COMPREHENSIVE GENERAL DENTISTRY ORAL PATHOLOGY REFRESHER

Question 1

How do you describe a lesion?

Answer 1

1. number of lesions
2. size
3. color
   4.symptoms
4. type of lesion
5. consistency
6. location

Question 2

when in doubt about a lesion, what do you do?

Answer 2

take a picture (good quality), take a biopsy, and if intraosseous - take a radiograph

Question 3

macule

Answer 3

focal area of change that is NOT elevated or depressed in relation to its surroundings

Question 4

if you run your fingers along a lesion and the texture changes, is it a macule?

Answer 4

No

Question 5

what is the most common type of macule?

Answer 5

melanotic macule

Question 6

papule

Answer 6

a solid, raised lesion that is less than 5mm in diameter

Question 7

nodule

Answer 7

a solid, raised lesion that is greater than 5mm in diameter

Question 8

can a nodule or papule be any color

Answer 8

yes

Question 9

what is the typical color of a nodule or a papule?

Answer 9

pink…white if traumatized

Question 10

are papules and nodules well circumscribed

Answer 10

yes

Question 11

what is a more acceptable term for a nodule or papule if the area is NOT well circumscribed?

Answer 11

swelling

Question 12

plaque

Answer 12

lesion that is slightly elevated and is flat on its surface

Question 13

what is the difference between a plaque and macule

Answer 13

a plaque will have some surface texture to it if you rub your fingers along it

Question 14

plaque is often associated with what type of lesion

Answer 14

dysplastic

Question 15

dyplastic lesions have the potential to be what

Answer 15

malignant

Question 16

sessile

Answer 16

a tumor or growth whose base is the widest part of the lesion

Question 17

pedunculated

Answer 17

a tumor or growth whose base is narrower than the widest part of the lesion

Question 18

papillary

Answer 18

a tumor or growth exhibiting numerous surface projections

Question 19

verrucous

Answer 19

a tumor or growth exhibiting a rough warty surface

Question 20

what is the difference between papillary and verrucous

Answer 20

verrucous lesions tend to have a more irregular surface than papillary lesions

Question 21

vesicle

Answer 21

a superficial blister 5mm or less in diameter that is usually filled with clear fluid

Question 22

bulla

Answer 22

a large blister that is greater than 5mm in diameter

Question 23

pustule

Answer 23

blister filled with purulent exudate (pus)

Question 24

vesicles compared to pustules and bullas tend to do what

Answer 24

occur in clusters

Question 25

erosion

Answer 25

partial or total loss of the surface epethelium

Question 26

ulcer/ulceration

Answer 26

lesion characterized by the loss of surface epithelium and some of the connective tissue

Question 27

what is the ending result of ulcers due to their characteristics?

Answer 27

depressed or excavated

Question 28

fibroma

Answer 28

reactive fibrous hyperplasia in response to local irritation, trauma

Question 29

is a fibroma a true neoplasm

Answer 29

no

Question 30

what are physical characteristics of a fibroma

Answer 30

smooth surface, pink nodule

Question 31

what is the most common location of a fibroma

Answer 31

buccal mucosa at the bite lone

Question 32

NEVER do what to tissue

Answer 32

throw it in the garbage

Question 33

mucocele

Answer 33

a common lession that results in the rupture of mucin into the surrounding soft tissues due to local trauma

Question 34

a mucocele has what physical appearance

Answer 34

dome shaped, mucosal swelling that can vary in size

Question 35

what color is a mucocele and why

Answer 35

the spilled mucin below that muccosal surface gives a blue hue BUT deeper ones may be lower in color

Question 36

what is the most common site for a mucocele

Answer 36

lower lip

Question 37

what is a fluctuant lesion of the upper lip

Answer 37

salivary gland tumor

Question 38

PSEUDOMEMBRANOUS CANDIDIASIS

Answer 38

white plaques that resemble cottage cheese of curdled milk

Question 39

what initiates PM candidiasis

Answer 39

broad spectrum antibiotics immune impairment

Question 40

In terms of PM candidiasis what is a rapid onset and what is slower

Answer 40

thrust from antibiotics is faster than an immunocompromised status

Question 41

can PM candidiasis be wiped off

Answer 41

YES with dry gauze

Question 42

what demographic is PM candidiasis common in

Answer 42

infants due to underdeveloped immune system

Question 43

what is a common characteristic of PM candidiasis

Answer 43

burning sensation

Question 44

what is a treatment for PM candidiasis

Answer 44

antifungal rinse (caution nystatin because of added sugar)

Question 45

leukoplakia

Answer 45

a white plaque that cannot be characterized clinically or pathologically as any other disease

Question 46

will you ever see a biopsy come back as a leukoplakia

Answer 46

NO

Question 47

what other entities could be seen as an oral white plaque

Answer 47

lichen planus, moriscatio, friction keratosis

Question 48

what is the most common oral precancer

Answer 48

leukoplakia

Question 49

when you use the word leukoplakia, there is a suspicion of what

Answer 49

pre-malignant process

Question 50

lesions should show what type of dysplasia have a malignant transformation potential of 20-43%

Answer 50

serve dysplasia

Question 51

name the progression of 'bad' to 'worse'

Answer 51

homogenous --> nonhomogenous --> speckled/erythroleukoplakia

Question 52

what type of incision is preferred for leukoplakia

Answer 52

scapel - laster and cautery may distort cells

Question 53

what is the rate of reoccurrence of leukoplakia after excision

Answer 53

10-35%

Question 54

should you follow up with leukoplakia?

