance that resembles BFOL

Answer 33

desmoplastic ameloblastoma

Question 34

A patient is diagnosed with basal cell carcinoma of the gingiva, what is the more likely diagnosis

Answer 34

a misdiagnosed ameloblastoma

Question 35

-unerupted tooth, usually canine -radiolucency frequently extends below the CEJ of the tooth -snowflake calcifications

Answer 35

AOT

Question 36

PTCH1 gene mutation occurs in what 2 entities?

Answer 36

OKC/Gorlin syndrome and CEOT

Question 37

driven snow calcification appearance

Answer 37

CEOT

Question 38

Amyloid-like acellular amorphous material occurring in CEOT is what?

Answer 38

odontogenic ameloblast-associated protein (ODAM)

Question 39

Clear cell histology DDX (5)

Answer 39

1. Clear cell odontogenic carcinoma 2. hyalinizing clear cell carcinoma 3. Intraosseous mucoep 4. clear cell variant of CEOT 5. Metastatic dz: renal, breast, melanoma

Question 40

A defect or groove in the palate may be caused by what odontogenic neoplasm

Answer 40

central odontogenic fibroma

Question 41

Ground substance in an odontogenic myxoma is composed of

Answer 41

GAGs: predominantly hyaluronic acid and chondroitin sulfate

Question 42

Clinical hallmarks: blue sclerae, hearing loss, joint hyperextensibility, contractures, triangular facies, frontal bossing, macrocephaly, flattened vertex and skull base, prominent occiput (back of the head) 3 conditions with blue sclera?

Answer 42

Osteogenesis imperfecta (brittle bone disease) -Osteogenesis imperfecta, ehlers-danlos, marfan syndrome

Question 43

4 Radiographic hallmarks of osteogenesis imperfecta

Answer 43

1. osteopenia 2. bowing of long bones 3. multiple fractures 4. increased number of wormian bones

Question 44

Increased number of intrasutural bones (wormian bones) in what two conditions

Answer 44

-cleidocranial dysplasia -osteogenesis imperfecta

Question 45

What disease: Spontaneous and progressive destruction of 1 or more bones (give the 5 names please) What are the histo findings?

Answer 45

1.massive osteolysis, 2.vanishing bone disesae, 3.gorham disease, 4.gorham-stout disease, 5.phantom bone disease Histo: Destroyed bone --\> vascular proliferation first → dense fibrous tissue

Question 46

Many basophilic reversal lines within bone creating a characteristic jigsaw puzzle/mosaic appearance is characteristic histology for what?

Answer 46

paget's disease (osteitis deformans)

Question 47

10 disorders with Multiple giant cell lesions (6 high yield)...What 2 entities have been associated with central giant cell granulomas in the jaw?

Answer 47

- **Cherubism** - Noonan-like/multiple giant cell lesion syndrome - **noonan syndrome** - ramon syndrome - **jaffe-campanacci syndrome** **neurofibromatosis type 1** - schimmelpenning syndrome - oculo-ectodermal syndrome **-pagets disease (giant cell tumors)** **-hyperparathyroidism (brown tumors)** JAW lesions assoc w central giant cell granulomas: 1. **Aneurysmal bone cyst** 2. **central odontogenic fibromas**

Question 48

What cell lines are affected by early post zygotic activating mutation in GNAS

Answer 48

-Melanocytes, endocrine cells, osteoblasts \*if late in embryogenesis only osteoblasts are affected

Question 49

Monostotic fibrous dysplasia that affects the maxilla and adjacent bones is termed

Answer 49

cranio-facial fibrous dysplasia

Question 50

3 Syndromes associated with polyostotic fibrous dysplasia

Answer 50

1. Jaffe-lichtenstein 2. Mazabraud 3. McCune Albright

Question 51

early presenting sign of polyostotic fibrous dysplasia is pain and long bone deformity- the deformity is specifically called what? (3 names)

Answer 51

deformity of the proximal femur = shepards crook deformity, coxa vara, hockey stick deformity (causes leg bowing)

Question 52

Clinical: anterior mandibular COD with progressive growth

Answer 52

expansive osseous dysplasia

Question 53

WHat diseasE? - Diffuse fibro-osseous lesions of the jaws with prominent psammoma bodies - bone fragility - bowing/cortical sclerosis of the long bones

Answer 53

Gnatho-diaphyseal dysplasia GDD1 mutation

Question 54

What disease? - Parathyroid adenoma or carcinoma - Ossifying fibromas of the jaws - Renal cysts - Wilms tumors

Answer 54

Hyperparathyroidism jaw tumor syndrome HRPT2 mutation

Question 55

-Multifocal osteomas -Supernumerary teeth, impacted teeth, odontomas -adenomatous polyps

Answer 55

Gardner's syndrome APC gene chromo 5

Question 56

Name 4 less frequently mentioned manifestations of Gardners syndrome

Answer 56

1. desmoid tumors- usually at the abdominal scar left after the patient receives colectomy 2. pigmented lesions of the ocular fundus: congenital hypertrophy of the retinal pigment epithelium 3. epidermoid cysts 4. thyroid carcinoma, pancreatic adeno, etc

Question 57

-Radiology: radiolucent nidus with possible central opacity "target-like" -Clinical: nocturnal pain relieved by NSAIDs

Answer 57

osteoid osteoma (should also be less than 1.5-2cm in size)

Question 58

Clinical: Genital lesions, conjunctivitis, arthritis, geographic tongue What condition? What HLA? Etiology?

Answer 58

-Reiter's syndrome (reactive arthritis) -HLA-B27 -occurs following venereal disease or dysentery

Question 59

Multiple chondromas are associated with what 2 diseases/syndromes

Answer 59

1. Ollier disease: sporadic chondromatosis with unilateral tendency 2. Maffucci syndrome: sporadic chondromatosis and soft tissue angiomas

Question 60

What syndromes increase the risk for osteosarcoma

Answer 60

Paget's disease Li-fraumeni syndrome Hereditary retinoblastoma Rothmund-thomson syndrome

Question 61

19 year old male Bx: Non specific vascular proliferation with fibrous CT and chronic inflammatory cells

Answer 61

Massive osteolysis Vanishing bone disease phantom bone disease gorham/gorham-stout disease

Question 62

25 year old male HX of veneral disease and arthritis What is the term for associated genital lesions? associated HLA?

Answer 62

Balanitis circinata HLA-B27

Question 63

5 year old female Other findings: Bone surrounding the teeth is lower denisty, hyperplasia of the soft tissue in the area DX? Histo findings?

Answer 63

Regional odontodysplasia (ghost teeth) Histo: enameloid conglomerates (also seen in amelogenesis imperfecta)

Question 64

Clinical: 20 year old female; Tower skull(acrobrachycephaly) appearance - Diagnosis? - What is this image depicting? - In more severe cases of this syndrome what type of skull deformity may occur? -

Answer 64

- Apert syndrome - Syndactyly - Cloverleaf skull

Question 65

55 year old male recently with new diagnosis and management of HTN - DDX? - What medications may cause this presentation?

Answer 65

- Medication related gingival hyperplasia vs Leukemic infiltrate - (anti-epileptic)Phenyltoin, (immunosuppressant) cyclosporine, calcium channel blockers (amlodipine)

Question 66

12 year old male What is the most likely diagnosis? What are these lesions? List all of the manifestations of this disease Mutation?

Answer 66

MEN2B Mucosal neuromas - Marfanoid body habitus, pheochromocytoma, medullary thyroid carcinoma - 95% germline mutation at codon 918(M918T) of RET proto-oncogene (smaller subset have A883F)

Question 67

- What is the term for the lesion shown? - What % of patients with this lesion have an associated syndrome? - What syndrome? - What mutation and inheritance pattern? - What other lesions would a patient with this syndrome have?

Answer 67

- Port wine stain (nevus flammeus) - 8-10% - Sturge Weber syndrome - GNAQ chromo 9; not inherited - Leptomeningeal angiomas, intellectual disability, contralateral hemiplegia, seizures

Question 68

- Most likely diagnosis? - What is the cause of the lesions? - Associated genetics? - Histologic buzzword?

Answer 68

- multifocal epithelial hyperplasia (Heck's disease) - HPV 13 and 32 - HLA DR4 - Mitosoid cell

Question 69

5 year old male with multiple rough itchy papules - Diagnosis? - Etiology? - Patients with what 3 conditions are prone to prolonged or florid disease? - Histo buzz words?

Answer 69

- Molluscum contagiosum - poxvirus infection MCV - HIV/AIDS, darier disease, atopic dermatitis - Henderson paterson bodies

Question 70

- What condition is the image depicting? - Associated somatic mutation? (what other lesion has the same one?) - If similar appearing lesions were throughout the body with associated pruritis what might you be concerned for? - If the patient scratched one of these lesons before biopsy what is the charactertistic term for the histologic appearance?

Answer 70

- Dermatosis papulosa nigra - FGFR3, PIK3CA (actinic lentigo) - Leser-Trelat sign: rare phenomenon associated with internal malignancy - Irritated sebK aka Inverted follicular keratosis of Helwig

Question 71

Biopsy of one of these lesions shows sebaceous hyperplasia - Name the associated syndrome - Name 3 other findings in this syndrome

Answer 71

Muirre-Torre Syndrome -visceral malignancies, sebaceous adenomas and carcinomas (shown in the image), keratoacanthomas

Question 72

What is the most likely diagnosis? - What other manifestations of disease would you expect? - If the condition was limited to skin manifestations what is your DDX

Answer 72

- Noonan syndrome with multiple lentigenes (formerly LEOPARD syndrome) - L:multiple lentigenes, E:electrocardiographic conduction defects, O: Ocular hypertelorism, P: pulmonary stenosis, A: abnormalities of the genitalia, R)etarded (slowed) growth resulting in short stature, D: deafness - DDX: Lentiginosis profusa, Peutz Jeghers, LEOPARD

Question 73

- The lesion seen is fully excised, what is the recurrence rate? - what if it was verrucous? - Transformation potential is this is mild vs moderate vs severe?

Answer 73

-10-35% for typical leukoplakia, 83% for verruciform variants Mild: ~1-7% Moderate: ~4-11% Severe: 20-43%

Question 74

This patient has been using smokeless tobacco for 10 years. - What histologic features would be seen on biopsy? - Clinical recommendations?

