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Clinical Ddx Flashcards

1
Q

Mucosal changes

Blue/purple lesions

A
  • Mucocele
  • Salivary gland tumor
  • Gingival cyst
  • Melanoma
  • Kaposi sarcoma
  • Varix
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2
Q

Mucosal changes

Cobblestone pattern

A
  • Crohn’s
  • Heck’s
  • Darier’s
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3
Q

Mucosal changes

Pigmented lesions (single):

A
  • Amalgam tattoo
  • Melanotic macule
  • Melanoma
  • Nevus
  • Melanoacanthoma
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4
Q

Mucosal changes

Pigmented lesions (multiple/diffuse):

A
  • Racial pigmentation
  • Smoker’s melanosis
  • Drug-­‐induced pigmentation
  • Melanoacanthoma
  • Peutz-­‐Jeghers
  • Addison’s disease
  • Heavy metal intoxication
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5
Q

Mucosal changes

Red lesion

A
  • Erythroplakia
  • Candidiasis
  • Burn
  • Hemangioma
  • Mucositis
  • Lupus
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6
Q

Mucosal changes

Red/white mixed lesions

A
  • Candidiasis
  • Lichen planus
  • Lupus
  • Erythroleukoplakia
  • Burn
  • Cinnamon reaction
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7
Q

Mucosal changes

Telangiectasias:

A
  • Hereditary hemorrhagic telangiectasias (Osler-­‐Weber-­‐Rendu syndrome)
  • CREST syndrome
  • Primary biliary cirrhosis
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8
Q

Mucosal changes

Ulceration (single)

A
  • Traumatic ulcer
  • Apthous ulcer
  • Tuberculosis
  • Leprosy
  • Deep fungal infection
  • Squamous cell carcinoma
  • Wegener’s
  • Syphilis
  • Chron’s
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9
Q

Mucosal changes

Ulceration (multiple)

A
  • Aphthae
  • Inflammatory bowel disease: Chron’s and ulcerative colitis
  • Celiac disease
  • Behcet’s disease
  • Reiter’s syndrome
  • MAGIC syndrome
  • Sweet’s syndrome
  • PFAPA (periodic fever, aphthous ulcers, pharyngitis, cervical adenitis)
  • Heavy metal intoxication (lead, mercury, arsenic, gold)
  • Blood dyscrasias (neutropenia, agranulocytosis, cyclic neutropenia, aplastic anemia, leukemia)
  • Lack of nutrients (iron, folate, vit B, zinc)
  • Vesiculo-­‐bullous and AI (pemphigus, pemphigoid, ELP, EM)
  • Mucositis (CT and RT)
  • GVHD
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10
Q

Mucosal changes

Warty Lesions:

A
  • Papilloma
  • Verruca vulgaris
  • Condyloma acuminatum
  • Heck’s Disease
  • Condyloma lata
  • Verruciform leukoplakia
  • Verrucous carcinoma
  • Verruciform xanthoma
  • Giant cell fibroma
  • Warty dyskeratoma/Darier’s disease
  • Acanthosis nigricans
  • Ductal papillomas
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11
Q

Mucosal changes

White lesion:

A
  • Candidiasis
  • Leukoplakia (Hyperkeratosis, dysplasia, carcinoma)
  • Morsicatio
  • Thermal/Chemical burn
  • Lichen planus
  • Lupus
  • Genodermatoses (White sponge nevus, HBID, pachyonychia congenita I, dyskeratosis congenita)
  • Uremic stomatitis
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12
Q

Mucosal changes

Yellow lesions

A
  • Parulis
  • Lymphoepithelial cyst
  • Lymphoid aggregate
  • Granular cell tumor
  • Lipoma
  • Verruciform xanthoma
  • Pyostomatitis vegetans (snail track ulceration)
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13
Q

Floor of mouth

Nodule:

A
  • Ranula
  • Lymphoepithelial cyst
  • Dermoid cyst
  • Salivary gland tumors
  • Mesenchymal tumor
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14
Q

Gingiva

Desquamative Gingivitis:

A
  • Lichen planus
  • Pemphigoid
  • Pemphigus vulgaris
  • Linear IgA disease
  • Epidermolysis bullosa
  • Lupus erytematosus
  • Chronic ulcerative stomatitis
  • Paraneoplastic pemphigus
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15
Q

