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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

A

HSV1

25
Q

Which are the presenting features of acute herpetic gingivostomatitis

A
  • Abrupt onset of vesicles and ulceration in the oral mucosa, especially the gingiva
  • With LNadeopathy, fever, anorexia, irritability
26
Q

What are the locations of recurrent herpetic stomatitis

A
  • Occurs in the same dermatome/ganglion of inoculation of mucosa
  • Commonly lips, nasal oriface, buccal mucosa, gingiva, and hard palate
27
Q

What are the morphologies of HSV infections in the oral cavity

A

-Bullae with clear serous fluid, that ruptures to yield painful, red-rimed, shallow ulceration

28
Q

What are the microscopic findings of HSV infections

A
  • Intranuclear inclusions

- giant cells aka multinuclear polykaryons found by the Tzanck test

29
Q

What infection is the Tzanck test used to diagnose

A

HSV

30
Q

Which form of candida of the oral cavity is most common

A

Pseudomembranous, aka thrush

31
Q

Which preexisting conditions can yield thrush

A
  • AIDS
  • immunosupression due to transplants
  • DM
32
Q

Which condition is characterized by:
1-Fiery red tongue with prominent papillae
2-White coated tongue with protruding hyperemic papillae project through

A

Scarlet fever (1 is raspberry tongue, 2 is strawberry tongue)

33
Q

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
A

Measles

34
Q

Which condition is characterized by:

  • Acute pharyngitis and tonsillitis causing coating of grey-white membrane
  • enlargement of the LN in neck
  • Palatal petechie
A

Infectious mononucleosis

35
Q

Which condition is characterized by:

-Dirty white, fibrinosuppurative, tough, inflammatory membrane over the tonsils and retropharynx

A

Diphtheria

36
Q

What is the cause of hairy leukoplakia

A

EBV in immunocompromised patients

37
Q

What are the clinical appearances of hairy leukoplakia

A

-white, confluence fluffy patch of hyperkaratotic thickenings, usually on the lateral portion of the tongue which can not be scraped off

38
Q

Which condition is characterized by acanthosis with ballon cells

A

Hairy leukoplakia

39
Q

Which lesions can be characterized as leukoplakia

A

Those that have a white patch that can not be scraped off and appear without an underlying cause

40
Q

Which precaution must be taken with leukoplakia

A

Must be considered precancerous until otherwise disproven

41
Q

What is the rate of malignant transformation in erythroplakia

A

Very high transformation, as 90% show some severe dysplasia

42
Q

What is the patient population in which erythroplakia or leukoplakia are commonly seen

A

Males. 40-70 years old

43
Q

Which activities lead to an increased risk for leukoplakia or erythroplakia

A

-Tobacco use (pipes, cigars, cigarettes, and smokeless)

44
Q

What type of cancers are the majority of head and neck and what are the percentages

A

95% of the head and neck are squamous cell carcinomas

45
Q

In North America and Europe, what is the cause of the most common oral cancer

A

Squamous cell carcinoma caused by tobacco and alcohol

46
Q

In India and Asia, what is the cause of the most common oral cancer

A

Squamous cell carcinoma caused by chewing betel quid and paan

47
Q

What are the predisposing influences for developing cancer of the lower lip

A

Actinic radiation (sunlight) and pipe smoking

48
Q

What is the most common cause of squamous cell carcinomas of the oropharynx and what is the percentage

A

70% are caused by HPV-16

49
Q

What are the common locations in the oropharynx that commonly harbor the HPV16 vaccine

A

Base of the tongue
Tonsils
Pharynx

50
Q

How common is HPV of the oral cavity

A

Uncommon

51
Q

What is the rate of survival in early stage squamous cell carcinoma and how does this compare to the late stage

A

80% in early and 20% in late

52
Q

Patients with which squamous cell carcinoma have a higher rate of survival

A

HPV-positive SCC

53
Q

What is a major factor in the determination in the outcome of classic SCC in the oropharynx

A

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
Q

What is the main cause of death in patients with classic SCC

A

Second primary tumor

55
Q

Classic SCC of the oropharynx generally contain mutation in which pathway and which proteins

A

-p53, with proteins p63 and NOTCH1

56
Q

Early stages of cancers in the oral cavity normally display which morphological features

A
  • Raised and firm
  • mucosal thickening
  • commonly mistaken for leukoplakia
57
Q

What is the histological pattern seen in cancers of the oral cavity

A

-begin as dysplasia lesions that may or may not progress to full thickness dysplasia (in situ) before it invades surrounding stroma

58
Q

What are the common locations that oral cancer will spread

A

Cervical lymph nodes, mediastinal, lungs, liver, and bones

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

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