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Oral Path 2 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

White patch that CANNOT be scraped off and cannot be diagnosed as any other condition:

A

Leukoplakia

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2
Q

What is just a clinical term that needs biopsy if persistent

A

Leukoplakia

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3
Q

Is leukoplakia premalignant?

A

YES!

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4
Q

Does cheek chewing cause leukoplakia?

A

NO! leukoplakia is only if it’s NOT diagnosed as something else

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5
Q

If cheek is white and you stretch it and it disappears, it is:

A

Leukoedema

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6
Q

Is smokeless tobacco kertosis premalignant?

A

NO!

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7
Q

Does candidiasis rub off?
Lichen planus?
Which one is bilateral?

A

Yes

  • No
  • Lichen
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8
Q

Leukoplakia is prevalent in:

  • Caused by:
  • Most affected site:
A

Older males >40

  • Cigarettes and UV exposure
  • Gingiva
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9
Q

Highest risk sites for dysplasia from leukoplakia

A

Tongue, floor of mouth, lip vermillion

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10
Q

Sharply demarcated (well defined) white plaque (hyperkeratosis) with variable surface

A

Leukoplakia

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11
Q

Which leukoplakia is worse, homogenous or heterogenous?

A

Heterogenous has higher risk

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12
Q

What is leukoplakia with red in it?

A

Erythroleukoplakia (speckled leukoplakia)

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13
Q

Which is more serious…leukoplakia or erythroplakia?

-Which is more common?

A

Erythroplakia is worse

-Leukoplakia is more common

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14
Q

Velvety red, well defined pathc usually on latral tongue, floor of mouth, or soft palate

A

Erythroplakia

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15
Q

Microscopically, 90% of these lesions are severe epithelial dysplasia or worse at time of biopsy

A

Erythroplakia

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16
Q

In erythroplakia, the red appearance is due to:

A

lack of keratin production on the surface of the lesion

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17
Q

What is a premalignant sun-induced skin lesion caused by chronic UV exposure?

A

Actinic (solar) Keratosis

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18
Q

Is Actinic Keratosis more common in upper or lower lip?

A

Lower

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19
Q

What is a scaly plaque with reddish base and sandpaper texture?

A

Actinic (solar) keratosis

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20
Q

What color is Actinic Keratosis

A

Red and White

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21
Q

Actinic Keratosis gives rise to:

A

Squamous Cell Carcinoma (SCC)

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22
Q

Actinic Keratosis treatment

A

Topical liquid nitrogen, surgical excision, laser ablation, 5-FU, or imiquimod (aldara)

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23
Q

What is the term for Actinic Keratosis of the lower lip?

A

Actinic Cheilosis (cheilitis)

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24
Q

Actinic Cheilosis treatment

A

Vermilionectomy or laser ablation. 5-FU and imiquimod in select cases

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25
Q

What is the most common skin cancer?

-How many cases diagnosed per year?

A

Basal Cell Carcinoma

-3 mil cases diagnosed per year

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26
Q

What usually develops in middle third of face?

A

Basal Cell Carcinoma

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27
Q

Nodulo-ulcerative (large lobules of tumor cells are characterisitic) type is the most common clinical presentation of:

A

Basal Cell Carcinoma

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28
Q

Umbilicated pearly papule that may show central ulceration describes:

A

Basal Cell Carcinoma

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29
Q

Why are Basal Cells pigmented?

A

Activation of benign melanocytes

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30
Q

What is the most aggressive (least common) form of Basal Cell

A

Sclerosing (morpheaform)

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31
Q

What resembles a scar due to induction of collagen formation by tumor cells?

A

Sclerosing form of Basal Cell

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32
Q

Is it easy to assess borders clinically of Sclerosing form of Basal Cell?

A

NO! because of infiltrative growth pattern

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33
Q

Tx of basal cell

A

Scalpel excision, electrocautery and curettage, cryotherapy, Topical agents (5-FU, imiquimod), Mohs micrographic surgery

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34
Q

Basal cell has a ____ prognosis with __% of patients cured after first treatment

A

Great

95%

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35
Q

Which Basal cells warrant Mohs Surgery

A

Larger lesions, reccurent lesions, tumors in areas of embryonic fusion

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36
Q

Most common ORAL malignancy

A

Squamous Cell Carcinoma

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37
Q

Squamous Cell a lot of times arises from:

A

Actinic Keratosis

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38
Q

Common sites for Squamous Cell Carcinoma

A

Face, helix of ear, dorsum of hands, and arms

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39
Q

Squamous Cell Carcinoma tx:

A

Surgical excision

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40
Q

How fast does actinically-induced SCC grow?

Are they differentiated?

