Dobson lecture 1: Oral Cavity and Salivary gland Flashcards
Apthous Ulcer, when does it present?
first 2 decades
- family prevalence
- -Immunologic
- IBD
- Behcet disease
What is a key characteristic of fibrous proliferative lesions?
They are all freaking benign!
What are the fibrous proliferative lesions?
Traumatic fibroma
pyogenic granuloma
granuloma
What people get pyogenic granulomas?
children, young adults, and pregnant women (pregnancy tumor)
What are the infections of the oral cavity?
HSV1 and 2
Candida
Deep fungal infections
What is associated with HSV1?
additional clinical symptoms lymphadenopathy, fever, anorexia, and irritability
-reactivation
What test do we use for HSV?
Tzanck smear
-multinucleation
What is the most common fungal infection of the oral cavity?
Candida
What immunocompromised states can be happening with a candida infection?
HIV/AIDS
Cancer
Organ or bone marrow transplants
What is Torus Palatinus?
a growth on the ROOF OF THE MOUTH that is associated with smokers…. not cancer don’t worry
What is hutchinson’s teeth and what underlying agent causes that?
congenital syphilis case with goofy looking teeth
What are people with down syndrome at risk for?
leukemia which means a risk for periodontis
Which inflammatory oral lesion is familial?
apthous ulcer
which gingival lesion comes up rapidly and might make us think of malignancy?
pyogenic granuloma… pregnancy tumor
-remember that those fibrous proliferative lesions are all BENIGN!
if there’s oral HSV, which one will it be?
HSV1 probably
If you see Tzanck test, what are we looking for?
Herpes!!!!!
- not specific for 1 or 2
- multinucleation
- the owl eye thing is CMV
Describe Candida
it’s white
YOU CAN SCRAPE IT OFF!
-they’re usually immunosuppressed
Which deep fungal infections do we need to look out for?
Aspergillosis
cryptococcosis
zygomycosis (DM and mucormycosis)
Organism associated with scarlet fever
group a B hemolytic strep.. strawberry tongue
Measles?
three C’s
koplik spots
Diptheria?
dirty white inflammatory membrane over the tonsils
Phenytoin ingestion (Dilantin)
striking fibrous enlargement of the gingiva
Hairy leukoplakia
CANNOT BE SCRAPED OFF
- EBV related…
- associated with nasopharyngeal carcinoma apparently
- 25% precancerous
erythroplakia
red, velvety, eroded lesions
-anywhere in oral cavity
-less common but more ominus
almost always severe dysplasia
95% of head and neck cancers are ….
Squamous cell carcinomas
Most common factor of precancerous lesions is….
Tobacco
new player is HPV
What issue do we have with HPV…
p16 overexpression..
-tumor suppressor ptn
where will you find SCC?
moreso on the bottom of mouth
Is there a preceding /precancerous lesion with HPV?
NO
-it can just kinda pop up
where do HPV tumors originate?
tonsillar cypts, base of tongue, oropharynx
-so, they’re hard to diagnose..
Which tumors have better outcome, HPV+ or HPV-?
HPV+ for sure!
-even with lymph node metastasis
Which tumor is associated with aggressive behavior and Ghorlin syndrome?
ODONTOGENIC cysts and tumors
-OKC’s
What are the major players of the Salivary Gland?
Xerostomia
Sialadenitis
Neoplasms
What are causes of dry mouth in patients?
DRUGS!!!
-Or sjogren and stuff
Sialadenitis…. where does it come from?
mumps! it’s apparently unilateral
what is the most common tumor in the salivary gland?
pleomorphic adenoma
-it’s benign
How does pleomorphic adenoma present
well demarcated masses of varying size
- usually from radiation
- small mass at angle of jaw
- recurs a lot
What is a Warthin tumor?
the other benign tumor of the parotid gland only
-8x more common in smokers
What cellular organelle is most common in oncocytic things
mitochondria
Mucoepidermoid carcinoma
most common primary malignancy
-balanced chromosomal translocation 11-19
Which tumor is the only one that presents with pain?
the adenoid cystic carcinoma
-grows along nerves so pain is common
