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Oral Pathology > Chapter 8 Nonneoplastic Diseases of Bone > Flashcards

Chapter 8 Nonneoplastic Diseases of Bone Flashcards

1
Q

_____: refers to the abnormal and disordered production of cementum and bone

A

Dysplasia

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2
Q

______: They are well- circumscribed with distinct histology and radiographc features

A

Central cementifying Fibroma

(aka Ossifying fibroma)

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3
Q

Nonneoplastic diseases are not cancerous. Nonneoplastic diseases do not need to be removed.

A) The first statement is true. The second statement is false.

B) The first statement is false. The second statement is true.

C) Both statements are false.

D) Both statemetns are true.

A

A) The first statement is true. The second statement is false.

Nonneoplastic diseases are not cancerous but they still need to be removed to to exssessive growth that can interfere with surrounding tissues.

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4
Q

Another definition of ______ is, the abnormal production of cementum and bone.

A

Dysplasia

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5
Q

Which of the following is not a cemento-osseous displasia type?

A) Periapical cemento-osseos

B) Polyostatic cemento-osseos

C) Focal cemento-osseous

D) Florid cemento-osseous

A

B) Polyostatic cemento-osseos

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6
Q

______ dysplasia is defined as involvement of a single bone.

A

monostatic fibrous

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7
Q

______ dysplasia is defined as involvement of more than one bone.

A

Fibrous polyostotic

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8
Q

Name the three types of polyostotic fibrous dysplasia.

A

Craniofacial type

Jaffe type

Albright syndrome

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9
Q

What is the following describing:

  • Relatively common disease of unknown cause that affects periapical bone
  • Occurs most commonly in the anterior mandible of patients older than 30
  • More common in women than men:
  • Many studies indicate a predilection for black women
  • Early lesions are well circumscribed and radiolucent; with time, they become increasingly calcified
  • Teeth in the affected area are vital
A

Periapical Cemento-Osseous Dysplasia

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10
Q

What is the following describing:

  • A condition of disordered cementum and bone development
  • Usually occurs in black women older than 40 years of age
  • Typically affects more than one quadrant in either the maxilla or mandible often in the POSTERIOR areas.
  • Usually no bone expansion occurs
A

Florid Cemento-Osseous Dysplasia

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11
Q

What is the following describing:

  • Masses of irregular opacification are noted that are composed of dense sclerotic bone, cementum, or both
  • Best diagnosed on the basis of its characteristic patient history, clinical presentation, and radiographic appearance
  • Asymptomatic florid cemento-osseous dysplasia does not require treatment
  • If a patient is edentulous and the sclerotic bone perforates the mucosa- causing connection to bacteria in the oral cavity to the bone- complications may result in the need for antibiotic treatment and/or surgery
A

Florid Cemento-Osseous Dysplasia

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12
Q

What is the following describing:

  • ˜An asymptomatic fibro-osseous lesion
  • ˜Occurs in women between 30 and 50 years of age
  • ˜More common in white people than black people
  • ˜Occurs in posterior mandible
  • ˜Isolated, well-delineated radiolucent-to-radiopaque lesion
  • ˜Less than 1.5 cm in size
A

Focal Cemento-Osseous Dysplasia

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13
Q

What is the following describing:

  • Developmental disease that is a genetic mutation
  • Characterized by replacement of bone with abnormal fibrous connective tissue interspersed with varying amounts of calcification
  • Histologically, it is a benign fibro-osseous lesion, with vascularized, cellular fibrous connective tissue interspersed with irregular trabeculae of bone
  • Classic radiographic appearance of “ground glass”
A

Fibrous dysplasia

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14
Q

Name two types of fibrous dysplasia.