Answer 74

1. hyperkeratotic and acanthotic - intraceullar vacuoles - parakeratin chevrons - amorphous subepithelial material in the superficial CT \*dysplasia is uncommon 2. Habit cessation- lesion should go away in ~ 2 weeks, if persists 6 weeks+ then it should be biopsied

Question 75

- Name 3 inherited syndromes associated with multiple of the lesion depicted in this image - Name one acquired cause

Answer 75

Multiple keratoacanthomas: **Inherited:** Muir-Torre (sebaceous adenomas/carcinomas, KAs, GI carcinoma) Ferguson-Smith syndrome (self-healing squamous epitheliomas, many KAs, Scottish descent) Witten-Zak syndrome, multiple familial keratoacanthoma **Acquired:** Grybowski syndrome (hundreds/thousands small papules skin/GI-- may be associated with internal malignancy)

Question 76

Multiple basal cell carcinomas are common in what inherited genetic disorders?

Answer 76

1. nevoid basal cell carcinoma syndrome 2. xeroderma pigmentosum 3. Albinism 4. Rombo syndrome 5. Bazex-Christol-Dupre syndrome 6. Dowling-Meara subtype of epidermolysis bullosa simplex

Question 77

DX?

Answer 77

Laugier–Hunziker syndrome is a rare acquired disorder characterized by diffuse hyperpigmentation of the oral mucosa and longitudinal melanonychia in adults. They appear as macular lesions less than 5 mm in diameter.

Question 78

Most commonly associated syndrome with this clinical presentation? What other syndromes also have this lesion?

Answer 78

Port wine stain (nevus flammeus) - Sturge Weber syndrome - Beckwith-Weidemann syndrome

Question 79

What is the term for this clinical presentation? What are 5 causes?

Answer 79

1. Bell’s Palsy (idiopathic, viral, **Lyme disease**) 2. Ramsey Hunt Syndrome (**VZV** infection) 3. Heerdfort syndrome (**Acute sarcoidosis**: Uveitis, Parotid swelling, Fever, Facial paralysis) 4. Melkerson Rosenthal Syndrome (**Orofacial Granulomatosis**: lip swelling, facial nerve paralysis, fissured tongue) 5. Perineural/neural invasion of tumor affecting CN VII

Question 80

Most likely diagnosis? - Key radiographic features - Key non-radiographic features - What may have a similar presentation and confuse you

Answer 80

Segmental odontomaxillary dysplasia - missing premolar, vertical oriented coarse bony trabeculae, smaller maxillary sinus - Becker nevus, gingival hyperplasia in the area - Fibrous dysplasia

Question 81

All lesions with BRAF mutations

Answer 81

Some ameloblastomas 50% of Langerhan cell histiocytosis Melanoma Acquired melanocytic nevus

Question 82

**The HLAs:** - Cw6 - B27 - DR4 - DR3/B8 - DRw52 - B51 - DRB1

Answer 82

Cw6= psoriasis (geographic tongue) B27= Reiters syndrome DR4= Hecks disease DR3/B8= primary sjogrens DRw52=primary or secondary sjogrens B51= Behcets BRB1=Rheumatoid Arthritis

Question 83

Mikulicz cells Mikulicz disease Mikulicz syndrome Mikulicz aphthae

Answer 83

Mikulicz cells: rhinoscleroma (klebsiella rhinoscleromatis) Mikulicz disease: IgG4 disease Bilateral painless swelling of lacrimal and salivary glands which show an intense chronic inflammatory infiltrate Mikulicz syndrome: Similar parotid and lacrimal enlargement but due to TB, sarcoid, lymphoma etc Mikulicz apthae: minor aphthous ulcers

Question 84

Things to see with a wood's lamp

Answer 84

- Ash leaf spots of Tuberous sclerosis - Red fluorescence of the teeth in Congenital Erythropoietic porphyria - Give tetracycline 48 hours before a debridement for osteomyelitis: alive bone fluroescense with woods lamp and dead bone does not

Question 85

_Some serologies:_ Diffuse cutaneous systemic sclerosis Limited cutaneous systemic sclerosis (includes CREST) Paget's disease Lupus Erythematous

Answer 85

DCSS: antitopoisomerase-1 antibodies also called **anti-scl70** LCSS: anticentromeric antibodies Paget's: elevated ALK phos Lupus: antibodies against dsDNA, antibodies against Sm(smith), elevated ANAs, elevated RF

Question 86

DX?

Answer 86

Lichen planus

Question 87

2 clinical syndromes of Acute Sarcoidosis

Answer 87

Lofgren syndrome: Erythema nodosum Bilateral hilar lymphadenopathy Arthralgia Heerfordt syndrome (uveoparotid fever) Parotid enlargement Anterior uveitis Facial paralysis Fever

Question 88

What is the term for this histologic finding? Diagnosis?

Answer 88

Asteroid body of sarcoidosis -entrapped fragments of collagen within the granuloma

Question 89

DX? Name of the entity depicted?

Answer 89

Sarcoid granuloma -Schumann body

Question 90

What is the official / "more appropriate" name for the pattern seen on sialography of Sjogren's Syndrome?

Answer 90

punctate sialectasia (fruit-laden branchless tree)

Question 91

Most likely diagnosis? What is the etiology? What is the clinical term applied to these lesions?

Answer 91

Bullous impetigo Typically staph aureus only Lacquer

Question 92

What is the most likely diagnosis? What are two other conditions might you consider in your DDX? What is the clinical term sometimes used to describe the appearance of this entity?

Answer 92

Non bullous impetigo DDX: HSV, exoliative chelitis(though not really in this picture) Corn flakes glued to the surface of the lesion

Question 93

What is the most likely diagnosis? What is the etiology? What two characteristic clinical terms are applied to this lesion?

Answer 93

Erysipelas Group A beta hemolytic strep infection peau d'orange & St. Anthony's fire \*\*St anthonys fire is alos applied to ergotism aka ergot poisoning

Question 94

This lesion is positive for staph aureus and strep pyogenes. This is a rare clinical presentation of what disease? What is the clinical term applied to this specific lesion? What differentiates this particular clinical pattern from other clinical patterns of this same disease?

Answer 94

Impetigo Ecthyma The lesion heals with a permanent scar- scarring is not expected in other lesions of impetigo either bullous or nonbullous

Question 95

List two conditions that can result in the lesion depicted If this patient had chronic intraoral lesions what is the most likely diagnosis? If this patient had chronic widespread involvement of oral, nasal, ocular, and laryngeal mucosa what autoantibody is likely? If lesions associated with this disease process were isolated to the oral cavity what autoantibody is likely?

Answer 95

1. two conditions possible: Mucosal membrane pemphigoid (aka cicatricial pemphigoid) AND erythema multiforme 2. CHRONIC= Mucous membrane pemphigoid 3. widespread involvement by MMP is associated with autoantibody to epiligrin 4. Oral only involvement of MMP is associated with autoantibodies to alpha-6-integrin

Question 96

Name that outdated and terrifying testing method: Sterilized sarcoid tissue is injected into the skin of a patient

Answer 96

Kveim test

Question 97

Olfactory neuroblastoma: 1. Name for low grade pseudo-rosette 2. Name for high grade true rosette

Answer 97

1. pseudo-rosette: Homer-Wright 2. true-rosette: Flexner-Wintersteiner

Question 98

Diagnosis?

Answer 98

Congenital syphilis

Question 99

Pupils that accomodate when patient looks at a close up object, but do not constrict with light are called _____ \_\_\_\_\_\_\_ pupils. This is seen in what condition?

Answer 99

Argyll Robertson pupils Tertiary syphillis

Question 100

Loss of coordination of movement in tertiary syphillis is termed?

Answer 100

tabes dorsalis

Question 101

What is the diagnosis? What other 2 clinical findings are part of the Hutchinson Triad?

Answer 101

Hutchinson teeth of Congenital syphilis -Eigth nerve deafness, interstitial keratitis

Question 102

BUGS summary: ## Footnote Name the (most common) bug for each disease (keep scrolling): - Diptheria - Tuberculosis - Syphilis - Rhinoscleroma - Rhinosporodosis - Leprosy - Gonorrhea - Measles - German measles - Mumps - Scarlet fever - Impetigo - Erysipelas - Actinomycosis - Cat scratch disease - Histoplasmosis - Blastomycosis - Paracoccidomycosis - Coccidioidomycosis - Cryptococcosis - Mucormycosis - Toxoplasmosis - Chicken pox - Shingles - Infectious mononucleosis - NOMA

Answer 102

Diptheria = Corynebacteria Diphtheriae aka klebs loffler bacillus Tuberculosis = Mycobacterium tuberculosis Syphilis = Treponema Pallidum Rhinoscleroma = Klebsiella rhinoscleromatis Rhinosporodosis = Rhinosporidum seeberi Leprosy = Mycobacterium leprae Gonorrhea = Niesseria gonorrhoeae Measles aka Rubeola = Paramyxoviridae, genus Morbillivirus. German measles aka Rubella = Togavirus, genus Rubivirus Mumps = Paramyxoviridae, genus Rubulavirus Scarlet fever = Group A Beta hemolytic strep Impetigo = staph aureus +/- strep pyogenes (aka group A, b-hemo) Erysipelas = beta hemolytic strep (usually strep pryogenes) Actinomycosis = actinomyces israelii Cat scratch disease = Bartonella henselae Histoplasmosis = Histoplasma capsulatum Blastomycosis = Blastomyces dermatitidis Paracoccidomycosis = Paracoccidioides brasiliensis Coccidoidomycosis = coccidioides immitis &/or posadasii Cryptococcosis = Cryptoccocus neoformans Mucormycosis = Mucoromycotina absidia/mucor/rhizopus Toxoplasmosis = toxoplasma gondii Chicken pox = Varicella Shingles = Herpes zoster Infectious mononucleosis = epstein barr virus; HHV-4 NOMA = Fusobacterium necrophorum and Prevotella intermedia

Question 103

This patient has anesthesia and loss of sweating of the overlying skin in these lesions. Biopsy demonstrated well formed granulomatous inflammation Diagnosis?

Answer 103

Tuberculoid aka paucibacillary leprosy

Question 104

Diagnosis? What is the term for the characteristic facies? What would you expect to see on biopsy?

Answer 104

Lepromatous (multibacillary) leprosy - Leonine facies - Sheets of lymphocytes with vacuolated histiocytes (aka lepra cells) - No well formed granulomas

Question 105

What is the general term for this clinical presentation? What is the differential diagnosis?

Answer 105

Macrocheilia

Question 106

Children with red teeth DDX

Answer 106

Congenital erythropoietic porphyria aka Gunther disease Leprosy

Question 107

What is the name for the cells depicted in this image? What is the diagnosis?

Answer 107

Lepra cells of lepromatous leprosy- they are vacuolated macrophages

Question 108

Other manifestations: fever, exanthematous rash, erythematous cheeks What is the term for the clinical lesions depicted? Diagnosis? What oral lesions do you expect to see?