Gingiva

Gingival hemorrhage

A
  • Gingivitis
  • Hemophilia
  • Thrombocytopenia
  • Leukemia
  • Chemotherapy
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16
Q

Gingiva

Gingival enlargement:

A
  • Hyperplastic gingivitis
  • Gingival fibromatosis/Familial gingival fibromatosis
  • Juvenile hyaline fibromatosis
  • Drug induced: cyclosporine, phenytoin and nifedipine
  • Plasma cell gingivitis
  • Leukemia
  • Scurvy
  • Wegener’s granulomatosis (strawberry gingivitis)
  • Cinnamon stomatitis
  • Diabetes
  • Blood dyscrasias
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17
Q

Gingiva

Gingival nodules:

A
  • Fibroma
  • 3P’s (pyogenic granuloma, peripheral ossifying fibroma, peripheral giant cell lesion)
  • Mesenchymal (neurofibroma, lipoma, etc)
  • Squamous cell carcinoma (~ PG)
  • Kaposi sarcoma
  • Odontogenic tumors/cysts (eruption cyst, gingival cyst, Gorlin cyst, ameloblastoma)
  • Metastatic tumors
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18
Q

Gingiva

Necrotizing gingivitis

A
  • NUG
  • Primary herpes (affects also ST, such as tongue, lips)
  • Gonorrhea (no odor)
  • Mononucleosis
  • Measles (if pt is malnourished)
  • Agranulocytosis (pt under CT)
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19
Q

Tongue

Dorsal tongue bumps

A
  • Fibroma
  • Granular Cell Tumor
  • Mesenchymal Tumors
  • Lingual thyroid
  • Enlarged Circumvallate Papilla
  • Osseous choristoma
  • Lipoma
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20
Q

Tongue

Fissured tongue

A
  • Melkerson-­‐Rosenthal syndrome
  • Down syndrome
  • Sjogren syndrome
  • Psoriasis
  • Geographic tongue
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21
Q

Tongue

Loss of papillae

A
  • Candidiasis
  • Anemia
  • Vitamin B deficiency
  • Iron deficiency
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22
Q

Tongue

Macroglossia:

A
  • Hemangiona/Lymphangioma/Vascular malformation
  • Beckwith-­‐Wiedemann syndrome
  • Down’s syndrome
  • Neurofibromatosis
  • MEN 2B
  • Mucopolysaccharidoses
  • Hemihyperplasia
  • Cretinism
  • Amyloidosis
  • Acromegaly
  • Angioedema
  • Myxedema
  • Carcinomas or other tumors
  • Edentulism
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23
Q

Tongue

Nodules:

A
  • Lymphangioma
  • Lingual thyroid
  • Mesenchymal (neuroma, neurofibroma, traumatic neuroma)
  • Cartilage/bone choristoma
  • Amyloidosis
  • Granular cell tumor
  • Pyogenic granuloma
  • Fibroma
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24
Q

Palate

Newborns:

A
  • Gingival cysts (more in MX alveolar process)
  • Palatal cysts (Epstein pearls-­‐midline; Bohn’s nodules-­‐scattered)
  • Congenital epulis
  • Melanotic neuroectodermal tumor of infancy
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25
# Palate Deep palatal ulcerations:
* Nasal NK/T cell lymphoma * Syphilis * Mucormycosis (aka zygomycosis, phycomycosis) * Wegener’s * Cocaine use - drug-induced palatal perforation * Leprosy * Necrotizing ulcerative mucositis
26
# Palate Masses:
* Fibrous dysplasia * Segmental odontomaxillary dysplasia * Lymphoma * Abscess * Nasopalatine duct cyst (anterior) * Salivary gland tumor * Renal osteodystrophy-­‐ the mass is a brown tumor * Kaposi sarcoma
27
# Palate Petecchiae/Ecchymosis
* Scarlet fever * Mononucleosis * Blood dyscrasias (thrombocytopenia, anemia) * Trauma (felatio, coughing, vomiting, convulsions, giving birth, increased thoracic pressure) * Upper respiratory tract infections * Hemophilia
28
# Lip Ulceration and crusts:
* Trauma (mechanical, chemical, electrical) * Erythema multiforme * Actinic cheilits * Squamous cell carcinoma * Exfoliative cheilitis * Cheilocandidiasis * Cheilitis glandularis
29
# Lip …involving perioral skin:
* Cheilocandidiasis * Circumoral dermatitis * Perioral dermatitis * Impetigo * Sialorrhea
30
# Lip Vesicles
* Herpes simplex * Varicella * Herpes zoster * Impetigo
31
# Lip Nodule: Upper lip-­‐
* Nasolabial cyst * Fibroma * Salivary gland tumor (canalicular >40; PA <40) * Mesenchymal (Hemangioma, NF, lipoma)
32
# Lip Nodule: Lower lip
* Mucocele * SCC/ KA * Fibroma * Mesenchymal (Hemangioma, NF, lipoma (most common))
33
Childhood/newborn lesions
* Congenital epulis of the newborn * Melanotic neuroectodermal tumor of infancy * Ameloblastic fibroma/fibro-­‐odontoma * Cystic hygroma * Cherubism * Hemangioma * Eruption cyst * Palatal cysts of the newborn * Teratoma
34
Extraction site growths
* Epulis Granulomatosa * Pulse Granuloma * Mylospherulosis * Ameloblastoma * Mets
35
# Extraoral Epidermoid cysts:
* Gardner syndrome * Nevoid basal cell carcinoma syndrome
36
# Extraoral Erythema nodosum
* Valley fever (coccidioidomycosis and erythema nodosum) * Sarcoidosis * Lofgren’s syndrome * Behçet syndrome -TB?
37
Facial paralysis:
* Bell’s palsy (idiopathic) * Melkersson-­‐Rosenthal Syndrome * Heerfordt’s Syndrome * Ramsay-­‐Hunt Syndrome * Multiple sclerosis * Guillan-­‐Barre syndrome * Sarcoidosis * Lyme disease * Wegener’s * Leprosy * Osteopetrosis
38
Frontal bossing:
* Gorlin syndrome * Osteopetrosis * Crouzon * Cleidocranial dysplasia * Acromegaly
39
Intestinal polyps
* Cowden (most are benign) * Peutz-­‐Jeghers (most are benign) * Gardner syndrome (most are malignant)
40
Increased cancer susceptibility
* Xeroderma pigmentosum (BCC, SCC) * Papillon-­‐Lefreve * Plummer Vinson * Gorlin syndrome * Peutz-­‐Jeghers (GI carcinoma, breast cancer) * Cowden’s * Gardner * Acanthosis nigricans * Recessive dystrophic epidermolysis bullosa (SCC) * Immunosuppressed patients (AIDS, transplant)
41
Joint laxity:
* Kabuki syndrome * Ehlers-­‐Danhlos * Cleidocranial dysplasia * Osteogenesis imperfecta
42
Leukemia:
* Down syndrome * Bloom syndrome * NF1 * Klinefelter * Fanconi’s anemia * Schwachman syndrome * Ataxia-­‐telangiectasia syndrome * Wiskott-­‐Aldrich syndrome
43
Lateral neck swelling:
* Lymphangioma (cystic hygroma) * Metastastic node * Reactive node (cat-­‐scratch disease, toxoplasmosis, mononucleosis) * Branchial cleft cyst * Hodgkin’s lymphoma * Paraganglioma