A

Monostatic fibrous dysplasia

Polyostatic dysplasia

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15
Q

What is the following describing:

  • Is a developmental disease characterized by involvement of a single bone
  • The posterior maxilla is more frequently involved than the mandible
  • Most commonly diagnosed in children and young adults, with no sex predilection
  • Clinical examination reveals a painless swelling or bulging of the buccal plate
  • The disease usually extends into the maxillary sinus and surrounding bones called Craniofacial Fibrous Dysplasia AND THEN BECOMES POLYOSTOTIC
A

Monostatic fibrous dysplasia

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16
Q

What is the following describing:

  • Characterized by involvement of more than one bone
  • Typically occurs in children, with a female predilection
  • The skull, clavicles and long bones are affected. When long bones are involved, they may exhibit bowing and an associated dull aching pain
  • Patients may have skin lesions appearing as light-brown macules called café au lait spots
A

Polyostatic fibrous dysplasia

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17
Q

What is a type of polyostotic fibrous dysplasia that involves the maxilla with extension into the sinuses and adjacent zygoma, sphenoid, and occipital bones?

A

Craniofacial fibrous dysplasia

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18
Q

What is a type of polyostotic fibrous dysplasia that involves multiple bones along with cafe au lait macules on the skin?

A

Jaffe type

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19
Q

What is a type of polyostotic fibrous dysplasia that is characterized by

  • endocrine abnormalities
  • young children
  • precocious puberty in females
  • stunting or deformity of skeletal growth in both sexes as a result of premature closing of the epiphyseal plates.
  • Diabetes and hyperthyroidism with café au lait spots
A

Albright syndrome

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20
Q

What is the following describing:

  • Typically a painless, progressive, unilateral enlargement of the mandible or maxilla
  • The classic radiographic appearance is a diffuse radiopacity looking like “ground glass”
A

Polyostotic Fibrous Dysplasia

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21
Q

What is the following describing:

  • A chronic metabolic bone disease
  • Characterized by resorption, osteoblastic repair, and remineralization of involved bone
  • Unknown cause: May be due to a virus, genetic or environmental
  • Most commonly occurs in men over age 50 years
  • Involves the pelvis, femur, spinal column, tibia, and skull.
  • The maxilla is more commonly affected than the mandible
  • Enlargement of affected bone
  • Patient often complains of pain
  • Headache, dizziness from impingement on cranial nerves
  • Spaces may increase between teeth as jaw bone enlarges
A

Paget disease

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22
Q

Radiographically, _______ will be a patchy radiolucency and radiopacity, “cotton wool” & have hypercementosis, loss of lamina dura, and obliteration of the periodontal ligament may occur

A

Paget disease

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23
Q

What is the following describing:

  • May experience pain; not common
  • Slow-growing lesion
  • Destructive
  • Unilocular or multilocular radiolucency
  • Sclerotic or ill-defined borders
  • Divergence of roots
A

Central Giant Cell Granuloma

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24
Q

What is the following describing:

  • Pseudocyst – abnormal cavity that resembles a cyst but has no lining of epithelium
  • Consists of blood-filled spaces surrounded by multinucleated giant cells and fibrous connective tissue
  • Commonly seen in the long bones. Jaw lesions are rare.
  • Radiographic: “Honeycomb” or “soap bubbles”
  • Less than 30 years of age
A

Aneurysmal Bone Cyst

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25
Q

What is the following describing:

  • Result of vitamin D deficiency causing a calcium deficiency and can be induced by certain tumors
  • Rickets
  • Hypophosphatemic vitamin D–resistant rickets
  • Clinical characteristics
    • Delayed tooth eruption
    • Periodontal disease
    • Pathologic fractures-
    • due to poor bone mineralization
A

Osteomalacia

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26
Q
A

Central Giant Cell Granuloma

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27
Q
A

Paget disease

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28
Q
A

Paget disease

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29
Q
A

Paget disease ray “cotton wool” look

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30
Q
A

Paget Disease

(enlargement of bone)

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31
Q
A

Polyostotic fibrous dysplasia

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32
Q
A

Polyostotic fibrous dysplasia

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33
Q
A

Polyostotic fibrous dysplasia

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34
Q
A

Cafe au lait spots

(Albright syndrome)

35
Q
A

Aneurysmal Bone cyst

36
Q
A

Maxillary overgrowth of monostatic fibrous dysplasia

37
Q
A

Monostatic fibrous dysplasia

38
Q
A

Monostatic fibrous dysplasia

39
Q
A

Fibrous dysplasia xray

(ground glass look)

40
Q
A

xray of Florid Cemento-Osseous dysplasia

(Common in black women)

41
Q
A

Periapical cemento-osseous dysplasia

42
Q
A

Periapical cemento-osseous dysplasia

43
Q

Which statement is true of periapical cemento-osseous dysplasia?