A

Slow

Well-differentiated

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41
Q

SCC prognosis

A

Good if lesion is identified early in course

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42
Q

Oral SCC is usually associated with

A

cigarette smoking

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43
Q

When oral SCC is seen in younger (

A

Tongue

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44
Q

Oral Squamous Cell Carcinoma appearance:

A

Irregular shape, mixture of red and white

  • Often ulcerated
  • Exophytic (growing out) or endophytic (growing in) growth pattern
  • Often much FIRMER than surrounding tissues
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45
Q

Symptoms of oral SCC

A

Early=Asymptomatic. Pain is late feature

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46
Q

Ragged radiolucency (“moth eaten”) is characteristic of _____ that involves underlying bone

A

SCC

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47
Q

What site is uncommon for oral SCC but is more common in WOMEN

A

Gingiva/Alveolar mucosa

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48
Q

Most SCC’s affecting the palate arise on the:

A

lateral soft palate

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49
Q

Oral SCC tx:

A

Wide surgical excision and/or radiation therapy

50
Q

Oral SCC prognosis:

Where can it spread to?

A 
Very Poor (60% survival) cuz most patients present in stage III or IV
-Regional lymph nodes
51
Q

Around 25% of ____ patients will develop new upper _____ malignancies

A

SCC

Aerodigestive tract malignancies

52
Q

What is the less aggressive and uncommon form of SCC

A

Verrucous Carcinoma

53
Q

Most common areas of Verrucous Carcinoma

A

Alveolar mucosa, buccal mucosa, and hard palate

54
Q

What lesion is diffues mix of red and white plaque that grows laterally

A

Verrucous Carcinoma

55
Q

What therapy should NOT be used on Verrucous Carcinoma

A

Radiation cuz it transform into more aggressive SCC

56
Q

Approximately __% of verrucous carcinomas, upon complete excision, show transformation to SCC

A

25%

57
Q

Most common location of Mucocele? __%?

A

Lower lip (75%)

58
Q

What is a non-tender, soft swelling, translucent to bluish lesion?

A

Mucocele

59
Q

Most common location of Sialolithiasis

A

Submandibular gland

60
Q

When do symptoms show from Sialolithiasis?

A

DURING meals

61
Q

What is Acute Sialadentitis?

-It is a _____ infection (associated with ____ , may follow _____)

A

Bacterial, often penicillinase producing staph

-Retrograde infection…xerostomia…general anesthesia)

62
Q

UNILATERAL swelling, PAINFUL and tender, PURULENT exudate expressed from parotid papilla describes:

A

Acute Sialadenitis

63
Q

Chronic Sialadenitis is often associated with:

A

Sialothiasis

64
Q

What shows “sausage link” appearance of ductal system?

A

Chronic Sialadenitis

65
Q

Tx for Chronic Sialadenitis

A

Tetracycline

66
Q

Xerostomia is usually associated with

A

Glandular hypofunction

67
Q

Types of medications that cause xerostomia

A

Antihistamines, antidepressants, sedatives/anxiolytics, hypertensive agents

68
Q

What are Sialogogues

A

Substance that increases salivary flow (like lemon drops)

69
Q

Benign Lymphoepithelial Lesion (BLEL) alone may represent an isolated form of _____ or it may be associated with it

A

Sjogren’s Syndrome

70
Q

Recent data suggests that a portion of the infiltrate from Benign Lymphoepithelial Lesion (BLEL) is monoclonal perhanps representing a low grade ____ in situ

A

Lymphoma

71
Q

Benign Lymphoepithelial Lesion (BLEL) is more predominant in:

A

females

72
Q

Benign Lymphoepithelial Lesion (BLEL) presents as:

A

unilateral or bilateral, firm, non-tender swelling of the parotid area

73
Q

On the sialography, what shows a “blossoms on a tree” pattern of punctate sialectasis

A

Benign Lymphoepithelial Lesion (BLEL)

74
Q

What causes destruction of the normal parotid parenchyma with replacement by a diffuse lymphocytic infiltrate?

A

Benign Lymphoepithelial Lesion (BLEL)

75
Q

In Benign Lymphoepithelial Lesion (BLEL) you must identify ____which probably represent residual duct structures

A

Epimyoepithelial Islands (which can be seen in lymphoma too)

76
Q

Benign Lymphoepithelial Lesion (BLEL) tx:

A

Varies from doing nothing to low-dose radiation or corticosteroid therapy

77
Q

BLEL prognosis

A

Good

78
Q

Sjogren’s Syndrome may be thought of as a continuation of:

A

BLEL

79
Q

Difference of Primary and Secondary Sjogren’s Sydnrome

A

Secondary includes an autoimmune disorder

80
Q

Sjogren’s syndrome has a marked _____ predilection with a __:__ ratio

A

Female 8:1

81
Q

What is the Schirmer test?

A

Strip to measure tears (lacrimal function)

82
Q

How many minor salivary glands need to be removed in Labial Salivary Gland Biopsy?

