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Robbins Pathology GI (Chptr 16,17,18,19) > Chapter 16-Oral Cavity > Flashcards

Chapter 16-Oral Cavity Flashcards

1
Q

What is the cause of dental carries

A

Focal demineralization of tooth structures by acidic metabolite of bacterial fermentation of sugars

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2
Q

What is the main cause of tooth loss before the age of 35

A

Dental carries

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3
Q

What is the function of fluoride included into drinking water

A

Forms flouroapatite, which resist degradation by acids

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4
Q

What are the contents of dental plaque

A
  • Bacteria
  • Saliva proteins
  • desquamated epithelial cells
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5
Q

How is calculus formed

A

Aka tartar

-When dental plaque is not removed and becomes crystallized

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6
Q

What is periodontitis

A

Inflammation of the supporting structures of the teeth such as alveolar bone and cementum

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7
Q

What is the result of periodonitis

A

Description of the periodontal ligament that results in detachment of the tooth to the alveolar bone

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8
Q

What are the general causes of periodonitis

A

-Poor oral hygiene that results in a change in the oral flora

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9
Q

What is the change in oral flora that results in the periodonitis

A

Normal: facultative gram positive
Periodonitis: anaerobic and microaerophilic gram negative

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10
Q

Which preexisting conditions can lead to periodonitiis

A 
AIDs
Leukemia
DM
Downs
Defects in Neutrophils (aka chediak higashi syndrome)
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11
Q

What conditions can arise from a case of periodontitis

A
  • Infective endocarditis

- pulmonary and brain abscesses

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12
Q

What are aphthous ulcers

A

Aka canker sores

-single ulceration with an erythematous halo surrounded by yellowish fibrinopurulent membrane

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13
Q

Which conditions are associated with an increased rate of aphthous ulcers

A

Immunological conditions:

  • celiac disease
  • IBD
  • Behcet disease
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14
Q

What is the infiltrate the is commonly seen with aphthous ulcers

A

Monocytes, but neutrophils are present if becomes infected

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15
Q

What is the process of irritation fibromyalgia development

A

Aka traumatic fibromyalgia/foal fibrous hyperplasia

-Mass of fibrotic connective tissue stroma along the buccal mucosa due to proactive proliferation

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16
Q

What is the treatment for irritation fibromyalgia and what is the prognosis

A

Surgical resection is a complete cure

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17
Q

What is a pyogenic granuloma

A

Inflammatory lesion on the gingiva, usually fast growing and is red to purple

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18
Q

Histologically, what are the features of a pyogenic granuloma

A

Highly vascular proliferation of organizing granulation tissue

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19
Q

What is the treatment for pyogenic granulomas

A

Complete surgical excision

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20
Q

What patient group develops pyogenic granulomas

A
  • Young children
  • adolescence
  • Pregnant women (aka pregnancy tumor)
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21
Q

What is a peripheral ossifying fibroma

A

Common gingival growth that arises from calcification of chronic pyogenic granuloma or periodontal ligaments