Answer 108

Pastia lines Scarlet fever -White strawberry tongue then red strawberry tongue

Question 109

Bacterial species of chronic periodontitis red complex

Answer 109

- Treponema denticola - Tannerella forsythensis - Porphyromonas gingivalis

Question 110

The area feels indurated or "wooden" to palpation On incision of this lesion yellow granular material is seen. DDX? If histology shows club shaped filamentous bacteria in a radiating rosette pattern what is the diagnosis?

Answer 110

- Actinomycosis - mimicked by Botryomycosis (usually caused by staph aureus) - Definitive diagnosis is Actino

Question 111

This patient also has hypoparathyroidism and hypoadrenocorticism. Diagnosis? Associated genetic mutation?

Answer 111

APECED: autoimmune polyendocrinpathy-candidasis-ectodermal dystrophy syndrome - mucocutaneous candidiasis, nail dystrophy, corneal keratopathy, hypoparathyroid/hypoparathyroid - childhood onset - Mutation in AIRE gene

Question 112

These are two different presentations of the same disease. What is the terminology used to describe each image? What is the diagnosis?

Answer 112

Luetic glossitis = atrophic form Interstitial glossitis = gummatous form Tertiary syphilis

Question 113

Patient has a fetid odor eminating from their mouth. Past medical history is signficant for smoking. What is the best diagnosis? - What bug is implicated in this process? - Risk factors associated with this process? - If there was no associated odor what else might you consider on the differential? - If this disease process spreads from the gingiva to the adjacent soft tissue what term would then apply? - If this disease process becomes chronic and causes the loss of alveolar bone what term would apply? - If this disease spread through multiple planes of soft tissue and onto the skin of the face what term would then apply?

Answer 113

**Necrotizing ulcerative gingivitis** - Fusobacterium nucleatum, prevotella intermedia, porphyromonas gingivalis, treponema spp., Selenomonas spp. - Smoking, Stress, Poor nutrition, AIDS, immunosuppresion, Poor nutrition - Neisseria gonorrhea infection - Necrotizing ulcerative mucositis - Necrotizing ulcerative periodontitis - Cancrum oris (NOMA)

Question 114

PMH: Healthy 35 year old male, areas have been present since adolescence. Most likely diagnosis? - In a 55 year old male with a clinical history significant for heart transplant what diagnosis is more likely? - Name 3 associated familial syndromes - TX?

Answer 114

**-Gingival Fibromatosis** ## Footnote - Medication induced gingival hyperplasia probably 2/2 cyclosporine and/or CCB - Byars-Jurkiewicz syndrome, Costello syndrome, Cross syndrome, Infantile systemic hyalinosis, Jones-Hartsfield syndrome, Ramon syndrome and more - Excellent oral hygiene +/- surgical revision based on severity (better outcome when you wait until after all permnanent teeth erupted)

Question 115

High yield genetic disorders associated with periodontitis in kids/young adults What is the specific terminology applied to this?

Answer 115

**Papilon Lefevre & Haim munk** **Acrodynia (pink disease of mercury poisoning)** **Ehlers Danlos** **Hypophosphatasia** **Trisomy 21** Others: Acatalasia, Chediak Higashi syndrome, Cohen syndrome, AIDS, DM, Kindler syndrome -Periodontal disease as a manifestation of systemic disease

Question 116

What is the predominant bacteria of localized aggressive periodontitis? This bacteria has also been found prevalently in the oral disease of patients with what disease?

Answer 116

**-A. Actinomycetemcomitans (**Aggregatibacter actinomycetemcomitans) **-Papilon Lefevre** Bacteria types expand when patients have generalized type and include the red complex

Question 117

What is the term for the histologic feature seen in this image? What conditions/diseases can this be found in?

Answer 117

Hamazaki-Wesenberg Bodies aka yellow-brown bodies myriad medical conditions: appendicitis, cirrhosis, lymphoid tumours, colon carcinoma and numerous others, most famously sarcoidosis

Question 118

**Viral/Fungal/Bacterial Buzz words, name that disease:** - Koplik spots - Mickey mouse ears/Mariners wheel histology - Forchheimer sign - Signficant cause of death in AIDS pts - Doubly refractile cell wall - Nine banded armadillo carries this - How about a regular armadillo carrier - Frequent overlying pseudoepitheliomatous hyperplasia on bx - Female hormones are protective against? - Hypersensitivity reaction to this is termed valley fever - Cutaneous form of disease has lesions that resemble a volcano - Mulberry-like ulcerations - Prominent mucopolysaccharide capsule (stain w/mucicarmine) - Pts taking deferoxamine or who are ketoacidotic at higher risk - Fruiting bodies - Obligate intracellular parasite - Black fever aka kala-azar

Answer 118

_Koplik spots_ = Measles (Rubeola) (Paramyxoviridae, Morbillivirus) _Mickey/Mariner_ = Paracoccidioidomycosis (Paracoccidioides brasiliensis) _Forchheimer sign_ = German Measles (Rubella) (Toga virus Rubivirus) _Signif COD in AIDs pts_ = cryptococcosis (Cryptococcus neoformans) _Doubly refractile cell wall_ = Blastomycosis (Blastomyces dermatitidis) _Nine banded armadillo_ = Paracoccidioidomycosis (Paracoccidioides brasiliensis) _Regular armadillo_ = Leprosy (Mycobacterium leprae) (Hansen disease) _Freq pseudoepi hyper_ = Blastomycosis (Blastomyces dermatitidis) _Female hormones protective_ = Paracoccidioidomycosis (Paracoccidioides brasiliensis) _Hypersensitivity rxn to coccidioidomycosis_ = valley fever (Coccidioides immitis or posadasii) _Cutaneous volcano_ = Leishmaniasis (species Leishmania) _Mulberry ulcerations_ = Paracoccidioidomycosis (Paracoccidioides brasiliensis) _Prom mucopolysaccharide capsule_= cryptococcosis (Cryptococcus neoformans) _Increased iron_ = increased risk of mucormycosis (Mucormycotina Rhizopus) _Fruiting bodies_ = aspergillosis (Aspergillus fumigatus) _Obligate intracellular parasite_ = leishmaniasis (species Leishmania) _Black fever_ = visceral leishmaniasis (species Leishmania)

Question 119

Direct immunofluorescence pattern for Chronic ulcerative stomatitis? Indirect immunofluorescence finding?

Answer 119

- speckled pattern of IgG deposits in the basal one-third of the epithelium - Indirect: presence of stratified epithelium specific anti-nuclear antigen (SES-ANA)

Question 120

What is the characteristic cell depicted here? What is this diagnostic of?

Answer 120

Floret cell Pleomorphic lipoma

Question 121

In addition to the clinical finding below this patient is also experiencing joint pain. What is the most likely diagnosis? List the features of this condition

Answer 121

SAPHO syndrome Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis

Question 122

Multiple bone involvement by primary chronic osteomyelitis in children is termed

Answer 122

CRMO: Chronic recurrent multifocal osteomyelitis thought to be a widespread variant of primary chronic osteomyelitis

Question 123

This finding is present on both the hands and feet in addition to a pruritic skin rash. DDX? - If this was a 5 year old patient with red eyes and cracked lips in addition to these findings, what diagnosis would you favor? - If this patient had HTN and neurologic symptoms what diagnosis would you favor? What is the term used for the neurologic symptoms? \*What oral manifestations would you expect in the second case?

Answer 123

- Acrodynia, Kawasaki disease, Polycythemia Vera (erythromelalgia) - Kawaski disease - **Acrodynia**; neurologic symptoms are termed Erethism-excitability, tremors, memory loss, delirium - Oral symptoms of acrodynia: excessive salivation (also excessive sweating) and premature tooth loss -

Question 124

34 year old male, HIV+, lesions are also present on the palms and soles of the feet DDX for this case? -What conditions cause a rash that includes the palms and soles of the feet?

Answer 124

Secondary syphilis Psoriasis (specifically guttate) Erythema multiforme (should expect more oral manifestations not shown) Palms and soles of the feet inclusive rashes: syphilis, psoriasis, EM, coxsackie viruses, rocky mountain spotted fever, mycosis fungoides, tinea

Question 125

DX?

Answer 125

Calcific metamorphosis and aseptic pulpal necrosis

Question 126

What are the two major clinical findings? What two conditions produce these radiographic findings?

Answer 126

- Thistle tube/flame shaped pulp chambers & pulp stones - Dentin dysplasia type 2 and pulpal dysplasia

Question 127

What termed is applied to this radiographic finding? What is the diagnosis? What is the histologic description of the root of these teeth?

Answer 127

Rootless teeth Dentin dysplasia type 1 Histo buzz: - whorls of tubular dentin - “stream flowing around boulders”

Question 128

What two pathoses can cause a "bull neck" appearance

Answer 128

Diptheria Ludwigs angina

Question 129

**Whats my keratin?** Epidermolysis Bullosa simplex White sponge nevus Pachyonychia congenita Oral lesions of pachyonychia congenita Pachyonychia congenita with neonatal teeth

Answer 129

EBS: Keratins 5 & 14 WSN: Keratin 4 & 13 Pachyonychia congenita: 6a, 6b, 16, 17 Pachyonychia with oral lesions: Keratin 6a PC neonatal teeth: Keratin 17

Question 130

At least 4 conditions associated with premature tooth loss

Answer 130

Acrodynia (pink disease) mercury exposure children Hypophosphatasia Dentin Dysplasia type 1 (rootless teeth) Papilon Lefevre Haim Munk Acatalasia Cohen Syndrome Ehlers-Danlos

Question 131

What clinical features are depicted in this image? What is the most likely diagnosis? What mutation and inheritance pattern is associated with this condition?

Answer 131

-bowing of long bones with a break (fragility of the bones), diffuse fibro-osseous lesions of the jaws (on histology they have prominent psamomma bodies) MUT: GDD1, auto dom

Question 132

Time to dominate Lipid Reticuloendothelioses.... What are the three diseases & their subtypes?

Answer 132

1. Goucher (Type 1 - least severe, Ashkenazi Jewish, Types 2/3 CNS invovment, severe) 2. Neimann Pick (ABC: A,C=severe, B=less severe) 3. Tay-Sach (Mild to severe: mild can live to adulthood, severe do not)

Question 133

What is the image depicting? What disease is this associated with? What is another important maxillofacial feature? What is the primary histological buzz phrase? What enzyme is lacking? What accumulates?