A

5

83
Q

Histology of Sjogren’s Syndrome:

-What does it differ from?

A

Lymphocytic Sialaenitis withOUT fibrosis

-Differs from non-specific chronic sclerosing sialadenitis

84
Q

Pts with Sjogren’s Syndrome tend to have elevated _____ rate, elevated levels of ___ and _____

A

Sedimedntation
ANA
Hypergammaglobulinemia

85
Q

Pts with Sjogren’s Sydrome have a __-__x increase in ______

A

20-44 TIMES

Lymphoma

86
Q

What general age group is Necrotizing Sialometaplasia more common in?

A

Adults

87
Q

Most common location of Necrotizing Sialometaplasia

A

Posterior hard palate/anterior soft palate

88
Q

How long after swelling does the piece of palate fall out from Necrotizing Sialometaplasia?
-How long does it take to heal once it falls out?

A

2 weeks

-4-6weeks

89
Q

Necrotizing Sialometaplasia is easily mistaken for _______ or _____
-How can you easily tell that Necrotizing Sialometaplasia isn’t cancer?

A

Mucoepidermoid Carcinoma or Squamous Cell Carcinoma

-It has sharp borders unlike cancer

90
Q

Necrotizing Sialometaplasia shows ________ with squamous metaplasia of the ______ epithelium

A

PEH (PseudoEpitheliomatous Hyperplasia)

-Ductal

91
Q

Dermatologic term for freckles

A

Ephildes

92
Q

What are Actinic Lenigines?

-Diff from freckles bc:

A

Sun spots on hands (age/liver spots)

-These don’t wax and wane with sun

93
Q

What is a common, harmless tan lesion on the lip or intraorally that has NO change with sun exposure

A

Melanotic Macule

94
Q

Tx for an intraoral Malanotic Macule

A

Excision to rule out early melanoma

95
Q

What has an average of 20/person in caucasians?

A

Acquired Melanocytic Nevus

96
Q

_____ nevi are the first stage of Acquired Melanocytic Nevus. They appear ___ and are usually ____ in color

A

Junctional

-Flat, dark

97
Q

A _____ nevus may evolve into a ____ nevus as patient gets older

A

Junctional –> Compound

98
Q

With time, nevus cells may proliferate to the extent that they are completely contained within the _________

A

Dermal Connective Tissue (hence “Intradermal Nevus”)

99
Q

Chance of nevus transformation into melanoma is:

A

1 in a million

100
Q

Congenital Melanocytic Nevus is present in __% of newborns

A

1%

101
Q

For Congential Maloncytic Nevus risk of malignant transformation is __% for small and __% for large

A

1% for small

15% for large

102
Q

Blue Nevus appears blue due to:

A

Depth of the melanin pigment (Tyndall effect)

103
Q

Blue Nevus usually appears in what decade of life?

A

Fourth (30’s)

104
Q

Blue Nevus microscopically shows a collection of _______ within the connective tissue

A

Dendritic Melanocytes

105
Q

If you had blistering sunburn early in life, you have increased risk of:

A

Melanoma

106
Q

Melanoma has a diameter greater than __mm

A

6mm

107
Q

What is Melanoma in a purely radial growth phase called?

A

Lentigo Maligna

108
Q

Large macular lesion with IRREGULAR borders and UNEVEN pigmentation on FACIAL skin affecting an older person with fair complexion =

A

Lentigo Maligna

109
Q

__% of melanomas arise in Lentigo Maligna

A

5

110
Q

__% of melanomas are Superficial Spreading Melanoma

A

70%

111
Q

Superficial Spreading Melanomas are usually found in ______ are of men, and ____of women.
-__% of Superficial Spreading are found in the head and neck region

A

Interscapular area of men
Legs of women
-20%

112
Q

__% of melanomas are Nodular Melanoma.

  • They appear as:
  • __% appear in the head and neck region
A

15%

  • Rapidly growing nodule
  • 33% (1/3)
113
Q

Nodular Melanoma may be ___ (don’t produce melanin and resemble pyogenic granuloma)

A

Ameloanotic

114
Q

__% of melanomas are:

A

Acral Lentiginous Melanoma

115
Q

Which melanoma affects palms, soles, and oral mucosa/

A

Acral Lentiginous Melanoma

116
Q

What is the most common clinical type of melanoma in persons of color?

A

Acral Lentiginous Melanoma

117
Q

Melanoma prognosis depends on:

A

Depth of invasion

118
Q

__% of Basal Cell Carcinoma arise in head and neck

A

80%

119
Q

Oral Squamous Cell Carcinoma is associated with cigarette smoking __% of the time

A

80%

120
Q

Leukoplakia perecentages..

  • __% of non-dysplastic lesions will transform if not treated
  • __% of dysplastic lesions will transform
  • __% of leukoplakis will recur
A

15
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30

Oral Path 2 (7 decks)

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