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GI II > Ch. 16 Robbins GI Path > Flashcards

Ch. 16 Robbins GI Path Flashcards

1
Q

What are dental carries?

A

Most common diseases world wide
- tooth loss before age 35

Colonization of teeth by bacteria (s. mutans) due to poor hygiene and high sugar diet

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2
Q

What are associated complications with dental carries

A

Pain
Weight loss/Nutrition deficits
Life threatening infections

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3
Q

What is dental plaque?

A

a sticky, colorless, biofilm that collects between and on the surface of teeth

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4
Q

What is periodontitis?

A

an inflammatory process that affects the supporting structures of the teeth (periodontal ligaments) alveolar bone, and cementum

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5
Q

Are gingivitis and periodontitis reversible?

A

yes!

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6
Q

What is the difference between inflammatory and reactive lesions?

A

Inflammatory has assaulting agent (ie bacteria) that causes local reaction

Reactive - response to stimulus and injurious stimuli (ie chemicals, hypoxia, drugs)

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7
Q

Describe aphthous ulcers and who the afflict

A

common. recurrent. exceedingly painful superficial ulcer of oral mucosa without know etiology

occur in people less than 20

resolve spontaneously in 7-10 days

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8
Q

Where do most traumatic fibrous proliferations occur?

A

Buccal mucosa from repeated trauma ie chewing on cheek.

Well circumscribed (benign) and easily removed surgically.

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9
Q

what is a pyogenic granuloma?

A

Inflammatory lesion typically found on the gingiva of children, young adults, and pregnant women

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10
Q

Why is pyogenic granuloma a misnomer?

A

on histology it is very vascular and lobular

NOTHING pyogenic or granulomatous about it

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11
Q

Describe a peripheral ossifying fibroma

A

Hard, red, ulcerated, and/or nodular lesion on gingiva

young teenage females

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12
Q

What layer must be removed during the excision of a peripheral ossifying fibroma?

A

periosteum - otherwise will reoccur

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13
Q

Describe tori palatini (torus palatinus)

A

a bony lesion on the roof of the mouth. Painless and often asymptomatic

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14
Q

Which subtype of HSV causes orofacial lesions

A

HSV-1

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15
Q

When do primary infections of HSV occur in most people?

A

2-4 y/o

herpetic stomatitis

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16
Q

What test can you run for HSV to confirm the presence of a herpes infection

A

Tzank test, however positive for all herpes? ie herpes zoster

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17
Q

What is the most common fungal infection of the oral cavity and the most frequent cause of human fungal infections?

A

Candidiasis

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18
Q

What factors influence clinical candidiasis infection?

A

the strain of C. albicans
composition of individual oral flora
immune status of the patient

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19
Q

Deficiency in which types of cells might predispose a patient to Candida

A

Neutrophils
macrophages
Th17

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20
Q

What is the major difference between candidiasis and leukoplakia

A

you can scrape off candidiasis

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21
Q

you prepare a wet mount slide of an exudate from your patient and see pseudohyphae, budding yeast, what organism are you looking at?

A

candida

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22
Q

What disease is associated with hairy leukoplakia?

A

EBV

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23
Q

What is the oral change associated with scarlet fever?

A

Strawberry tongue - white coated tongue with hyperemic papillae

Raspberry tongue - fiery red tongue with prominent papillae

24
Q

What is the oral change associated with measles?

A

spotty enanthma precedes skin rash - koplik spots

25
Q

what is the oral change associated with infectious mononucleosis

A

acute pharyngitis and tonsillitis, grey-white exudative membrane, palatal petichiae

26
Q

What is the oral change associated with diphtheria

A

characteristics dirty white, fibrinosupurrative, tough, inflammatory membrane over the tonsils

27
Q

What is the oral presentation of myeloid neoplasms?

ie AML

A

tumors with monocytic differentiation often infiltrate the skin (leukemia cutis) and the gingiva

28
Q

a patient presents with gingival hyperplasia, they have decent hygiene and you see a med in their hx. what medication are they on?