Answer 133

Erlymeyer Flask Deformity (EFD) of the longbones Gaucher Disease Multiple RLs of the mandible (filled with Gaucher cells) Gaucher cells (macrophages) with wrinkled silk cytoplasm Glucocerebrosidase missing so accumulation of glucosylceramide

Question 134

Niemann Pick Disease: What enzyme is missing? What accumulates as a result? Of the types, which are more severe? What is the genetic mutation? What is the characteristic cell?

Answer 134

Sphingomyelinase missing, so sphingomyelin accumulates A,C are most severe...Type B survives into adulthood NPC1, NPC2 "Sea-Blue" Histiocyte seen on bone marrow aspirate

Question 135

Tay-Sachs: How does it compare to the other lipoidendoreticuloses? What enzyme is missing? What accumulates? What cell type is affected?

Answer 135

Most severe of the lipoidendoreticuloses...only mild cases survive to adult hood Beta-hexosaminidase A missing, ganglioside accumulates Neurons (hense the severe nature as opposed to Gaucher and NP where accumulation happens in macrophages)

Question 136

Infant with bilateral facial swellings, fever, leukocytosis, and hyperostosis of his facial bones. Blood cultures negatve. What's the most probable diagnosis?

Answer 136

Caffey Disease (AD, a COL1A1 mutation has been found)

Question 137

Name the skin lesion...What systemic condition is it associated with?

Answer 137

Lupus pernio. Sarcoidosis Lupus pernio is a chronic raised indurated (hardened) lesion of the skin, often purplish in color. It is seen on the nose, ears, cheeks, lips, and forehead. It is pathognomonic of sarcoidosis.

Question 138

What are the 3 main components of RAMON syndrome?

Answer 138

1. Cherubism 2. Gingival fibromatosis 3. seizures

Question 139

What is the most likely diagnosis for for lesion depicted? What syndrome is associated with these lesions? What are the major components of this syndrome?

Answer 139

- Multiple large congenital nevi - Neurocutaneous melanosis - Potentially fatal condition in which patients have multiple or large congenital nevi + melanocytic neoplasms of the CNS (melanomas)

Question 140

What is the term for areas indicated by the yellow arrows? What diagnosis is this feature specific for? What mutation is associated?

Answer 140

- Kamino bodies - Spitz nevus - HRAS

Question 141

- What is the most likely diagnosis? - What is the most common mutation associated with this lesion overall? - What is a common mutation associated with this lesion at this specific site? - What are the 4 clinicopathologic subtypes of this entity? which subtype is most common in the oral cavity? which subtype is most common in Blacks? which subtype is most common on the skin?

Answer 141

- Melanoma - BRAF 50% - Mucosal melanomas are also associated with KIT mutations - Clincopathologic subtypes: superficial spreading, nodular, acral lentigenous, lentigo maligna melanoma (lentigo maligna aka hutchinson freckle is the precursor lesion and is just melanoma in situ) - Oral cavity = acral lentigenous - Blacks = acral lentigenous - Skin = superficial spreading (70%)

Question 142

A 75 year old male presents with complaints of right sided jaw and neck pain. IOE is WNL. EOE is positive for the image shown. - What is the most likely diagnosis? - What would you see on biopsy? - What other symptoms are classic for this condition?

Answer 142

- Temporal arteritis aka giant cell arteritis aka Horton disease - transmural and perivascular infiltrate of lymphocytes, histiocytes and giant cells +/- granulomas. Elastic layer is fragmented - blurry vision, headaches, jaw pain

Question 143

This biopsy is from the posterior lateral tongue. Diagnosis? - is this a neoplastic process?

Answer 143

- Sub-gemmal neurogenous plaque - This is part of normal anatomy. Plexus underlies taste buds on the posterior lateral tongue. Taste buds are CK 8/18+

Question 144

This is a biopsy of an enlarged cervical lymph node. On higher power the following are seen: Karryorhexis, fibrin deposits, plasmacytoid monocytes - Most likely diagnosis? - What other entities are considered on the differential? How would you exlcude them?

Answer 144

- Kikuchi disease - Cat scratch disease: there should be a history of cat exposure and a skin papule. You also typically see follicular hyperplasia and more neutrophils - Lymphoma with necrosis: should see more atypia and no plasmacytoid monocytes - Lupus lymphadenitis: architecture of the lymph node is presevered, necrosis is in the paracortical area

Question 145

Patient presented with a well-defined, oval, red nodule of the skin. Diagnosis? - Is this process benign, malignant, or reactive/nonneoplastic? - What are the 3 histologic components of this entity?

Answer 145

Intravascular papillary endothelial hyperplasia (Massons tumor) - Non neoplastic/reactive process - Dilated vascular spaces, fibrin deposition, endothelial cell proliferation

Question 146

6 year old patient, Diagnosis? - Characteristic finding on electron microscopy? - stains? What classification system is currently used?

Answer 146

- LCH - Birbeck granules - CD1a, langerin (CD207) CLASSIFICATION: 1. Single organ: usually bone or skin, can be multiple lesions but only of one system 2. Multiorgan w/o organ dysfunction 3. Multiorgan w/ organ dysfuction low risk: skin, LN, pituitary, bone 4. Multiorgan w/ organ dysfunction high risk: lung, liver, spleen, BM

Question 147

This clinical presentation is characteristic for what? What is the responsible genetic mutation? The mutation results in overproduction of what product? What is the inheritance pattern? What 2 other conditions/diseases can produce a similar appearance of the body habitus?

Answer 147

- Marfan syndrome - Fibrillin-1 - TGF-Beta - Autosomal dominant - MEN2B, NBCCS

Question 148

A 20 year old patient present with a well-defined radiolucency of the mandible. All teeth in the area are vital. A biopsy is performed and shows the following. - What is the histologic buzzword for this presentation? - What is this characteristic (but not specific) for? - What stains would you perform for confirmation? - What is the classic clinical presentation for this disease? - What is the prognosis/outcome for the majority of patients?

Answer 148

- Emperipolesis: the active penetration of one cell by another which remains intact - Rosai-Dorfman disease aka sinus histiocytosis with massive LAD - S100 and CD1a: S100 positive (same as langerhan cell histiocytosis), CD1a negative (to rule out langerhan histiocytes) - Massive painless cervical LAD in a younger patient, of unknown etiology - 80% of cases spontaneous resolve, this is not a clonal process

Question 150

Diagnosis? Term for the foot manifestation? Oral findings?

Answer 150

- Arsenic poisoning - Black foot disease - necrotizing ulcerative stomatitis, excessive salivation,

Question 151

This patient was previously treated with gold. -What is the term for manifestation seen in this photo and what is insighting event? What is a common oral complication in patients treated with gold?

Answer 151

Chrysiasis: when patients are treated with gold therapy they can develop this slate blue pigmentation in areas exposed to sunlight -Oral mucositisi

Question 152

What bacteria is most commonly responsible for Lemierre syndrome?

Answer 152

Fusobacterium necrophorum - usally occurs in teens - can be life threatening - basically an oropharyngeal infection that can lead to sepsis

Question 153

A newborn is born with jaundice. If the baby is not treated these may develop ______ a dangerous accumulation of bilirubin in the brain

Answer 153

Kernicterus

Question 154

DDX? - This patient had peripheral blood eosinophilia, what is the diagnosis? - A biopsy is performed of the lymph node, what would you expect to see?

Answer 154

- DDX: Branchial cleft cyst, Unicentric castleman disease, kikuchi disease, kimura disease, metastatic (HPV+ SCC) carcinoma - Kimura disease - eosinophils, eosinophilic microabscesses, vessels with hyalinzation, follicular hyperplasia

Question 155

Diagnosis?

Answer 155

-Cholesteatoma

Question 156

A patient complains of profuse sweating near her right ear when eating spicy and sour foods. PMH signficant for previous excision of a pleomorphic adenoma in the parotid glad. WHat is the most likely diagnosis? What test could be used to better demonstrate the patients symptoms?

Answer 156

- Frey's syndrome: results from injury of the salivary gland - Starch iodine test

Question 157

Local causes of delayed tooth eruption Systemic causes of delayed tooth eruption

Answer 157

Local causes: gingival fibromatosis, clefts, ROD, SOD, supernumeraries, tumors Systemic: anemia, celiac, cerebral palsy, chemotherapy, endocrine disturbances, vit D resistant rickets

Question 158

DX? What intraoral finding is found in 92% of these patients

Answer 158

Rubinstein-Taybi Talon cusp

Question 159

Answer 159

Dens en dente aka dens invaginatus

Question 160

DX? What might this be caused by?

Answer 160

buccal bifurcation cyst -cervical enamel extension

Question 161

What syndrome would you suspect? What are the other associated findings?

Answer 161

PHACES P: posterior fossa brain anomalies H: Hemangioma A: arterial anomalies C: Cardic defects E: Eye anomalies S: sternal cleft, supraumbilical raphe

Question 162

What is the term for this finding? Name an associated syndrome?

Answer 162

sternal cleft PHACES

Question 163

What is the term for this radiographic finding? What is it characteristic of?

Answer 163

tram-track or tram-line calcifications Sturge weber syndrome

Question 164

Salt fish diet --\> Leather and wood-working --\>

Answer 164

salt fish = sinonasal adenocarcinoma leather and wood-working = intestinal type sinonasal adenocarcinoma

Question 165

The child has had multiple episodes of swelling There is no pus on palpation of the duct DX? TX? Is this condition the most common cause worldwide of parotid swelling?

Answer 165

Juvenile recurrent parotitis Usually happens around 3-6 yrs old, multiple episodes, seld resolves by puberty -Worldwide: Mumps, in the USA: Juvenile recurrent parotitis

Question 166

DX?

Answer 166

Cheilitis glandularis

Question 167

What conditions can produce complaints of excess drooling? If there is no obvious cause, and they get episodic sialorrhea, what is the term?

Answer 167

- cerebral palsy, down syndrome, ALS, parkinsons, heavy metal poisoning, rabies - idiopathic paroxysmal sialorrhea

Question 168

Rose bengal dye test is used for? What other test is used for the same purpose?

Answer 168

- diagnosis of keratoconjunctivitis sicca - Schirmer test

Question 169

Difference between Epstein Pearl vs Bohn Nodule vs Ging Cyst of Newborn

Answer 169

Epstein pearls: traped epithelium along fusion MIDLINE Bohns Nodule: minor salivary glands, scattered over hard palate, near soft palate junction Gingival cyst of newborn: dental lamina, on alveolar ridge

Question 170

Conditions that affect the nails (8)

Answer 170

Lichen planus: thinned with longitudinal ridging and fissuring Hand foot mouth disease: Beau lines, Onychomadesis(spontaneous separation of nail from matrix) Plummer-vinson: Koilonychia aka spoon shaped nails APECED/mucocutaneous candidiasis Pachyonychia congenita: Nail thickening Dyskeratosis congenita: nail dystrophy Dariers disease: candy-cane nails (alternating red and white bands) Laugier-Hunziker: longitudinal pigmented band on the nail

Question 171

Large radiolucency is seen in a skull film of a patient with elevated alk phos and bone pain. What is the clinical term for this lesion?