Answer 54

YES

Question 55

what causes tobacco pouch keratosis

Answer 55

chewing tobacco dry snuff moist snuff

Question 56

what clincal symptoms often occur with tobacco pouch keratosis

Answer 56

gingival recession, tooth staining, and caries (due to sugar content

Question 57

geographic tongue is also known as

Answer 57

migratory stomatitis

Question 58

geographic tongue often occurs with what

Answer 58

fissured tongue

Question 59

reticular lichen planus

Answer 59

the most common type of lichen planus that has wickham striae - fine , lacelike network of white lines

Question 60

common sites of reticular lichen planus are

Answer 60

lateral tongue dorsal tongue gingiva vermillion border palate

Question 61

types of lichen planus

Answer 61

reticular errosive

Question 62

melanotic macule

Answer 62

a flat pigmented lesion that is caused by an increased amount of melanin in the skin or mucous membranes

Question 63

LESION acronym

Answer 63

Location Edge Size/shape Interal Other structures Number

Question 64

location

Answer 64

mandible/maxilla, anterior/posterior, local/generalized, unilateral/bilateral

Question 65

edge

Answer 65

well or ill defined corticated sclerotic

Question 66

size/shape

Answer 66

use other radiographic landmarks to describe size

Question 67

internal

Answer 67

radio-pacity level

Question 68

other structures

Answer 68

does the lesion resorb teeth?

Question 69

periradicular cyst

Answer 69

inflammation can stimulate epithelium at the apex of a noncavitated tooth to form a TRUE cyst

Question 70

what cannot be used to differ between periapical granuloma and periapical cyst

Answer 70

size/shape

Question 71

dentigerous cyst

Answer 71

a cyst that originates by separation of the follicle from around the crown of an unerrupted tooth

Question 72

what is the most common type of developmental odontogenic cyst

Answer 72

dentigerous cyst

Question 73

what is the most common location for a dentigerous cyst

Answer 73

impacted 3rd molars rare in primary teeth

Question 74

what is the 'internal' of a dentigerous cyst look like

Answer 74

unilocular, well-defined radiolucency

Question 75

other lesions that can be pericoronal to an impacted tooth

Answer 75

hyperplastic follicle adenamatoid odontogenic tumor unicystic ameloblastoma orthokeratinizing odontogenic cyst ameloblastic fibroma mucoepedermoid carcinoma

Question 76

what are differential for radiolucencies

Answer 76

MACHO or MACHA

Question 77

always do what to teeth first to determine an inflammatory cause

Answer 77

vitality test

Question 78

MACHO

Answer 78

M - myxoma (odontogenic) A - Ameolblastoma C - central giant cell granuloma H- hemangioma (intrabony vascular malformation) O - odontogenic keratocyst

Question 79

what helps us come up with a differential for bumps on the gums

Answer 79

the 3 Ps pyogenic granuloma, peripheral giant cell granuloma, peripheral ossifying fibroma

Question 80

pleomorphic adenoma

Answer 80

benign salivary gland tumors

Question 81

malignant salivary gland tumors

Answer 81

mucoepidermoid carcinoma adenoid cystic carcinoma, polymorphous adenocarcinoma

Question 82

benign soft tissue tumors

Answer 82

schwannoma, neuroma, neurofibroma, fibroma, THE OMAS

Question 83

a benign papillary lesion (squamous) is known by what type of HPV

Answer 83

6 & 11

Question 84

verruca vulgaris is known by what strand of HPV

Answer 84

2

Question 85

multifocal epithelial hyperplasia is known by what strand of HPV

Answer 85

13 and 32

Question 86

what are malignant papillary lesions

Answer 86

squamous cell carcinoma verrucous carcinoma

Question 87

what are the high risk HPV strands

Answer 87

16 and 18 oropharyngeal squamous cell carcinoma

Question 88

traumatic ulcer

Answer 88

mechanical injury to oral mucosa caused by biting sharp foods, tooth brushing, ill-fitting dentures

Question 89

the most common location of a traumatic ulcer is

Answer 89

tongue

Question 90

apthous stomatitis

Answer 90

canker sores that occur most frequently in children and young adults

Question 91

what are the 3 forms of apthous stomatitis

Answer 91

minor, major, and herpetiform

Question 92

recurrent herpes labialis

Answer 92

aka cold sore or fever blister most common on the vermillion border

Question 93

what can trigger recurrent herpes labialis

Answer 93

UV light, physical or mental stress, trauma, dental treatment