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22
Q

What is the peak incidence for peripheral ossifying fibroma

A

Young and teenage females

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23
Q

What is the treatment for peripheral ossifying fibroma

A

Surgical resection down to the periosteum

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24
Q

What strain is the common cause of most orofacial herpetic infection

25
Which are the presenting features of acute herpetic gingivostomatitis
- Abrupt onset of vesicles and ulceration in the oral mucosa, especially the gingiva - With LNadeopathy, fever, anorexia, irritability
26
What are the locations of recurrent herpetic stomatitis
- Occurs in the same dermatome/ganglion of inoculation of mucosa - Commonly lips, nasal oriface, buccal mucosa, gingiva, and hard palate
27
What are the morphologies of HSV infections in the oral cavity
-Bullae with clear serous fluid, that ruptures to yield painful, red-rimed, shallow ulceration
28
What are the microscopic findings of HSV infections
- Intranuclear inclusions | - giant cells aka multinuclear polykaryons found by the Tzanck test
29
What infection is the Tzanck test used to diagnose
HSV
30
Which form of candida of the oral cavity is most common
Pseudomembranous, aka thrush
31
Which preexisting conditions can yield thrush
- AIDS - immunosupression due to transplants - DM
32
Which condition is characterized by: 1-Fiery red tongue with prominent papillae 2-White coated tongue with protruding hyperemic papillae project through
Scarlet fever (1 is raspberry tongue, 2 is strawberry tongue)
33
Which condition is characterized by: - Spotty enanthema in the oral cavity, followed by skin rash - ulceration on the buccal mucosa - Koplik spots about Stinson duct
Measles
34
Which condition is characterized by: - Acute pharyngitis and tonsillitis causing coating of grey-white membrane - enlargement of the LN in neck - Palatal petechie
Infectious mononucleosis
35
Which condition is characterized by: | -Dirty white, fibrinosuppurative, tough, inflammatory membrane over the tonsils and retropharynx
Diphtheria
36
What is the cause of hairy leukoplakia
EBV in immunocompromised patients
37
What are the clinical appearances of hairy leukoplakia
-white, confluence fluffy patch of hyperkaratotic thickenings, usually on the lateral portion of the tongue which can not be scraped off
38
Which condition is characterized by acanthosis with ballon cells
Hairy leukoplakia
39
Which lesions can be characterized as leukoplakia
Those that have a white patch that can not be scraped off and appear without an underlying cause
40
Which precaution must be taken with leukoplakia
Must be considered precancerous until otherwise disproven
41
What is the rate of malignant transformation in erythroplakia
Very high transformation, as 90% show some severe dysplasia
42
What is the patient population in which erythroplakia or leukoplakia are commonly seen
Males. 40-70 years old
43
Which activities lead to an increased risk for leukoplakia or erythroplakia
-Tobacco use (pipes, cigars, cigarettes, and smokeless)
44
What type of cancers are the majority of head and neck and what are the percentages
95% of the head and neck are squamous cell carcinomas
45
In North America and Europe, what is the cause of the most common oral cancer
Squamous cell carcinoma caused by tobacco and alcohol
46
In India and Asia, what is the cause of the most common oral cancer
Squamous cell carcinoma caused by chewing betel quid and paan
47
What are the predisposing influences for developing cancer of the lower lip
Actinic radiation (sunlight) and pipe smoking
48
What is the most common cause of squamous cell carcinomas of the oropharynx and what is the percentage
70% are caused by HPV-16
49
What are the common locations in the oropharynx that commonly harbor the HPV16 vaccine
Base of the tongue Tonsils Pharynx
50
How common is HPV of the oral cavity
Uncommon
51
What is the rate of survival in early stage squamous cell carcinoma and how does this compare to the late stage
80% in early and 20% in late
52
Patients with which squamous cell carcinoma have a higher rate of survival
HPV-positive SCC
53
What is a major factor in the determination in the outcome of classic SCC in the oropharynx
The number, as multiple primary tumors decreases the chance of survival. These cancers have the tendency to form second primary tumors a higher than normal rate
54
What is the main cause of death in patients with classic SCC
Second primary tumor
55
Classic SCC of the oropharynx generally contain mutation in which pathway and which proteins
-p53, with proteins p63 and NOTCH1
56
Early stages of cancers in the oral cavity normally display which morphological features
- Raised and firm - mucosal thickening - commonly mistaken for leukoplakia
57
What is the histological pattern seen in cancers of the oral cavity
-begin as dysplasia lesions that may or may not progress to full thickness dysplasia (in situ) before it invades surrounding stroma
58
What are the common locations that oral cancer will spread
Cervical lymph nodes, mediastinal, lungs, liver, and bones

Robbins Pathology GI (Chptr 16,17,18,19) (32 decks)

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