Answer 171

osteoporosis circumscripta- occurs in early stage disease

Question 172

What 3 disease cause Forcheimer spots

Answer 172

German measles (rubella) Scarlet fever Mono

Question 173

Lesion is firm BX demonstrates benign appearing bone and cartilage

Answer 173

Cutright lesion AKA Reactive osseous and chondromatous metaplasia

Question 174

Diagnosis? Recommended therapy?

Answer 174

DX: Perioral dermatitis 1. "zero therapy" tell the patient to discontinue anything they have been applying in the area 2. topical pimecrolimus or topical erythromycin. 3. Oral tetracycline (though not in children or pregnant patients)

Question 175

DX? Tx?

Answer 175

DX: Exfoliative chelitis TX: 1. Elimination of habit 2. Tx of any superimposed infection: antiobiotic and or antifungal 3. topical tacrolimus

Question 176

DX? TX?

Answer 176

DX: transient ligual papillitis TX: self resolving though you can give topical corticosteroids or analgesics for discomfort

Question 177

Differential DX? Ancillary testing to confirm dx?

Answer 177

Behcet's syndrome, IgA deficiency, cyclic neutropenia, IBD, Sweet syndrome, MAGIC syndrome Ancillary test for Behcets = positive pathergy test cyclic neutropenia = concurrent blood tests, biopsy that shows little neutrophil acitivity in the ulcer

Question 178

Describe the finding being depicted in this image. What systemic condition(s) is this typical of?

Answer 178

Loss of lamina dura- generalized - Hyperparathyroidism, osteomalacia, pagets disease, fibrous dysplasia

Question 179

In addition to the finding depicted this male child has the following bloodwork: ## Footnote - Hypophosphatemia - Low serum calcium What is the most likely diagnosis? What characteristic finding is seen on histology of one of these teeth?

Answer 179

The picture is showing an abscess which frequently results from pulpal extensions to the surface in Vitamin D resistent rickets \*\*teeth on histology demonstrate globular dentin

Question 180

What is this image depicting and where is this commonly found?

Answer 180

Hyaline body aka pulse granuloma Walls of inflammatory cysts

Question 181

Metastasis to the mandible that is PAX8 and TTF1:

Answer 181

thyroid

Question 182

Cherry-red spot on the macule is associated with:

Answer 182

Tay-Sachs (Lysosomal storage disorders, retinal ischemia, and retinal infarction)

Question 183

Negri bodies are associated with:

Answer 183

rabies

Question 184

T1 SCC with tumor thickness < 3mm, which may have you do a neck dissection and radiation:

Question 185

Which of the following is associated with NUT-something:

Answer 185

NUT midline

Question 186

PAX-FOX01 seen in:

Answer 186

alveolar rhabdomyosarcoma

Question 187

EWS is paired with which gene in Ewing sarcoma:

Answer 187

FLI1

Question 188

EWSR1-ATF1 is seen in which two:

Answer 188

clear cell sarcoma and clear cell odontogenic carcinoma

Question 189

What is the female equivalent of a seminoma:

Answer 189

dysgerminoma

Question 190

Which subtype of rhabdo has a specific translocation:

Answer 190

alveolar

Question 191

Most common nasal septum papilloma:

Answer 191

fungiform

Question 192

Nasal papilloma most likely to be malignant:

Answer 192

inverted

Question 193

Nasal papilloma that is destructive and malignant:

Answer 193

inverted

Question 194

Most common nasal disease seen in family practice:

Answer 194

rhinitis

Question 195

Patient with red face and bumps that goes away with tetracycline:

Answer 195

rosacea

Question 196

STAT6 in which soft tissue tumor:

Answer 196

solitary fibrous tumor

Question 197

Most likely to have Flexner-Wintersteiner rosettes:

Answer 197

olfactory neuroblastoma

Question 198

Chromosome for nevoid basal cell carcinoma syndrome:

Answer 198

9

Question 199

Pierre-Robin is seen with:

Answer 199

Velocardiofacial syndrome (Digeorge) Stickler syndrome

Question 200

Most common lesion in a person with Beckwith-Wiedemann

Answer 200

Wilms (Wilms tumor, adrenal carcinoma, hepatoblastoma, rhabdomyosarcoma, neuroblastoma )

Question 201

Best site for FNA:

Answer 201

soft palate swelling (other answers were epithelial)

Question 202

Which amelogenesis imperfecta is scattered in primary: (scattered pits?)

Answer 202

Hypoplastic? Other variants - hypocacification, hypomaturation and AI with taurodontism

Question 203

Which symptom associated with DSPP mutation

Answer 203

Hearing loss (vs dysosmia etc)

Question 204

Old male patient with renal failure, lumbar pain, and IgG spike

Answer 204

multiple myeloma

Question 205

Which is true about thyroglossal duct cyst

Answer 205

**midline presentation below the hyoid** Midline Adjacent to hyoid bone Any age - peds-first 2 decades of life most common Respiratory lining most often, cuboidal or even small intestine epithelium occasionally

Question 206

Which has perinuclear eosinophilic condensation

Answer 206

white sponge nevus

Question 207

Genodermatosis with autosomal recessive and problems with DNA repair

Answer 207

xeroderma pigmentosum

Question 208

Most common salivary neoplasm on lower lip

Answer 208

?? Mucoep

Question 209

Most common thyroid carcinoma in ectopic thyroid sites

Answer 209

PTC

Question 210

Dental manifestation of oral-dento-facial-cardio syndrome

Answer 210

radiculomegaly, oligodontia, retained primary teeth, and malocclusion **root dilacerations**, malocclusion, and cataracts https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6466113/#B1-ijerph-16-00928

Question 211

OKCs in NBCCS have upregulation of

Answer 211

p53

Question 212

Most common location for lateral periodontal cyst

Answer 212

mandibular canine/premolar (Mandibular premolar-canine-lateral incisor area)

Question 213

Most common presentation of orthokeratinizing odontogenic cyst

Answer 213

unerupted molar

Question 214

Most common odontogenic cyst in anterior mandible

Answer 214

glandular odontogenic cyst

Question 215

Most likely variant of ameloblastoma to present as RL/RO

Answer 215

desmoplastic

Question 216

Best stain for peripheral ameloblastoma or intraoral BCC

Answer 216

Ber-EP4

Question 217

Second "hit" of double-hit in colorectal cancer

Answer 217

One copy of a tumour suppressor gene (TSG) is inactivated by a nonsense or frameshift mutation, and the other copy is inactivated by a similar mutation or by loss of heterozygosity (LOH) it has been shown that the earliest event of sporadic colorectal cancers is the inactivation ofthe APC gene,1,2 or other genes involved in the Wnt pathway.3,4 The APC gene inhibits members of the Wnt signaling pathway, which promote the expression of β-catenin. In its turn, β-catenin acts as an enhancer of cell division.

Question 218

Which is most likely to be trisomy

Answer 218

Patau Down Syndrome (Trisomy 21), Edwards Syndrome (Trisomy 18), Patau Syndrome (Trisomy 13), Klinefelter Syndrome (XXY Syndrome)

Question 219

Most common thing with Chtovek sign:

Answer 219

hypocalcemia

Question 220

Facial paralysis, fever, and serum/urine calcium; which chronic granulomatous most likely with these

Answer 220

sarcoid

Question 221

Best test for lingual thyroid

Answer 221

99-technitium scan

Question 222

Which is not a required feature for Sjogren

Answer 222

scarring alopecia

Question 223

Parabasal/basal and speckled DIF

Answer 223

chronic ulcerative stomatitis

Question 224

Which antibody for chronic ulcerative stomatitis

Answer 224

delta-NP63-alpha

Question 225

Chicken-wire pattern of DI

Answer 225

pemphigus

Question 226

Shaggy deposition of fibrinogen at basement membrane with cytoid bodies:

Answer 226

lichen planus

Question 227

Lichen planus can sometimes be seen in association with:

Answer 227

superficial mucoceles

Question 228

GFAP staining peripheral of which salivary neoplasm

Answer 228

PA

Question 229

Which is associated with HLA-DR4:

Answer 229

prurigo (Hecks and giant cell arteritis not on the list)

Question 230

Laryngeal papillomatosis is associated with:

Answer 230

HPV6, 11

Question 231

Osteogenic osteomalacia is most often seen with:

Answer 231

phosphaturic mesenchymal tumor

Question 232

Which are associated with HPV:

Answer 232

E7 (E6 not on the list)

Question 233

Which is true regarding AOT:

Answer 233

well-circumscribed RL (the others made less sense)

Question 234

Lyre is associated with:

Answer 234

carotid body paraganglioma

Question 235

Most likely site for saddle embolism to come from:

Answer 235

leg/lower extremities

Question 236

Odontohypophosphatasia is most often associated with:

Answer 236

stress fractures and premature loss of adult dentition

Question 237

USP6 can be used to identify which spindle cell tumor:

Answer 237

nodular fasciitis

Question 238

USP6 is rearranged in which bone tumor:

Answer 238

aneursymal bone cyst

Question 239

Example of transient neoplastic disease:

Answer 239

nodular fasciitis

Question 240

Most common soft tissue location for metastatic tumor:

Answer 240

gingiva

Question 241

Which is associated with NKX3.1:

Answer 241

prostate

Question 242

Which site is most likely to have dysplasia or early invasive carcinoma on biopsy:

Answer 242

floor of mouth? high risk sites - lateral tongue?

Question 243

Most common soft tissue tumor in children:

Answer 243

rhabdomyosarcoma

Question 244

Leser-Trelat sign is associated with onset of multiple:

Answer 244

seborrheic keratoses

Question 245

Most common head and neck site for osteoma:

Answer 245

frontal sinus

Question 246

Loose bodies are seen in:

Answer 246

synovial chondromatosis

Question 247

Rhomboid bodies seen in:

Answer 247

gout (buzzword: needle shaped crystals)

Question 248

Patient with trismus, no radiographic changegs, acellular dense fibrous tissue

Answer 248

oral submucous fibrosis (scleroderma on differentiatial)

Question 249

Bartonella causes cat scratch

Answer 249

bacillary angiomatosis

Question 250

Lyme disease is caused by

Answer 250

Borrelia burgdorferi Rarely, Borrelia mayonii

Question 251

Most common mutation in melanoma:

Answer 251

BRAF

Question 252

Which is true regarding PGCG:

Answer 252

occurs on ridge

Question 253

Fibrous dysplasia may mimic which type of osteosarcoma:

Answer 253

fibroblastic?

