Ch 16 Robbins

Question 1

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?

Answer 1

1) Dental plaque
2) Gingivitis
3) Calculus (tartar)

Question 2

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?

Answer 2

1) Periodontal ligaments, alveolar bone, and cementum

2) Down’s syndrome patients

Question 3

What are the characteristics of normal flora in healthy gingiva?

Answer 3

Facultative gram positive

Question 4

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?

Answer 4

1) Irritation fibroma (aka traumatic fibroma)

2) Reactive proliferation due to repetitive trauma

Question 5

Primary HSV infection typically occurs in what population?

How do they present?

Answer 5

1) Children 2 to 4 years old

2) Asymptomatic with no significant morbidity

Question 6

Where does recurrent herpetic stomatitis (i.e. reactivation) occur?

Answer 6

At the site of primary inoculation or in adjacent mucosa associated with the same ganglion

Question 7

What diagnostic test is used for HSV?

Answer 7

Tzanck test

Question 8

What is characterized by a superficial gray to white inflammatory membrane and can be scraped off to reveal erythematous inflammatory base?

Answer 8

Pseudomembranous oral candidiasis (thrush)

Question 9

What causes scarlet fever?

Answer 9

Group A beta hemolytic bacteria (i.e. strep pyogenes)

Question 10

What is the hallmark of measles?

Answer 10

Koplik spots on buccal mucosa

Question 11

Hairy leukoplakia is a distinctive oral lesion where?

What does it reveal when scraped off?

It has a distinctive microscopic appearance consisting of?

Answer 11

1) Lateral border of the tongue
2) It CANNOT be scraped off
3) Hyperkeratosis and acanthosis with ‘balloon cells’ in the upper
spinous layer

Question 12

What must be considered with all leukoplakia and erythroplakia?

Answer 12

They are precancerous lesions to squamous cell carcinoma

Question 13

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?

Answer 13

1) Erythroplakia

2) It’s associated with severe dysplasia and has a greater risk of malignant transformation

Question 14

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?

Answer 14

1) Squamous cell carcinoma

2) Multiple primary tumors

Question 15

HPV E6 leads to the inactivation of?

HPV E7 leads to the inactivation of?

Answer 15

1) p53

2) RB

Question 16

Multilocular keratocystic odontogenic tumors are found where?

What is the morphology?

Answer 16

1) Epithelium lined cysts in the mandible and maxilla

2) Prominent basal layer with ridged epithelial surface

Question 17

Where do dentigerous cysts originate?

The unilocular lesions are most often associated with?

Answer 17

1) Near the crown of unerupted teeth

2) Impacted 3rd molars (wisdom teeth)

Question 18

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?

Answer 18

Periapical cyst

Question 19

Which odontogenic tumor has no ectomesenchymal differentiation?

Answer 19

Ameloblastoma

Question 20

What drains saliva from each bilateral submandibular and sublingual glands to
the sublingual caruncle at the base of the tongue?

Answer 20

Wharton’s duct

Question 21

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?

Answer 21

1) Sjogrens
2) Mumps
3) Mucocele
4) Staph aureus/Strep viridans

Question 22

How do mucoceles present?

Answer 22

Fluid filled lesion on lower lip with blue translucent hue

Question 23

What are ranulas?

Answer 23

Mucocele of the sublingual gland

Question 24

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?

Answer 24

1) Submandibular glands
2) Ductal obstruction produced by stones (sialolithiasis)
3) Unilateral involvement of single gland
4) Phenothiazines that suppress salivary secretion

Question 25

What increases the likelihood of salivary glands malignancy?

Answer 25

The smaller the gland, the more likely the neoplasm is malignant

Question 26

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?

Answer 26

1) Pleomorphic adenoma
2) Parotid
3) Ionizing radiation
4) PLAG1

Question 27

What is the morphology of Pleomorphic adenoma?

Answer 27

Epithelial nests in a matrix of myxoid, hyaline, chondroid or osseous differentiation

Question 28

What is the most aggressive of all salivary gland malignant neoplasms?

Answer 28

Carcinoma that arises from a pleomorphic adenoma

Question 29

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?

Answer 29

1) Warthin tumor (papillary cystadenoma lymphomatosum)

2) Smokers

Question 30

What is the morphology of a Warthin tumor?

Answer 30

Distinctive double layer of neoplastic epithelial cells resting on a dense lymphoid stroma, sometime bearing germinal centers

Question 31

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?

Answer 31

1) Mucoepidermoid carcinoma
2) Parotids
3) MECT1-MAML2

Question 32

What has a worse prognosis if they arise in the minor salivary glands than those that arise in the parotid gland?

Answer 32

Adenoid cystic carcinoma

Question 33

Why is pain a common symptom of Adenoid cystic carcinoma?

Answer 33

They grow along nerves

Question 34

What is composed of cells that have clear cytoplasm but may either be solid or at other times vacuolated?

Answer 34

Acinic cell carcinoma

Question 35

What painful, superficial oral mucosal ulcerations is associated with immunologic disorders including celiac disease, inflammatory bowel disease, and Behçet disease?

Answer 35

Aphthous ulcers (canker sores)