44
Leonine facies
* Leprosy * Paget’s * Amyloidosis * Mycosis fungoides * Lipoid proteinosis
45
Midline neck swelling:
* Thyroglossal duct cyst * Dermoid cyst * Ranula * Diphteria (bull neck) * Ludwig’s angina (bull neck) * Thryroid disease
46
Multiple nodules of mouth and or/face:
* MEN 2B (neuromas) * Neurofibromatosis (NF-­‐omas) * Cowden’s (Trichilemmomas of the skin and oral fibromas) * Tuberous Sclerosis (mouth-­‐fibromas; face-­‐angiofibromas) * Lepromatous (multibacillary) leprosy (“leonine facies”) * Blastomycosis * Coccidioidomycosis (esp. nasolabial fold) * Cryptococcosis (skin papules) * Molluscum contagiosum (skin papules)
47
Nail Changes:
* Pachyonychia congenita * Dyskeratosis congenita * Dyskeratosis follicularis (Darier’s disease) * APECED (endocrine-­‐candidiasis) syndrome * Ectodermal Dysplasia (incl. odonto-­‐onychodermal dysplasia) * Papillon-­‐Lefevre (and Haim-­‐Munk & Meleda’s disease) * Darier’s disease * Lichen planus * Plummer-­‐Vinson
48
Orofacial granulomatosis:
* Angioedema * Melkersson-­‐Rosenthal syndrome/cheilitis granulomatosa * Sarcoidosis * Crohn’s * Tuberculosis * Leprosy (macrochelia) * Cheilitis granulomatosa (macrochelia)
49
Painful skin lesion (ANGEL)
* Angiolipoma * Neuroma * Glomus tumor * Eccrine spiradenoma * Leiomyoma
50
Palmoplantar keratosis
* Papillon-­‐Lefevre * Haim Munk * Unna Thost syndrome * Meleda disease * Pachyonychia congenita * Darier’s disease (dyskeratosis follicularis) * Cowden’s syndrome
51
Pheochromocytomas
* MEN 2A * MEN 2B * NF1 * Sturge-­‐Weber * Von Hippel-­‐Lindau
52
Pigmented lesions of the skin:
* Peutz-­‐Jeghers syndrome (perioral) * Addison’s disease * McCune-­‐Albright (café au lait -­‐ rough edges) * Neurofibromatosis (café au lait -­‐ smooth edges) * LEOPARD syndrome * Nevus * Melanoma * Ephelis (freckles) * Actinic lentigo * Lentigo simplex * Seborrheic keratosis * Pigmented basal cell carcinoma
53
Port wine stain (nevus flammeus)
* Sturge Weber * Beckwith-­‐Wiedemann * Hemihyperplasia
54
Salivary gland enlargement:
* Salivary gland tumors * Sjogrens/BLEL * MALT lymphoma * Sarcoidosis/Heerfordt * Sialadenosis * Mumps * CMV infection * AIDS-­‐related multicystic disease
55
Strike of the sword (en coup de sabre):
* Progressive hemifacial atrophy (Romberg syndrome) * Limited scleroderma
56
Syndromes with seizures:
* Sturge-­‐Weber * Tuberous sclerosis * Incontinentia pigmenti * Mucopolysaccharidosis
57
Syndromes with development of head/neck tumors:
* Neurofibromatosis 1 and 2 * MEN 2B * Cowden * Gardner * Sjogren * Gorlin syndrome * Xeroderma pigmentosum
58
Thyroid gland enlargement
* Goiter (Hyperthyroidism) * Autoimmune disease * Adenoma * Carcinoma (Papillary, Follicular, Medullary)
59
Waxy eye skin lesions
* Amyloidosis * Lipoid proteinosis * Plasminogen deficiency * Xanthelasma
60
Cancer viruses HHV8, H.pylori, HTLV-1, HPV
* HHV8: KS, primary effusion lymphoma, Castleman’s disease, and plasmablastic lymphoma * H.pylori: stomach MALT lymphoma * HTLV-­‐1: leukemia, peripheral T cell lymphoma * HPV: cervical cancer (16/18)
61
EBV Positive Lesions:
* Burkitt’s lymphoma * Hodgkin’s disease * Mononucleosis * Nasopharyngeal carcinoma * Hairy leukoplakia * AIDS related lymphomas (includes plasmablastic lymphoma) * Post-­‐transplant lymphoproliferative disorder * Gastric carcinomas * NK-­‐T cell lymphoma
62
HPV-­‐induced diseases
