Ch 16 Robbins Flashcards
What is a sticky, colorless biofilm that collects between and on the surface of teeth?
Buildup of this beneath the gum line can cause?
If it is not removed, it becomes mineralized to form?
1) Dental plaque
2) Gingivitis
3) Calculus (tartar)
Periodontitis is an inflammatory process that affects the supporting structures of the teeth such as?
What population are more likely to get this due to the likelihood of them getting leukemia?
1) Periodontal ligaments, alveolar bone, and cementum
2) Down’s syndrome patients
What are the characteristics of normal flora in healthy gingiva?
Facultative gram positive
What is a submucosal nodular mass of fibrous connective tissue stroma that occurs primarily on the buccal mucosa along the bite line or the gingiva?
How does it occur?
1) Irritation fibroma (aka traumatic fibroma)
2) Reactive proliferation due to repetitive trauma
Primary HSV infection typically occurs in what population?
How do they present?
1) Children 2 to 4 years old
2) Asymptomatic with no significant morbidity
Where does recurrent herpetic stomatitis (i.e. reactivation) occur?
At the site of primary inoculation or in adjacent mucosa associated with the same ganglion
What diagnostic test is used for HSV?
Tzanck test
What is characterized by a superficial gray to white inflammatory membrane and can be scraped off to reveal erythematous inflammatory base?
Pseudomembranous oral candidiasis (thrush)
What causes scarlet fever?
Group A beta hemolytic bacteria (i.e. strep pyogenes)
What is the hallmark of measles?
Koplik spots on buccal mucosa
Hairy leukoplakia is a distinctive oral lesion where?
What does it reveal when scraped off?
It has a distinctive microscopic appearance consisting of?
1) Lateral border of the tongue
2) It CANNOT be scraped off
3) Hyperkeratosis and acanthosis with ‘balloon cells’ in the upper
spinous layer
What must be considered with all leukoplakia and erythroplakia?
They are precancerous lesions to squamous cell carcinoma
Red, velvety, eroded area of the oral cavity that may remain level or appear eroded in relation to surrounding mucosa describes what condition?
Although it is much less common it is considered much more ominous because?
1) Erythroplakia
2) It’s associated with severe dysplasia and has a greater risk of malignant transformation
What makes up roughly 95% of cancers of the head and neck due to its association with alcohol/tobacco abuse, and HPV?
It causes a high rate of?
1) Squamous cell carcinoma
2) Multiple primary tumors
HPV E6 leads to the inactivation of?
HPV E7 leads to the inactivation of?
1) p53
2) RB
Multilocular keratocystic odontogenic tumors are found where?
What is the morphology?
1) Epithelium lined cysts in the mandible and maxilla
2) Prominent basal layer with ridged epithelial surface
Where do dentigerous cysts originate?
The unilocular lesions are most often associated with?
1) Near the crown of unerupted teeth
2) Impacted 3rd molars (wisdom teeth)
What is an inflammatory lesion at the apex of teeth that commonly comes from the chronic inflammation of the tooth (pulpitis) due to caries or trauma?
Periapical cyst
Which odontogenic tumor has no ectomesenchymal differentiation?
Ameloblastoma
What drains saliva from each bilateral submandibular and sublingual glands to
the sublingual caruncle at the base of the tongue?
Wharton’s duct
What is the most common autoimmune cause of Sialadenitis (Inflammation of the oral glands)?
Most common viral cause of Sialadenitis?
Most common trauma cause of Sialadenitis?
Most common bacterial cause of Sialadenitis?
1) Sjogrens
2) Mumps
3) Mucocele
4) Staph aureus/Strep viridans
How do mucoceles present?
Fluid filled lesion on lower lip with blue translucent hue
What are ranulas?
Mucocele of the sublingual gland
Nonspecific sialadenitis most often involves the major salivary glands, particularly?
It is usually secondary to?
How does it present?
It occurs in patients receiving long-term?
1) Submandibular glands
2) Ductal obstruction produced by stones (sialolithiasis)
3) Unilateral involvement of single gland
4) Phenothiazines that suppress salivary secretion
What increases the likelihood of salivary glands malignancy?
The smaller the gland, the more likely the neoplasm is malignant
What are benign tumors that consist of a mixture of ductal (epithelial) and myoepithelial cells, and therefore they show both epithelial and mesenchymal differentiation?
Between parotid or submandibular glands which does it affect more?
What is a known risk factor for it?
What genetic rearrangement is associated with it?
1) Pleomorphic adenoma
2) Parotid
3) Ionizing radiation
4) PLAG1
What is the morphology of Pleomorphic adenoma?
Epithelial nests in a matrix of myxoid, hyaline, chondroid or osseous differentiation
What is the most aggressive of all salivary gland malignant neoplasms?
Carcinoma that arises from a pleomorphic adenoma
What is the second most common salivary gland neoplasm that is benign and occurs almost exclusively in the parotid glands?
What population is at 8X increased risk of developing this?
1) Warthin tumor (papillary cystadenoma lymphomatosum)
2) Smokers
What is the morphology of a Warthin tumor?
Distinctive double layer of neoplastic epithelial cells resting on a dense lymphoid stroma, sometime bearing germinal centers
What is the most common primary malignant salivary tumor?
What gland does it most commonly affect?
It is due to a balanced chromosomal translocation (11:19)(q21;p13) that produces what fusion gene product?
1) Mucoepidermoid carcinoma
2) Parotids
3) MECT1-MAML2
What has a worse prognosis if they arise in the minor salivary glands than those that arise in the parotid gland?
Adenoid cystic carcinoma
Why is pain a common symptom of Adenoid cystic carcinoma?
They grow along nerves
What is composed of cells that have clear cytoplasm but may either be solid or at other times vacuolated?
Acinic cell carcinoma
What painful, superficial oral mucosal ulcerations is associated with immunologic disorders including celiac disease, inflammatory bowel disease, and Behçet disease?
Aphthous ulcers (canker sores)
