Dobson lecture 1: Oral Cavity and Salivary gland

Question 1

Apthous Ulcer, when does it present?

Answer 1

first 2 decades

• family prevalence
• -Immunologic
• IBD
• Behcet disease

Question 2

What is a key characteristic of fibrous proliferative lesions?

Answer 2

They are all freaking benign!

Question 3

What are the fibrous proliferative lesions?

Answer 3

Traumatic fibroma
pyogenic granuloma
granuloma

Question 4

What people get pyogenic granulomas?

Answer 4

children, young adults, and pregnant women (pregnancy tumor)

Question 5

What are the infections of the oral cavity?

Answer 5

HSV1 and 2
Candida
Deep fungal infections

Question 6

What is associated with HSV1?

Answer 6

additional clinical symptoms lymphadenopathy, fever, anorexia, and irritability
-reactivation

Question 7

What test do we use for HSV?

Answer 7

Tzanck smear

-multinucleation

Question 8

What is the most common fungal infection of the oral cavity?

Answer 8

Candida

Question 9

What immunocompromised states can be happening with a candida infection?

Answer 9

HIV/AIDS
Cancer
Organ or bone marrow transplants

Question 10

What is Torus Palatinus?

Answer 10

a growth on the ROOF OF THE MOUTH that is associated with smokers…. not cancer don’t worry

Question 11

What is hutchinson’s teeth and what underlying agent causes that?

Answer 11

congenital syphilis case with goofy looking teeth

Question 12

What are people with down syndrome at risk for?

Answer 12

leukemia which means a risk for periodontis

Question 13

Which inflammatory oral lesion is familial?

Answer 13

apthous ulcer

Question 14

which gingival lesion comes up rapidly and might make us think of malignancy?

Answer 14

pyogenic granuloma… pregnancy tumor

-remember that those fibrous proliferative lesions are all BENIGN!

Question 15

if there’s oral HSV, which one will it be?

Answer 15

HSV1 probably

Question 16

If you see Tzanck test, what are we looking for?

Answer 16

Herpes!!!!!

• not specific for 1 or 2
• multinucleation
• the owl eye thing is CMV

Question 17

Describe Candida

Answer 17

it’s white
YOU CAN SCRAPE IT OFF!
-they’re usually immunosuppressed

Question 18

Which deep fungal infections do we need to look out for?

Answer 18

Aspergillosis
cryptococcosis
zygomycosis (DM and mucormycosis)

Question 19

Organism associated with scarlet fever

Answer 19

group a B hemolytic strep.. strawberry tongue

Question 20

Measles?

Answer 20

three C’s

koplik spots

Question 21

Diptheria?

Answer 21

dirty white inflammatory membrane over the tonsils

Question 22

Phenytoin ingestion (Dilantin)

Answer 22

striking fibrous enlargement of the gingiva

Question 23

Hairy leukoplakia

Answer 23

CANNOT BE SCRAPED OFF

• EBV related…
• associated with nasopharyngeal carcinoma apparently
• 25% precancerous

Question 24

erythroplakia

Answer 24

red, velvety, eroded lesions
-anywhere in oral cavity
-less common but more ominus
almost always severe dysplasia

Question 25

95% of head and neck cancers are ....

Answer 25

Squamous cell carcinomas

Question 26

Most common factor of precancerous lesions is....

Answer 26

Tobacco | new player is HPV

Question 27

What issue do we have with HPV...

Answer 27

p16 overexpression.. | -tumor suppressor ptn

Question 28

where will you find SCC?

Answer 28

moreso on the bottom of mouth

Question 29

Is there a preceding /precancerous lesion with HPV?

Answer 29

NO | -it can just kinda pop up

Question 30

where do HPV tumors originate?

Answer 30

tonsillar cypts, base of tongue, oropharynx | -so, they're hard to diagnose..

Question 31

Which tumors have better outcome, HPV+ or HPV-?

Answer 31

HPV+ for sure! | -even with lymph node metastasis

Question 32

Which tumor is associated with aggressive behavior and Ghorlin syndrome?

Answer 32

ODONTOGENIC cysts and tumors | -OKC's

Question 33

What are the major players of the Salivary Gland?

Answer 33

Xerostomia Sialadenitis Neoplasms

Question 34

What are causes of dry mouth in patients?

Answer 34

DRUGS!!! | -Or sjogren and stuff

Question 35

Sialadenitis.... where does it come from?

Answer 35

mumps! it's apparently unilateral

Question 36

what is the most common tumor in the salivary gland?

Answer 36

pleomorphic adenoma | -it's benign

Question 37

How does pleomorphic adenoma present

Answer 37

well demarcated masses of varying size - usually from radiation - small mass at angle of jaw - recurs a lot

Question 38

What is a Warthin tumor?

Answer 38

the other benign tumor of the parotid gland only | -8x more common in smokers

Question 39

What cellular organelle is most common in oncocytic things

Answer 39

mitochondria

Question 40

Mucoepidermoid carcinoma

Answer 40

most common primary malignancy | -balanced chromosomal translocation 11-19

Question 41

Which tumor is the only one that presents with pain?

Answer 41

the adenoid cystic carcinoma | -grows along nerves so pain is common