Exam 5-INFECTIVE stomatitis-VIRAL Flashcards
What are the 4 types of viral infections we discussed that can cause stomatitis?
1.HPV 2.HHV 3.Coxsackie A 4.ParaMYXOvirus
What are the 3 most common manifestations of Human Papilloma Virus? What is a 4th, less common manifestation?
1.Papilloma 2.Verruca Vulgaris 3.Condylomata acuminatum 4.Focal epithelial hyperplasia
What type of virus is HPV?
DNA yo
What are the 2 virus-es causing infective stomatitis that are DNA virus-es?
1.HPV 2.HHV
A papilloma is most likely the manifestation of which 2 types of HPV?
HPV 6 and 11
Which HPV manifestation is described as a virus-induced benign proliferation of stratified squamous epithelium?
Papilloma
What is the most common age range for manifestations of a Papilloma (HPV 6 and 11)?
30 to 50 years
What is the most common area in the oral cavity for a Papilloma? What are 2 other common sites?
1.Soft Palate 2.tongue 3.lips
A papilloma can be described as White/red/normal color “__________” shaped and ________ (because of the least amount of resistance for the hyperplasia to go to the surrounding air)
“cauliflower” ….. exophytic
What are the three forms of a papilloma?
Nodule, sessile, or pedunculated
Papillomas are typically small, but they can grow large…up to ___ cm
3cm
What is the most common HPV subtype that produces Verruca Vulgaris?
HPV 2 (2 V’s!)
Which form of HPV is known as “common wart”?
Verruca Vulgaris
What are the three most common oral locations for verucca vulgaris?
- Vermillion Border 2. Labial mucosa 3.Anterior tongue
Which HPV lesion can be described as Pink/white nodule with rough, pebbly surface and is usually less than 5 mm?
A common wart, verruca vulgaris
What is the name of enlarged cells with cytoplasmic clearing and which type of virus is it associated with?
KOIL-O-cytes…HPV 2 (verruca vulgaris)
Common warts can be histologically described as large ________ granules
kerato-hyaline granules
Well this can be confusing, which common manifestations is caused by HPV 6 and 11 (among others), but is NOT a papilloma? Who is affected by it the most?
Condyloma A-cumin-a-tum…teenagers and young adults
What are the three most common locations in the oral cavity for Condyloma Acuminatum?
- Labial Mucosa 2.Soft palate 3.lingual frenum
What is the most common mode of transmission for a condyloma acuminatum? How long does it take to incubate?
Sexual transmission and 1-3 months
What are the 4 MAIN (not all) HPV subtypes associated with Condyloma Acuminatum? Which 2 are associated with an increased risk of MALIGNANT transformation?
HPV 6,11,16,18….16 & 18 associated with malignant transformation
Condyloma acuminatum fften occur in _______ and not quite as exophytic and papillary as papillomas or vurruca
CLUSTERS
What is the nickname for focal epithelial hyperplasia?
Heck’s Disease
What is the official name for “Heck’s Disease”?
Focal Epithelial Hyperplasia
Hmmm which HPV condition am I describing??? Multiple soft, flattened papules clustered together…
Focal epithelial hyperplasia (Heck’s disease)
Which two HPV subtypes are responsible for FOCAL EPITHELIAL HYPERPLASIA (Heck’s Disease)?
HPV 13 and 32
Which HPV manifestation is most common in children often malnourished and in poor living conditions and was 1st described in Native Americans (IN NEW MEXICO) and Eskimos?
Focal Epithelial hyperplasia (Heck’s disease) (HPV 13 and 32)
What are the three most common locations for focal epithelial hyperplasia? What are the two types of cells HISTOLOGICALLY?
1.Labial 2.Buccal and 3.Lingual MUCOSA…K-OI-LO-cytes and MIT_OS_OID cells. (mitosioid-cells in which the nuclear DNA has fragmented, resulting in a cell that appears as if it is undergoing mitosis)
In general, HPV is identified by DNA ______ hybridization, immunohistochemical analysis, and PCR
in situ
What can sometimes spur spontaneous regression of an HPV outbreak? (like focal epithelial hyperplasia)
improving living conditions
What are the two most common culprits for HPV induced cervical and oropharyngeal cancer? ALSO what is the incidence of THROAT cancer today caused by HPV?
HPV 16 and 18…75%
Since its important, going beyond the major two HPV types that cause cancer, what are those two and the additional types (4) found to cause it?
16, 18, 6, 11, 30s, 50s.
Humans are natural reservoirs of which virus? Once you have it, it never goes away, just remains dormant and latent…
Human Herpes Virus
What are the 5 HHVirus-es that have oral manifestations?
1.Herpes Simplex 2.Veracella-Zoster 3.Epstein-Barr 4.CytoMegaloVirus 5.HHV-8 (kaposi’s sarcoma)
Which HSV virus usually causes ORAL infections?
HSV 1 (food goes in mouth first)
Which HSV usually causes GENITAL infections with about 20% crossover?
HSV-2 (food comes out body second)
More than ___% of PRIMARY HSV infections are ASYMPTOMATIC
90%
Which HSV related condition has a very ACUTE onset and is USUALLY in children 6mo-5y/o? (but can happen in adults like Dr. W’s story about the 37 y/o woman)…
Acute Herpetic GingivoStomatitis
Which HSV condition can be described with fever, lymphadenopathy, nausea, irritability Painful, erythematous gingiva and tiny (1–3 mm) coalescing vesicles progress to widespread, multiple sharply marinated ulcers
of oral mucosae and skin around mouth & lips?
Acute herpetic gingivoStomatitis
In adults Acute Herpetic GingivoStomatitis may present as _____________ and it heal SPONTANEOUSLY in HOW long?
pharyngotonsillitis…1-2 weeks