A. It is a neoplasm.

B. The lesion is painful and occurs most often in the posterior maxilla.

C. Teeth in the area are usually not vital.

D. Older lesions are primarily radiopaque.

A

D. Older lesions are primarily radiopaque.

44
Q

Which type of lesions typically arises in the posterior mandible and appears as an isolated, well-delineated radiolucent-to-radiopaque lesion that is less than 1.5 cm in size?

A. Periapical cemento-osseous dysplasia

B. Focal cemento-osseous dysplasia

C. Florid cemento-osseous dysplasia

D. Monostotic fibrous dysplasia

A

B. Focal cemento-osseous dysplasia

45
Q

Surgical treatment would most likely be recommended for a patient with ________ dysplasia.

A. periapical cemento-osseous

B. focal cemento-osseous

C. florid cemento-osseous

D. fibrous

A

D. fibrous

46
Q

Characteristics of monostotic fibrous dysplasia include that

A. it is commonly diagnosed in middle-aged women.

B. the expanding nature of the lesion may lead to malocclusion, tipping, or displacement of adjacent teeth.

C. it involves a painful swelling or bulging of the buccal plate of the maxilla or mandible when seen orally.

D. it involves multiple bones.

A

B. the expanding nature of the lesion may lead to malocclusion, tipping, or displacement of adjacent teeth.

47
Q

Café au lait skin macules are associated with

A. monostotic fibrous dysplasia.

B. polyostotic fibrous dysplasia.

C. Paget disease of bone.

D. osteomalacia.

A

B. polyostotic fibrous dysplasia.

48
Q

Paget disease of bone

A. typically occurs in children under the age of 18.

B. is painless.

C. may reveal a “cotton-wool” appearance on radiographs.

D. results in shrinkage of affected bone.

A

C. may reveal a “cotton-wool” appearance on radiographs.

49
Q

Mosaic bone may be observed in a patient with Paget disease as a result of

A. lack of trabeculae.

B. prominent reversal lines resulting from resorption and deposition of bone.

C. the presence of “giant cells.”

D. a “ground glass” appearance.

A

B. prominent reversal lines resulting from resorption and deposition of bone.

50
Q

Which statement is true of osteomalacia?

A. It is the result of a deficiency in phosphate.

B. In adults it may be related to various problems such as malabsorption syndrome.

C. It may be treated by the use of antacids.

D. Accelerated tooth eruption is associated with osteomalacia.

A

B. In adults it may be related to various problems such as malabsorption syndrome.

51
Q

All conditions are benign fibrous-osseous lesions that affect the maxilla and mandible except one. Which is the exception?

A. Periapical cemento-osseous dysplasia

B. Fibrous dysplasia

C. Florid cemento-osseous dysplasia

D. Gingival fibromatosis

A

D. Gingival fibromatosis

52
Q

Which type of lesion occurs most often in black women older than age 40 and is characterized by disordered cementum and bone, typically affecting more than one quadrant of the maxilla and mandible in the posterior regions?

A. Periapical cemento-osseous dysplasia

B. Focal cemento-osseous dysplasia

C. Florid cemento-osseous dysplasia

D. Monostotic fibrous dysplasia

A

C. Florid cemento-osseous dysplasia

53
Q

Cementoma is a term once used for periapical cemento-osseous dysplasia. Because the disease does not represent a neoplasm, cementoma has been replaced with periapical cemento-osseous dysplasia.

A. Both statements are true.

B. Both statements are false.

C. The first statement is true, and the second is false.

D. The first statement is false, and the second is true.

A

A. Both statements are true.

54
Q

For which disease of bone is surgical recontouring most often recommended as its treatment modality?

A. Periapical cemento-osseous dysplasia

B. Florid cemento-osseous dysplasia

C. Polyostotic fibrous dysplasia

D. Focal cemento-osseous dysplasia

A

C. Polyostotic fibrous dysplasia

55
Q

Numerous gritty pieces of soft and hard tissue that contain fibrous connective tissue interspersed with bone trabeculae and cementum-like material is characteristic of which condition?