Question 254

Cemento-osseous dysplasia is often seen with:

Answer 254

simple bone cyst?

Question 255

Which of the following has an autosomal dominant pattern of inheritance with genetic imprinting:

Answer 255

paraganglioma

Question 256

Which of the following defines epigenetic

Answer 256

methylation of DNA

Question 257

Which of the following stains calcium

Answer 257

von Kossa Calcium salts appear as dark blue to purple, brittle deposits on H&E stain and can be stained with alizarin red (more specific) or von Kossa stains (black).

Question 258

Cochineal beetles are related to oral pathology because

Answer 258

eosin dye

Question 259

Which stains oncocytomas

Answer 259

PTAH

Question 260

False positives in TB testing:

Answer 260

vaccination with BCG

Question 261

Who will most likely get parotid lymphoepithelial cysts

Answer 261

HIV patients

Question 262

Which is true about giant cell arteritis

Answer 262

Sudden blindness (alt: seen in women or men) Can also have tongue necrosis

Question 263

Which odontogenic neoplasm can have clear cell changes

Answer 263

CEOT

Question 264

Spheroid bodies with Maltese cross

Question 265

Hereditary angioedema is the result of:

Answer 265

C1-INH enterase deficiency

Question 266

Metastasis to the mandible that is PAX8 and TTF1

Answer 266

Thyroid

Question 267

Cherry-red spot on the macule is associated with

Answer 267

Tay-Sachs

Question 268

Negri bodies associated with

Answer 268

rabies

Question 269

T1 SCC with tumor thickness <3mm, which may have you do a neck dissection with radiation?

Answer 269

Not sure what they're going for here. Just look up SCC staging

Question 270

Which of the following is associated with NUT-something?

Answer 270

NUT midline

Question 271

PAX-FOX01 seen in

Answer 271

alveolar rhabdomyosarcoma

Question 272

EWS paired with which gene in Ewing Sarcoma?

Answer 272

FLI1

Question 273

EWSR1-ATF1 seen in which 2 entities?

Answer 273

clear cell sarcoma and clear cell odontogenic carcinoma

Question 274

Female equivalent of seminoma

Answer 274

dysgerminoma

Question 275

which subtype of rhabdomyosarcoma has a specific translocation?

Answer 275

alveolar

Question 276

most common nasal septum papilloma

Answer 276

fungiform

Question 277

nasal papilloma most likely to be malignant

Answer 277

inverted

Question 278

nasal papilloma that is destructive and malignant

Answer 278

inverted

Question 279

most common nasal disease seen in family practice?

Answer 279

rhinitis

Question 280

Patient with red face bumps that go away with tetracycline?

Answer 280

rosacea

Question 281

STAT6 for which soft tissue tumor

Answer 281

solitary fibrous tumor

Question 282

Flexner-Wintersteiner rosettes

Answer 282

olfactory neuroblastoma

Question 283

chromosome for nevoid basal cell carcinoma syndrome? mutation?

Answer 283

9...patch PTCH1

Question 284

Pierre-Robin sequence seen with which syndrome?

Answer 284

velocardial facial syndrome

Question 285

Most common lesion in a person with Beckwith-Wiedemann syndreome?

Answer 285

Wilms tumor

Question 286

Best site for an FNA

Answer 286

Soft palate swelling (other answers were epithelial)

Question 287

Which amelogenesis imperfecta is scattered in primary

Answer 287

Hypoplastic AI often affects both primary and permanent, but can affect primary only, so maybe they are referring to this?

Question 288

Which symptom associated with DSPP mutation?

Answer 288

hearing loss

Question 289

Old dude with renal failure, lumbar pain, IgG spike

Answer 289

multiple myeloma

Question 290

True about thyroglossal duct cyst:

Answer 290

midline presentation below the hyoid

Question 291

Perinuclear eosinophilic condensation

Answer 291

white sponge nevus

Question 292

Genodermatosis with autosomal recessive and problems with DNA repair

Answer 292

xeroderma pigmentosum

Question 293

most common salivary neoplasm on lower lip

Answer 293

mucoepidermoid carcinoma (pg443 neville)

Question 294

Most common thyroid carcinoma in ectopic thyroid sites

Answer 294

PTC

Question 295

5 Most common dental maifestation in oculo-facio-cardio-dental syndrome

Answer 295

1. radiculomegaly 2. oligodontia 3. root dilacerations 4 malocclusion 5 delayed eruption

Question 296

OKCs in NBCCS have up regulation of which gene

Answer 296

p53

Question 297

Most common location for lateral periodontal cyst

Answer 297

mandibular canine / premolar

Question 298

most common presentation of orthokeratinizing odontogenic cyst

Answer 298

unerupted molar

Question 299

Most common odontogenic cyst in the anterior mandible

Answer 299

glandular odontogenic cyst

Question 300

Most likely variant of ameloblastoma to present as mixed RL/RO

Answer 300

desmoplastic ameloblastoma

Question 301

Best stain for a peripheral ameloblastoma or intraoral BCC

Answer 301

BerEP4

Question 302

Second hit of double hit colorectal cancer

Answer 302

According to Robbins: Methylation abnormalities, inactivation of normal alleles: APC and B-catinin

Question 303

Which is most likely to be trisomy?

Answer 303

Patau (trisomy 13)

Question 304

Most common thing with Chtovek sign

Answer 304

hypocalcemia

Question 305

Facial paralysis, fever, serum/urine calcium; which chronic granulomatous condition is most likely associated with these?

Answer 305

Sarcoid

Question 306

Best test for lingual thyroid

Answer 306

99-technitium scan

Question 307

What is NOT a required feature of sjogren?

Answer 307

scarring alopecia

Question 308

Parabasal/basal and speckled DIF

Answer 308

CUS chronic ulcerative stomatitis

Question 309

Which antibody is used for chronic ulcerative stomatitis?

Answer 309

delta-NP63-alpha

Question 310

CHichen-wire pattern DIF

Answer 310

pemphigus

Question 311

Shaggy deposition of fibrinogen at basement membrane with cytoid bodies

Answer 311

lichen planus

Question 312

lichen planus can sometimes be seen in association with

Answer 312

superfical mucoceles

Question 313

GFAP stainin peripheral of which salivary gland neoplasm?

Answer 313

PA

Question 314

Which is associated with HLA-DR4

Answer 314

prurigo (Hecks and Giant cell arteritis not options

Question 315

Laryngeal papillomatosis is associated with which HPV strains

Answer 315

6,11

Question 316

Osteogenic osteosarcoma is most often seen with which type of tumor?

Answer 316

phosphturic mesenchymal tumor

Question 317

which proteins are associated with HPV

Answer 317

E7 (E6 not an option)

Question 318

Which is true regarding AOT:

Answer 318

well-circumscribed RL

Question 319

Lyre is associated with

Answer 319

Carotid body paraganglioma )lyre sign = splaying of the internal and external carotid arteries

Question 320

Most likely site for a saddle embolism to originate

Answer 320

leg

Question 321

Odontohypophosphatasia is most often associated with

Answer 321

stress fractures and premature loss of adult dentition

Question 322

USP6 can be used to identify which spindle cell tumor?

Answer 322

nodular fasciitis

Question 323

USP6 is rearranged in which bone tumor?

Answer 323

Aneurysmal bone cyst

Question 324

Example of transient neoplastic disease

Answer 324

nodular fasciitis

Question 325

Most common soft tissue location for metastatic tumor

Answer 325

gingiva

Question 326

Which is associated with NKX3.1

Answer 326

Prostate

Question 327

Most specific marker for differentiating adrenal cortical carcinoma from a met?

Answer 327

SF1? In the past, SF-1 has been suggested as a marker to differentiate between tumors of adrenocortical and nonadrenocortical origin [34]. Recent studies have demonstrated overexpression of SF-1 in most cases of childhood adrenocortical tumors [11]. Moreover, Sbiera et al. [35] confirmed that SF-1 is a highly valuable immunohistochemical marker to determine the adrenocortical origin of an adrenal mass and demonstrated that SF-1 expression is of stage-independent prognostic value in patients with ACC.

Question 328

Which site is most likely to have dysplasia or early invasive carcinoma on biopsy

Answer 328

floor of mouth

Question 329

Most common soft tissue tumor in children

Answer 329

rhabdomyosarcoma

Question 330

Leser-Trelat sign is associated with onset of multiple what?

Answer 330

seborrheic keratoses

Question 331

Most common head and neck site for an osteoma

Answer 331

frontal sinus

Question 332

loose bodies are seen in

Answer 332

synovial chondromatosis

Question 333

rhomboid bodies are seen in:

Answer 333

gout

Question 334

Patient with trisumus, no radiographic changes, acellular dense fibrous tissue

Answer 334

oral submucous fibrosis (but scleroderma also option)

Question 335

Bartonella causes cat scratch and

Answer 335

bacilliary angiomatosis

Question 336

Lyme disease is caused by

Answer 336

borrella burgdorferi

Question 337

Most common mutation in melanoma

Answer 337

BRAF

Question 338

Which is true regarding PGCG?

Answer 338

Occurs on the ridge

Question 339

Fibrous dysplasia may mimic which type of osteosarcoma?

Answer 339

fibroblastic?

Question 340

Cemento-osseous dysplasia is often seen with

Answer 340

simple bone cyst

Question 341

Which of the following has an autosomal dominant pattern of inheritance with genetic imprinting?

Answer 341

Paraganglioma

Question 342

Which of the following defines epigenetic?

Answer 342

methylation of DNA

Question 343

Which of the following stains calcium

Answer 343

von Kossa

Question 344

Cochineal beetles are related to oral pathology because

Answer 344

eosin dye

Question 345

Which stains oncocytomas?

Answer 345

PTAH

Question 346

False positives in TB testing

Answer 346

vaccination with BCG

Question 347

Who will most likely get parotid lymphoepithelial cysts?

Answer 347

HIV

Question 348

Which is true about giant cell arteritis?

Answer 348

sudden blindness (or seen in women or men - women are affected 2x more)

Question 349

Which odontogenic neoplasms can have clear cell changes?