Virus Disease 26, 37 Keratoacathoma 16, 18, 31, 33 High risk cervical cancer 13, 32 Heck’s disease 6,11 Squamous papilloma, fungiform papilloma 2, 4, 6, 40 Verruca vulgaris 2, 6, 11, 16, 18, 31, 53, 54 Condyloma acuminatum 6, 11, 16, 18 Inverted papilloma (CD44+) 7, 32 Butcher’s warts (immunocompromised pts)
63
HHVs
* HHV1 : HSV1 – Labial herpes * HHV2 : HSV2 – Genital herpes * HHV3 : VZV – Varicella and Herpes Zoster * HHV4 : EBV * HHV5 : CMV * HHV6 : Roseola (exanthema subitum) * HHV7 : Roseola-­‐like cutaneous eruption * HHV8 : KSHV
64
Infections caused by group A β-­‐hemolytic streptococci:
* Impetigo * Erysipelas * Streptococcal tonsilitis and pharyngitis * Scarlet fever
65
Tonsilitis/Pharyngitis
* Streptococcal tonsillitis/pharyngitis * Scarlet fever * Diphteria * Gonorrhea * Mononucleosis * Enteroviroses (Hand-­‐foot-­‐and-­‐mouth, Herpangina, Acute lymphonodular pharyngitis)
66
Dentin dyplasia-­‐like teeth:
* Tumoral calcinosis * Calcinosis universalis * Skeletal anomalies/Sclerotic bone * Rheumatoid arthritis * Vitaminosis D
67
Hypercementosis:
* Occlusal problems * Paget’s disease of bone * Inflammation from adjcent teeth * Calcinosis * Goiter * Arthritis * Vit. A deficiency * Acromegaly
68
Premature tooth loss
* Hypophosphatasia * Papillon-­‐Lefreve * Ectodermal dysplasia
69
Pulp calcifications:
* Dentin dysplasia (Id and II) * Pulpal dysplasia * Tumoral calcinosis * Calcinosis universalis * Ehlers-­‐Danlos syndrome
70
Pulp obliteration:
* Dentinogenesis imperfecta * Osteogenesis imperfeta (teeth + other altered bones) * Fibrous dysplasia of dentin (has small RL foci) * Calcific metamorphosis
71
# Stains: Extrinsic-­‐
* Chromogenic bacteria (green, black, orange) * Medications (doxycycline; stannous fluoride, chlorhexidine) * Gingival hemorrhage (green from hemoglobin breakdown into biliverdin) * Habits (tobacco, food, beverages) * Iron * Restorative materials
72
# Stains: Intinsic-­‐
* Amelogenesis imperfecta * Dentinogenesis imperfecta * Dental fluorosis * Erythropoietic porphyria * Hyperbilirubinemia (erythroblastosis fetalis and biliary atresia) * Ochronosis * Trauma * Red blood cell breakdown * Medications (minocycline, tetracycline)
73
# Stains: Supernumary teeth:
* Gardner’s Syndorme * Sturge-­‐Weber * Crouzon * Apert * Cleidocranial dysplasia
74
# Stains: Taurodontism:
* Tricho-­‐dento-­‐osseous (AI + taurodontism) * Oro-­‐facial-­‐digital syndrome, type II (Mohr) * Hyper/hypophosphatasia * Kleinfelter * Oculo-­‐dental-­‐digital dysplasia * Down syndrome * Ectodermal dysplasia
75
Beaten metal skull:
* Crouzon syndrome (craniofacial dysostosis) * Apert syndrome (acrocephalosyndactyly) * Hypophosphatasia (childhood)
76
Bowing deformity of long bones
* Osteogenesis imperfecta * Rickets * Hypophosphatasia * Fibrous dyplasia
77
Cotton wool:
* Cemento-­‐osseous dysplasia * Paget’s disease * Gardner syndrome * Gigantiform familial cementoma
78
Ground glass:
* Fibrous dysplasia * Hyperparathyroidism * Renal osteodystrophy * Juvenile active ossifying fibroma (when in the sinus)
79
Hair-­‐on-­‐end:
* Sickle cell anemia * Thalassemia * Gaucher disease
80
Loss of lamina dura:
* Burkitt’s lymphoma * Osteomalacia (vit D deficiency) * Paget’s disease * Hyperparathyroidism * Fibrous dysplasia
81
Maxillary sinus opacity/cloudiness:
* Antral pseudocyst * Sinus mucocele * Anthrolith * Juvenile active ossifying fibroma * Aspergilloma * Sinusitis
82
Mixed radiolucent/ radiopaque lesions (well-­‐defined):