A. Focal cemento-osseous dysplasia

B. Central cementifying fibroma

C. Florid cemento-osseous dysplasia

D. Ossifying fibroma

A

A. Focal cemento-osseous dysplasia

56
Q

The most common type of fibrous dysplasia, characterized by involvement of a single bone, is termed

A. Paget disease.

B. polyostotic fibrous dysplasia.

C. monostotic fibrous dysplasia.

D. central giant cell granuloma.

A

C. monostotic fibrous dysplasia.

57
Q

Light brown skin macules associated with polyostotic fibrous dysplasia are termed

A. Koplik spots.

B. café au lait spots.

C. brown tumors.

D. gritty tissue.

A

B. café au lait spots.

58
Q

Osteitis deformans and leontiasis ossea are other names for what chronic metabolic bone disease?

A. Central giant cell granuloma

B. Jaffe-Lichtenstein

C. Paget disease

D. Albright syndrome

A

C. Paget disease

59
Q

This 74-year-old patient presents with an enlargement of the maxilla, pain, and a chief complaint that his dentures no longer fit. Radiographic examination reveals a patchy radiolucency and radiopacity that resembles cotton wool. These findings are indicative of what disease of bone?

A. Osteomalacia

B. Paget disease of bone

C. Fibrous dysplasia

D. Florid cemento-osseous dysplasia

A

B. Paget disease of bone

60
Q

Giant cell granulomas located in the gingiva or alveolar mucosa are referred to as central. Giant cell granulomas located within the maxilla or mandible are referred to as peripheral.

A. Both statements are true.

B. Both statements are false.

C. The first statement is true; the second is false.

D. The first statement is false; the second is true.

A

B. Both statements are false.

61
Q

A lesion of bone identical to the central giant cell granuloma and termed brown tumor occurs in patients with what type of disease?

A. Hyperparathyroidism

B. Peripheral giant cell granuloma

C. Hypothyroidism

D. Peripheral ossifying granuloma

A

A. Hyperparathyroidism

62
Q

An aneurysmal bone cyst contains the following except one. Which is the exception?

A. Fibrous connective tissue

B. Epithelial lining

C. Multinucleated giant cells

D. Blood-filled spaces

A

B. Epithelial lining

63
Q

Osteomalacia is a disease of bone that develops over a long period as a result of an iron deficiency. Delayed tooth eruption and periodontal disease are associated with osteomalacia.

A. Both statements are true.

B. Both statements are false.

C. The first statement is true, and the second is false.

D. The first statement is false, and the second is true.

A

D. The first statement is false, and the second is true.

64
Q

All statements are characteristic of osteomalacia except one. Which is the exception?

A. It is the result of a deficiency in calcium.

B. In adults it may be related to the chronic use of antacids.

C. It is treated with vitamin D and calcium nutritional supplements.

D. The pattern of diseased bone is best described as mosaic bone.

A

D. The pattern of diseased bone is best described as mosaic bone.

65
Q

_______________ fibrous dysplasia is characterized by endocrine abnormalities, including precocious puberty in females and stunting or deformity of skeletal growth in both sexes as a result of early epiphyseal plate closure.

A. Craniofacial

B. Jaffe-Lichtenstein type

C. Albright syndrome

D. Monostotic

A

C. Albright syndrome

66
Q

“Ground glass” is the classic radiographic description of _________________.

A. Osteomalacia

B. Paget disease of bone

C. Fibrous dysplasia

D. Florid cemento-osseous dysplasia

A

C. Fibrous dysplasia

67
Q

Laboratory evaluation reveals that the serum _______________ level is significantly elevated in active Paget disease.

A. alkaline phosphatase

B. platelet

C. hematocrit

D. leukocyte

A

A. alkaline phosphatase

68
Q

When osteomalacia occurs in young children, it is usually caused by a nutritional deficiency in vitamin _____.

a. A
b. D
c. E
d. K

A

b. D

69
Q

Early lesions of periapical cemento-osseous dysplasia are well circumscribed and radiolucent and may resemble which condition?

A. Periapical abscess

B. Benign cementoblastoma

C. Odontoma

D. Osteoma

A

A. Periapical abscess

70
Q

Characteristics of periapical cemento-osseous dysplasia include the following except one. Which is the exception?