Answer 349

CEOT

Question 350

Spheroid bodies with Maltese cross

Answer 350

High urinary protein nephrotic syndrome /Fabry disease vs babesiosis aka babesia microti (tick borne illness)

Question 351

Ferruginous bodies seen in

Answer 351

asbestos fibers

Question 352

Electric cautery of acinar cells in parotid glands can make them seem like

Answer 352

spindle cells

Question 353

Increased risk of oral cancer can be seen in

Answer 353

dyskeratosis congenita

Question 354

Wernicke-Korsakoff in alcoholics caused by deficiency in

Answer 354

thiamine (B1)

Question 355

Vitamin A deficiency associated with

Answer 355

blindness

Question 356

Which is true about a blue nevus

Answer 356

tyndall effect

Question 357

Which is true about a halo nevus

Answer 357

hyperpigmented lesion surrounded by hypopigmentations

Question 358

McCune-Albright genetic mutation

Answer 358

GNAS1

Question 359

BRAF inhibitors may be used in the treatment of which odontogenic lesion

Answer 359

ameloblastoma

Question 360

mutations in SH3BP2 seen in

Answer 360

cherubism

Question 361

Which syndrome presents with cherubism-like CGCG-like leisons

Answer 361

Noonan syndrome

Question 362

Which is the most common complication of a middle ear infection?

Answer 362

Cholesteatoma or acute mastoiditis (I'm going to favor mastoiditis thanks to google)

Question 363

What is used in reverse transcriptase PCR?

Answer 363

cDNA

Question 364

HHV8 associated with

Answer 364

KS

Question 365

Hyaline globules associated with

Answer 365

KS

Question 366

Kikuchi-Fujimoto disease AKA

Answer 366

necrotizing histiocytic lymphadenitits

Question 367

Emperipolesis is seen in

Answer 367

massive sinus histiocytosis with lymphadenopathy (Rosai Dorfman)

Question 368

Sarcomatoid differentiation can be seen in which salivary neoplasm

Answer 368

salivary duct carcinoma

Question 369

Most common salivary duct carcinoma cell type

Answer 369

apocrine

Question 370

What part of the body controls sleep and appetitie?

Answer 370

hypothalamus

Question 371

Which is associated with myasthenia gravis

Answer 371

thymoma

Question 372

Stage III and IV oropharyngeal carcinoma which have prognostic implications

Answer 372

both HPV and tobacco use

Question 373

If a child has gingival bleeding and arthralia, consider:

Answer 373

vitamin c deficiency

Question 374

MDM2 therapy and radiation therapy is novel treatment for

Answer 374

rhabdomyosarcoma

Question 375

MUC4 is a specific marker for

Answer 375

low grade fibromyxoid sarcoma

Question 376

what type of lung cancer is a mid age female non-smoker

Answer 376

ALK positive lung cancer (EGFR as well) About 50% to 60% of lung cancers found in people who never smoked are adenocarcinomas. About 10% to 20% are squamous cell carcinomas. A few (6% to 8%) are small cell lung cancers, and the rest are other types of lung cancer.

Question 377

Extravasated RBCs and fibrin in biopsy seen in

Answer 377

plasminogen deficiency

Question 378

Biphasic salivary gland tumor

Answer 378

PA, epi-myoepi carcinoma, cribriform (?), Adenoid cystic ca

Question 379

Progressive multifocal leukoencephalopathy is seen in

Answer 379

AIDS

Question 380

Hypophosphatasia is associated with reduced levels of

Answer 380

alkaline phosphatase

Question 381

Segmental odontomaxillary dysplasia may present with

Answer 381

hypertrichosis!

Question 382

Which 2 markers are best for diagnosing a desmoplastic melanoma

Answer 382

HMB45 and S100

Question 383

Which stain uses the same target as MART-1

Answer 383

Melan-A

Question 384

Which marker is positive in PEComa

Answer 384

HMB45

Question 385

Which is true regarding amyloidosis in dialysis

Answer 385

beta-2-microglobulin

Question 386

Adult patient presenting for extraction with severe bleeding, which may be an initial sign of:

Answer 386

von Willebrand disease

Question 387

Cytoplasmic antineutrophil antibody seen in

Answer 387

Wegener (GPA)

Question 388

Nuclear staining with beta catenin seen in

Answer 388

desmoid fibromatosis

Question 389

Which of the following is inherited in X-linked fashion

Answer 389

Hemophilia A

Question 390

WHich of the following is a manifestation of Crohn disease

Answer 390

linear ulceration

Question 391

Which of the following presents with skip lesions of the colon

Answer 391

Crohn disease

Question 392

Eosinophilic anucleated squamous like cells on all slides during a day may be from

Answer 392

dandruff LOL is this a real question??

Question 393

Formication is meth addicts with

Answer 393

thinking there are bugs on them

Question 394

Which has fruiting bodies

Answer 394

aspergillosis

Question 395

Demitaceous fungal organisms seen in

Answer 395

allergic fungal sinusitis

Question 396

Which of the following has increased risk for mucormycosis

Answer 396

hemochromatosis

Question 397

Mycosis fungoides is a disease of which cells

Answer 397

Helper T lymphocytes

Question 398

Pautrier abscesses are seen in

Answer 398

cutaneous T cell lymphoma (mycosis fungoidies)

Question 399

Facial paralysis in the setting of VZV is called

Answer 399

Ramsay Hunt Syndrome

Question 400

Anhydrosis, miosis, enopthalmos in a patient with an apical lung carcinoma is called

Answer 400

Horner syndrome

Question 401

Most common CNS lymphoma

Answer 401

diffuse large B cell lymphoma

Question 402

Lesion in spleen positive with podoplanin

Answer 402

lymphangioma

Question 403

Cardiac myxomas seen in

Answer 403

carney complex

Question 404

Bilateral acoustic schwannomas

Answer 404

NF2

Question 405

Most common non-odontogenic oral/facial cyst

Answer 405

nasopalatine duct cyst?

Question 406

Most common cause of granulomatous gingivitis

Answer 406

implantation of dental abrasives

Question 407

Which is true regarding Graves

Answer 407

Immunoglobulins against TSH receptors Graves' disease, one of the autoimmune thyroid diseases, is caused by the production of IgG autoantibodies directed against the thyrotropin receptor. These antibodies bind to and activate the receptor, causing the autonomous production of thyroid hormones

Question 408

Cell of origin for a granular cell tumor

Answer 408

schwann cells

Question 409

Electron micrographs of a granular cell odontogenic tumor show that the granules are

Answer 409

lysozymes

Question 410

Reed-Sternberf cell in Hodgkin is what origin?

Answer 410

B cell

Question 411

Michaelis-Guttman bodies are seen in

Answer 411

malakoplakia

Question 412

Pink teeth during autopsy may be caused by

Answer 412

The post mortem pink tooth is a common finding related to cases of asphyxia, such as strangulation, drowning or suffocation

Question 413

Odontogenic tumor most likely at multiple sites

Answer 413

squamous odontogenic tumor

Question 414

1st president of the ABOMP

Answer 414

so mean: Henry Goldman, DMD?

Question 415

Concept of a globular maxillary cyst is no longer in favor because

Answer 415

most have proven to be OKCs

Question 416

SCC occuring in a branchial cleft cyst is most likely

Answer 416

met SCC to a cervical LN

Question 417

Paramedian lip pits

Answer 417

clefting: kabuki, popliteal-pterygium, and van der woude

Question 418

commisure lip pits also associated with

Answer 418

auricular pits

Question 419

tests ordered for suspecting Wegeners (GPA)

Answer 419

cANCA (PR3-anca) and pANCA (mPo-anca)

Question 420

Hyaline membrane disease cause

Answer 420

deficiency of pulmonary surfactant in an immature lung

Question 421

Swiss cheese holes processing artifact

Answer 421

Freezing artifact

Question 422

End point decalcification - determining methods

Answer 422

Three methods used to assess decalcification. Physical method of decalcification (least accurate) * Visual assessment * Manual Testing - test for tissue's flexibility and hardness usinf fine probe X-ray method method of decalcification (most accurate) Chemical method of decalcification - use of chemical solutions test for residual calcium (accurate)

Question 422

Drug for pemphigus, pemphigoid, and b cell lymphoma

Answer 422

Rituximab, veltuzumab? CHOP therapy?

Question 423

Rituximab mechanism of action

Answer 423

Monoclonal antibody that targets CD20 By targeting CD20, rituximab promotes cell lysis while sparing hematopoietic and plasma cells without this surface antigen Cell lysis mechanisms - Complement-dependent cytotoxicity (CDC) and antibody-dependent cell-mediated cytotoxicity (ADCC)

Question 424

COVID most common oral manifestation

Answer 424

Taste alteration - loss of taste? Others - ulcer, erosion, bulla, vesicle, pustule, fissured or depapillated tongue, macule, papule, plaque, pigmentation, halitosis, whitish areas, hemorrhagic crust, necrosis, petechiae, swelling, erythema, and spontaneous bleeding

Question 425

Similarity between covid and Kawasaki

Answer 425

An increasing number of COVID-19 cases in children have been associated with a new multisystem inflammatory syndrome. Its clinical features and laboratory characteristics are similar to those of Kawasaki disease (KD), KD shock syndrome, and toxic shock syndrome

Question 426

Calceneurin mechanism

Answer 426

Calcineurin inhibitors exert their immunosuppressive effects by reducing interleukin-2 (IL-2) production and IL-2 receptor expression, leading to a reduction in T-cell activation Calcineurin (CaN) is a calcium and calmodulin dependent serine/threonine protein phosphatase (also known as protein phosphatase 3, and calcium-dependent serine-threonine phosphatase). It activates the T cells of the immune system and can be blocked by drugs

Question 427

Mantle zone lymphoma

Answer 427

** Cyclin D1 ** Classical immunophenotype of MCL is CD20-positive/ CD5-positive/ cyclin D1-positive/ CD23-negative/ CD10-negative.

Question 428

Imatinib used to treat

Answer 428

Certain types of cancer (such as acute lymphoblastic leukemia, chronic myeloid leukemia, gastrointestinal stromal tumors, and myelodysplastic/myeloproliferative diseases)

Question 429

Best pain killer after oral surgery

Answer 429

Acetaminophen and Ibuprofen????