* Cemento osseous dysplasia * Ossifying fibroma * Odontoma * Ameloblastic fibro-­‐odontoma * Calcifying odontogenic cyst (Gorlin cyst) * Calcifying epithelial odontogenic tumor (Pindborg)
83
Mixed radiolucent/ radiopaque lesions (ill-­‐defined):
* Osteomyelitis * Bisphosphonate associated osteonecrosis * Osteosarcoma * Chondrosarcoma * Metastatic tumor
84
Multilocular Radiolucency (M A C H O M A C H O):
* Myxoma * Ameloblastoma/Ameloblastic fibroma * Central giant cell granuloma * Hemangioma * Odontogenic cysts (OKC, OOC, Gorlin) * Metastatic tumors, mucoepidermoid carcinoma * Aneurysmal bone cyst * Cherubism * Hyperparathyroidism * Odontogenic fibroma
85
Multilocular Radiolucency cross midline
* Myxoma * Ameloblastoma * CGCG * Hemangioma * Glandular odontogenic cyst
86
Neck radiopacities
* Calcified lymphnode (TB most common) * Sialolith * Tonsilolith (midportion of Md ramus) * Phlebolith * Dystrophic calcification of cystic acne * Carotid artery calcification (multiple radiopacities)
87
# Radiographic changes Onion skin
* Osteomyelitis with proliferative periostitis (so-­‐called Garret osteomyelitis) * Ewing’s sarcoma * Langerhans cell histiocytosis * Osteosarcoma * Trauma * Fluorosis * Congenital syphilis
88
Radiopaque lesions:
* Condensing osteitis (no RL rim) * Bone scar (no RL rim) * Idiopathic osteosclerosis (no RL rim, can be multifocal) * Cemento-­‐osseous dysplasia (can be multifocal) * Odontoma (with RL rim) * Osteoma (can be multifocal in Gardner syndrome)
89
Severe periodontal bone loss:
* Periodontitis * Blood dyscrasia (leukemia, lymphoma) * Langerhans cell histiocytosis * Cyclic Neutropenia * Papillon-­‐Lefevre syndrome * Haim-­‐Munk syndrome
90
Solitary lytic bone lesions (**especially outside jaws) FOG MACHINES
* Fibrous dysplasia * Osteoblastoma * Giant cell tumor * Multiple myeloma (punched-­‐out RL)/metastasis * Aneurysmal bone cyst (long bone or vertebral column) * Chondroblastoma/chondromyxoid fibroma * Hyperparathyroidism/hemangioma * Infections * Non-­‐ossifying fibroma * Eosinophilic granuloma/Enchondroma * Solitary bone cyst (long bones)
91
Sunburst:
* Osteosarcoma * Chondrosarcoma * Hemangioma * Melanotic neuroectodermal tumor of infancy
92
Tram-­‐track calcifications
* Cleidocranial dysplasia * Sturge-­‐Weber syndrome
93
Unilocular Radiolucency (pericoronal):
* Dentigerous cyst * Keratocyst * Ameloblastoma * Adenomatoid odontogenic tumor * Gorlin cyst
94
Unilocular radiolucency (periapical)
* Granuloma * Radicular cyst * Periapical cemento-­‐osseous dysplasia * Periapical scar
95
Unilocular radiolucency (other locations)
* Ameloblastoma * Keratocyst * Ossifying fibroma * Cemento-­‐osseous dysplasia * Odontogenic fibroma
96
Unilocular radiolucency (multifocal)
* Odontogenic keratocyst * Langerhans cell histiocytosis * Periodontal disease * Metastatic tumors * Multiple myeloma
97
Unilocular radiolucency (poorly defined borders)
* Osteomyelitis * Metastatic tumor * Multiple myeloma * Osteosarcoma * Ewing sarcoma * Lymphoma
98
Widening of the PDL:
* Osteosarcoma * Chondrosarcoma * Scleroderma (generalized widening) * Periapical abscess * Metastasis
99
Ddx for Ellis-van Creveld
Jeune syndrome (JS), Orofaciodigital syndrome (OFDS), McKusick-Kaufman syndrome (MKK) and Weyers acrofacial dysostosis (WAD)
100
Ddx for taurodontism
Ellis-van creveld Oro-facial-digital

AAOMP Guide (25 decks)

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