A. The lesions are seen in the anterior mandible.

B. The common patient complaint is pain upon chewing.

C. A predilection for black women exists.

D. The condition is discovered on routine radiographic examination.

A

B. The common patient complaint is pain upon chewing.

71
Q

What is one difference between the diagnosis of periapical cemento-osseous dysplasia and florid cemento-osseous dysplasia?

A. Florid cemento-osseous dysplasia usually affects more than one quadrant of the maxilla and mandible, including posterior regions.

B. Periapical cemento-osseous dysplasia affects black females; florid cemento-osseous dysplasia affects all ethnicities.

C. The two conditions have various radiographic appearances.

D. Symptoms of the two conditions vary from asymptomatic to extremely painful.

A

A. Florid cemento-osseous dysplasia usually affects more than one quadrant of the maxilla and mandible, including posterior regions.

72
Q

Asymptomatic florid cemento-osseous dysplasia usually requires no treatment. However, in an edentulous patient, the sclerotic masses may perforate the mucosa causing which complication?

A. Fibrous dysplasia

B. Aneurysmal bone cyst

C. Osteomyelitis

D. Central giant cell granuloma

A

C. Osteomyelitis

73
Q

Café au lait spots appear on the skin as which color(s)?

A. Reddish pink

B. Light brown

C. Yellow white

D. Black

A

B. Light brown

74
Q

The painless jaw swelling seen in monostotic fibrous dysplasia may cause all symptoms except one. Which is the exception?

A. Tooth mobility

B. Malocclusion

C. Displacement of adjacent teeth

D. Tipping of teeth

A

A. Tooth mobility

75
Q

Characteristics of polyostotic fibrous dysplasia include the following except one. Which is the exception?

A. Most cases are asymptomatic.

B. Male predilection

C. Occurs in children under 10 years of age

D. Seen in association with skin lesions

A

B. Male predilection

76
Q

Why is treatment with radiation therapy for polyostotic fibrous dysplasia contraindicated?

A. It is too severe of a treatment for a young child.

B. An association exists with malignant transformation to osteosarcoma.

C. Because of the defined borders of the lesions, surgery is the treatment of choice.

D. The lesions remain asymptomatic and localized.

A

B. An association exists with malignant transformation to osteosarcoma.

77
Q

All are likely complaints of a patient with Paget disease of bone except one. Which is the exception?

A. “My partial denture does not fit.”

B. “I can’t hear you, can you speak louder?”

C. “I have spaces between my teeth that I never had before.”

D. “My tongue is always sore.”

A

D. “My tongue is always sore.”

78
Q

The serum alkaline phosphatase level is significantly elevated in persons with active Paget disease. This is detected through which diagnostic process?
A. Historical

B. Laboratory

C.. Therapeutic

D. Differential

A

B. Laboratory

79
Q

The aneurysmal bone cyst is a “pseudocyst” which means:

A. No epithelial lining exists.

B. The cyst does not appear on radiographic images.

C. The cyst is really a fibroma.

D. Malignant potential is present.

A

A. No epithelial lining exists.

80
Q

What is a common feature of the central giant cell granuloma?

A. Heat and cold sensitivity

B. Fast-growing lesion

C. High recurrence rate

D. Divergence of roots of teeth adjacent to the lesion

A

D. Divergence of roots of teeth adjacent to the lesion

81
Q

Osteomalacia is a disease of bone that develops over a long period of time as a result of deficiency of which substance?

A. Connective tissue

B. Calcium

C. Fluoride

D. Vitamin A

A

B. Calcium

82
Q

Where does the disease extend when fibrous dysplasia involves the maxilla?

A. Nasal cavity

B. Orbits

C. Maxillary sinus

D. Periapical areas of maxillary molars

A

C. Maxillary sinus

83
Q

The most severe form of polyostotic fibrous dysplasia is termed Albright syndrome. This condition is characterized by endocrine abnormalities such as precocious puberty that may begin at which age?

A. 2 years

B. 4 years

C. 6 years

D. 8 years

A

A. 2 years

Oral Pathology (14 decks)

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