A

Dilantin (Phenytoin)

29
Q

Describe Osler-Weber-Rendu (Hereditary Hemorrhagic Telangiectasia)

A

a rare AD disorder that affects blood vessels throughout the body (causes vascular dysplasia) and results in tendency for bleeding

30
Q

Why must the multicellular keratocystic odontogenic tumor be differentiated from other odontogenic tumors?

A

due to the aggressive nature of the neoplasm

occur mostly in males within the posterior mandible

31
Q

what type of carcinomas make up 95% of all head and neck cancers

A

Squamous Cell Carcinoma

32
Q

An old curmudgeon sits on his porch with a shotgun after the second american civil war in November of 2020. The porch isnt covered and he puffs tobacco from a pipe waiting for someone to fuck around and find out. what cancer is he predisposing himself too

A

SCC/Cancer of the lower Lip

33
Q

Which variants of HPV are highly responsible for oral and pharyngeal squamous cell carcinomas

A

HPV 16 a lot

HPV 18 also

34
Q

Who is most at risk for oropharyngeal squamous cell carcinoma?

A

White, non smoking males age 35-55

….so dylan

35
Q

Which two viral genes of HPV inactivate which cellular pathways

A

E6 P53

E7 RB

36
Q

If a patient has HPV pos SCC, do they have a better or worse long term survival?

A

greater

37
Q

If a white, male, non-smoking patient presents with fatigue, weight loss, painful swallowing, and a lump on his neck what is your top DX

A

HPV SCC

38
Q

acquired and mutations involved in classic oral SCC target which genes

A

p53
Notch1
p63

39
Q

Where does classic oral SCC present?

A 
ventral tongue
floor of  mouth
lower lip 
Soft Palate
Gingiva
40
Q

Is erythroplakia or leukoplakia more omonous

A

erythroplakia - almost always associated with carcinoma in situ

41
Q

If the early stage survival for classic SCC is 80% why is it so dangerous

A

many neoplasms are associated with other primary tumors that are missed and many lesions are asymptomatic until late stage where 5 yr survival is 20%

42
Q

which gland produces salivary amylase?

A

parotid gland

43
Q

which gland produces lingual lipase?

A

submucosal layer of the tongue

44
Q

what is xerostomia?

A

dry mouth

incidence higher in pts over 70.

45
Q

presence of xerostomia in burning mouth syndrome suggests what other possible pathology?

A

hypofunctioning PNS

46
Q

which group of people are most prone to mucoceles

A

toddlers, the elderly, and tanner on a table at Leinenkugel’s. Basically any one with a predisposition to falling

47
Q

what is the treatment of mucocele

A

complete excision

48
Q

What autoimmune disorder is known for having dry mouth

A

Sjogren syndrome

49
Q

how common are salivary gland neoplasms

A

not very common at all

50
Q

What is the relationship between size of gland and likelihood of a neoplasm to become malignant?

A

inverse

bigger gland -> less likely malignant

51
Q

What is a pleomorphic adenoma/mixed tumor?

A

divergent differentiation of a single neoplastic clone

well demarcated mass

can become malignant (aggressive)

PLAG1 rearrangements

52
Q

Which malignancy of the mouth and face area has a male predominance, it is exclusively parotid, and smokers are at an 8X greater risk?

A

Warthin Tumor

AKA Papillary Cystadenoma Lymphomatosum

53
Q

What is the most common primary malignancy of the salivary glands

A

Mucoepidermoid Carcinoma (15% of all salivary tumors)

60-70% in parotid but also minor glands

54
Q

What is the chromosomal translocation in Mucoepidermoid carcinoma

A

11:19(q21;p13) balanced translocation producing MECT1-MAML2

55
Q

What is dangerous about adenoid cystic carcinoma?

A

50% in minor glands (poor prognosis)

unpredictable - 50% disseminate before primary tumor removal

56
Q

What is gingivitis?

A

Inflammation of the oral mucosa (gums)

GI II (16 decks)

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