Question 430

Oral amyloidosis type of amyloid

Answer 430

Light chain

Question 431

Water fixation artifact

Question 432

Denosumab (Xgeva)

Answer 432

Denosumab prevents RANKL from activating its receptor, RANK, on the surface of osteoclasts and their precursors. Prevention of the RANKL/RANK interaction inhibits osteoclast formation, function, and survival, thereby decreasing bone resorption and increasing bone mass and strength in both cortical and trabecular bone

Question 433

most frequent hematologic manifestations

Answer 433

anemia, leukopenia, lymphopenia, thrombocytopenia, lymphadenopathy, and splenomegaly

Question 434

Mucopolysaccharidosis most common oral manifestation

Answer 434

* Oral manifestations vary according to types ○ Some degree of macroglossia ○ Gingival hyperplasia may be present, particularly in anterior regions, as a result of drying and irritating effects of mouth breathing ○ Dental changes = thin enamel with pointed cusps on posterior teeth § Seem to be a unique feature to mucopolysaccharidosis type IVA ○ Numerous impacted teeth with prominent follicular spaces, possibly caused by accumulation of glycosaminoglycans in follicular connective tissue Reports of multiple impacted teeth that are congregated in single large follicle, forming rosette pattern radiographically

Question 435

Glucocerebrosidase deficiency

Answer 435

Gaucher disease

Question 436

Erlenmeyer flask and bone pain which disease

Answer 436

Gaucher disease

Question 437

Gleason score what the numbers mean

Answer 437

Gleason X: The Gleason score cannot be determined. Gleason 6 or lower: The cells look similar to healthy cells, which is called well differentiated. Gleason 7: The cells look somewhat similar to healthy cells, which is called moderately differentiated. Gleason 8, 9, or 10: The cells look very different from healthy cells, which is called poorly differentiated or undifferentiated.

Question 438

Fibrotic bands buccal mucosa but no submucous fibrosis as option

Answer 438

Submucosal Fibrotic Bands in Oral Lichen Planus?

Question 439

DSPP which conditions

Answer 439

Dentinogesis imperfecta

Question 440

Complication of using immune checkpoint inhibitors

Answer 440

Widespread inflammation Fatigue, headache, arthralgia, rash, pruritus, pneumonitis, diarrhoea and/or colitis, hepatitis and endocrinopathies

Question 441

monotypic salivary gland neoplasm

Answer 441

Monophasic? Polymorphous adenocarcinoma vs Canalicular adenoma

Question 442

Cetuximab mechanism of action

Answer 442

Cetuximab is a monoclonal antibody that binds specifically to the EGFR on both normal and tumour cells to competitively inhibit the binding of epidermal growth factor (EGF) and other ligands that are produced by normal and tumour tissue epithelial cells

Question 443

Premalignant oral condition with highest rate of transformation (oral submucous vs PVL?)

Question 444

Which genetics technique includes microwaving

Answer 444

microwave irradiation

Question 445

If tumor stage is like rT3N2bM0 what do the lower case letters mean

Answer 445

Each of the T, N, and M categories might be written with a lowercase letter in front of it, showing if it’s a clinical or pathological classification: A clinical stage is noted with “c” (for example, cT1) A pathological stage is noted with “p” (for example, pN2) For staging that is done after treatment or after cancer recurrence/progression, a category might also be given another lowercase letter in front of it: For cancers that are restaged after neoadjuvant therapy (or other therapy), a “y” might be used in front of the category (for example, ycT1 or ypT2) For cancers that are restaged after recurrence or progression of the cancer, an “r” might be used in front of the category (for example, rcT1 or rpT2)

Question 446

Most common head and neck location for carcinoid tumor

Answer 446

Both typical and atypical carcinoid tumours commonly involve the supraglottic compartment of the larynx, whereas small cell neuroendocrine carcinoma typically has a more homogeneous involvement of the larynx

Question 447

How to ddx Merkel cell from other small round blue cell with IHC

Answer 447

CK20 "Perinuclear dot" pattern

Question 448

Non-smoking young woman what kind of lung cancer

Answer 448

Lung cancer in non-smokers is almost exclusively non-small cell lung cancer, with adenocarcinoma being the most common type

Question 449

Which salivary gland tumor can be ciliated or warthin like

Answer 449

warthin-like mucoep or ciliated mucoep

Question 450

Follicular adenoma vs Follicular adenocarcinoma

Answer 450

A follicular carcinoma cannot be distinguished from a follicular adenoma based on cytologic features alone. It is distinguished from a follicular adenoma on the basis of capsular invasion, vascular invasion, extrathyroidal tumor extension, lymph node metastases, or systemic metastases

Question 451

Eosinophilic esophagitis findings on endoscopy

Answer 451

GERD?

Question 452

Necrotic hepatocytes

Answer 452

Hepatic necrosis is defined as death of hepatocytes, which maybe single cell, multiple cells in piecemeal, focal, multifocal, submassive or massive

Question 453

Intrahepatic cause of cirrhosis

Answer 453

Intrahepatic causes of portal hypertension include cirrhosis and hepatic fibrosis or scarring Alcohol abuse, Hepatitis B and C infections,

Question 454

Most common bladder cancer

Answer 454

Urothelial carcinoma, also known as transitional cell carcinoma (TCC), is by far the most common type of bladder cancer.

Question 455

What kind of epithelium is used for dx of paraneoplastic pemphigus

Answer 455

rat urinary bladder mucosa (rich expression of plakins)

Question 456

Hodgkin associated with which virus

Answer 456

EBV

Question 457

Ddx adenoid cystic from basaloid squamous ca

Answer 457

In addition to certain histological features, such as the absence of bi-layered structures, the presence of necrosis, and/or the presence of prominent cellular atypia, diffuse immunopositivity for p63/p40, p53 and Ki-67 and negativity for p16 are useful for differentiating BSCC from AdCC and HMSC

Question 458

GIST

Answer 458

Most common primary mesenchymal neoplasm of GI tract Usually older adults (median age: 60 years) Stomach and small bowel most common sites Extremely broad and variable morphologic spectrum Tumors are spindled, epithelioid, or mixed type Characteristic CD117 and DOG1 (+)

Question 459

Nasopharyngeal ca which virus

Answer 459

EBV

Question 460

Spitz

Answer 460

HRAS Skin of extremities or face during childhood Solitary, dome-shaped, pink to reddish-brown papule < 6mm in greatest diameter Young age and small size Kamino body

Question 461

HRPT which protein is defective

Answer 461

Parathyroid hormone-related protein? MEN1?

Question 462

Schwannoma histo description

Question 463

GNAS1

Answer 463

fibrous dysplasia

Question 464

GNAS stands for

Answer 464

GNAS stands for Guanine Nucleotide binding protein, Alpha Stimulating activity polypeptide

Question 465

Eosinophilic angiocentric sclerosis

Answer 465

Eosinophilic angiocentric fibrosis (EAF) is an exceedingly rare and potentially disfiguring and obstructing benign lesion involving the upper airways Nasal mass biopsy. Thick collagen bundles with perivascular fibrosis in an “onion-skin” type whorling pattern. Eosinophil-rich inflammatory infiltrate is also present

Question 466

Drugs for hypophosphatasia

Answer 466

STRENSIQ® (asfotase alfa) is the first and only prescription medicine used to treat people with perinatal/infantile- and juvenile-onset hypophosphatasia (HPP). Attempts to treat by infusing alkaline phosphatase have been unsuccessful, presumably because enzyme functions within cell rather than in extracellular environment

Question 467

IHC for Gorham Stout

Answer 467

D2-40 stain to highlight lymphatic endothelium

Question 468

Histo description on Paget's

Answer 468

* Uncontrolled resorption and formation of bone * Resorptive phase, ○ Numerous hyperactive osteoclasts surround the bone trabeculae (enlarged with increased number of nuclei) ○ Highly vascular fibrous connective tissue replaces the marrow ○ Gradual conversion from pre-dominantly osteoclastic to osteoblastic activity ○ Osteoblasts form osteoid rims around bone trabeculae and bone lacks an organized lamellar pattern ○ Basophilic reversal lines, which indicate junction between alternating bone resorption and formation, result in "jigsaw puzzle" or "mosaic" appearance * Sclerotic phase Large masses of dense bone with prominent reversal lines

Question 469

SOX10 which salivary tumor

Answer 469

secretory carcinoma canalicular adenoma

Question 470

ki-67 increased in which layer of OKC

Answer 470

Greater expression of proliferating cell nuclear antigen (PCNA) and Ki-67 in suprabasilar layer

Question 471

Syndromic OKC what's upregulated

Answer 471

OKCs show overexpression of p53 and cyclin D1 (bcl-1) oncoprotein

Question 472

Esophageal varices most common cause

Answer 472

Scarring (cirrhosis) of the liver is the most common cause of esophageal varices

Question 473

Multiple trichoepitheliomas what syndrome

Answer 473

Brooke-Spiegler syndrome (CYLD cutaneous syndrome)

Question 474

Saponification

Answer 474

Saponification is the hydrolysis of an ester to form an alcohol and the salt of a carboxylic acid in acidic or essential conditions. Saponification is usually used to refer to the soap-forming reaction of a metallic alkali (base) with fat or grease

Question 475

Tongue necrosis can be a manifestation of

Answer 475

giant cell arteritis

Question 476

Stains for Rosai dorfman

Answer 476

S100 (+), CD1a (-), langerin (-)

Question 477

Stains for LCH

Answer 477

(+) CD-1a or CD-207 (langerin) or S100

Question 478

VEGF inhibitors

Question 479

Dermatitis herpetiformis

Answer 479

Dermatitis herpetiformis (DH) is a chronic, intensely itchy, blistering skin manifestation of gluten-sensitive enteropathy, commonly known as celiac disease

Question 480

Oral findings in tuberous sclerosis

Answer 480

Developmental enamel pitting on facial aspect of anterior permanent dentition in 50-100% of patients Multiple fibrous papules Predominantly on anterior gingival mucosa Diffuse fibrous gingival enlargement - even those who are not taking phenytoin

Question 481

VHL and endolymphatic sac tumor

Answer 481

Associated with Von hippel lindau Most arise within intraosseous portion of the endolymphatic duct / sac, with precursor lesions present in VHL patients

Question 482

Endolymphatic sac tumor characteristics and location

Answer 482

Embryologically, the sac derives from the neuroectoderm and is located on the posteromedial surface of the temporal bone

Question 483

Homer Wright rosettes but no olfactory neuroblastoma or retinoblastoma as options

Answer 483

medulloblastoma, supratentorial PNETs and pineoblastomas, Ewing

Question 484

Mdm2 and cdk4 which tumors

Answer 484

Osteosarc Liposarc

Question 485

Which of the following markers is most useful to differentiate tubular / trabecular predominant basal cell adenoma from pleomorphic adenoma? Beta catenin Calponin CMA p63 S100

Answer 485

Beta catenin. Jo et al. reported that nuclear beta catenin staining can be present in 83% of basal cell adenomas. All adenoid cystic carcinomas (0/20) and pleomorphic adenomas (0/20) were negative. 4 of 5 basal cell adenomas had exon 3 CTNNB1 mutations (Am J Surg Pathol 2016;40:1143).