Fellowship MC Flashcards
Metastases to the jaws bypassing filtration through the lungs occurs via the ?
Batson plexus
Following chemotherapy for leukemia a patient has a recurrence. What region of the body may still harbor neoplastic cells for recurrence and why?
Recurrence may spread from the brain because the blood brain barrier is not crossed by traditional chemotherapy agents
Metastatic disease to the jaw is typically via ______ spread
hematogenous
Location (s) of cleft in paraneoplastic pemphigus
subepithelial or intraepithelial
Location (s) of cleft in mucous membrane pemphigoid
subepithelial
Antibodies against ? are implicated in paraneoplastic pemphigus
plakin family of desmosomal components including periplakin and envoplakin (also sometimes desmoglein 1 &3)
What internal malignancy(ies) are most commonly associated with paraneoplastic pemphigus?
CLL, lymphoma
What is bronchiolitis obliterans
sloughing occuring in the bronchioles that can obstruct the airway, listed as a clinical feature of paraneoplastic pemphigus
Location (s) of cleft in angina bullosa hemorrhagica
subepithelial
Location (s) of cleft in epidermolysis bullosa acquisita
subepithelial
INheritance pattern of epidermolysis bullosa acquisita and autoantibodies implicated
Not inherited! (occurs in older adults)
autoantibodies to collagen type VII
Differentiate the DIF of MMP and epidermolysis bullosa acquisita
MMP: IgG C3 on the “roof” of the bullous lesion aka on the epithelial side
EBA: IgG deposits on the CT side of the bulla where the type VII collagen is
Location (s) of cleft in fogo selvage
fogo selvage aka endemic pemphigus foliaceus
intraepithelial clefting (IgG/C3)
Common feature of acanthosis nigricans and Leser-Trelat sign
Gastrointestinal malignancy
Inheritance pattern of hereditary mucoepithelial dyspasia
autosomal dominant or sporadic
Inheritance pattern for incontinentia pigmenti
X-linked dominant so female predominant disease
Location (s) of cleft in warty dyskeratoma
suprabasilar cleft
what is Papyraceous healing and what population does it occur in?
“crumpled cigarette paper” look to the skin after it heals in Ehlers Danlos, occurs with minor injury
Conditions with premature loss of teeth
Sarcoidosis hypophosphatasia papillon-lefevre syndrome Ehlers Danlos Haim-Munk Dentin dysplasia type 1 Swift-feer disease (Acrodynia)
Amianthoid fibers are characteristic of
myofibroblastoma aka intranodal hemorrhagic spindle cell tumor with amianthoid fibers
“tissue culture-like” and “feathery” growth describe
nodular fasciitis
pattern-less round to spindle proliferation describes
solitary fibrous tumor
Short intersecting fascicles aka storiform pattern describes
fibrous histiocytoma
Nodular or multinodular (lobular) fibroblastic proliferation decribes
myofibroma
What molecular test can be used to distinguish lipoblastoma from liposarcoma
lipoblastoma (occurs in infants) = recurrent rearrangement that includes PLAG1
Cells of origin for CEOT
stratum intermedium aka rests of the dental lamina
Entities that can originate from the rests of the dental lamina
gingival cyst of the newborn gingival cyst of the adult LPC Ameloblastoma (other things it can originate from too) AOT CEOT SOT OKC
entities that can originate from the rests of Malassez
SOT
Periapical cyst/radicular
The rests of malassez are derived from
hertwigs epithelial root sheath
Infectious process resulting in a subcutaneous vascular proliferation recognized in patients with AIDS is termed? causative organism?
Bacillary angiomatosis
Bartonella henselae
Most common cause of chronic regional LAD in children
Cat scratch disease
Features of unicystic ameloblastoma
younger age group
90% in mandible, usually posterior
Classified with vickers gorlin criteria
treated with enucleation with only 10-20% recurrence
EBV related malignancies
extranodal NK/T cell lymphoma, sinonasal type
Some nasopharyngeal carcinomas
Hodgkin lymphoma (significant # of cases)
Burkitt lymphoma
lymphomatoid granulomatosis
salivary lymphoepithelial carcinoma
Plasmablastic lymphoma
Increased levels of serum alpha-fetoprotein are seen in?
hepatocellular carcinoma, ovarian cancer, germ cell tumor of the testes
Hypertension, gross hematuria, fever, and Abdominal pain in a child may be indicative of?
Wilm’s tumor: most common kidney cancer in children
What syndromes have Wilm’s tumor as a component
Beckwith weidemann
Hemifacial hyperplasia
Hyperparathyroidism jaw tumor syndrome
Angiomyolipoma and cardiac rhabdomyoma are less common features of what condition?
-What are the major features of this condition?
Tuberous sclerosis
-Major: ash leaf spots, shagreen patches, facial angiofibromas, gingival fibromas, ungual and periungal fibromas, hamartomas of the CNS –> intellectual disability, seizures
Primitive mesenchymal cells, cartilage, muscle, necrosis and foci of neuroepithelial differentiation describes
immature teratoma
Most common malignant ovarian germ cell tumor
Female counterpart to testicular seminoma
Most common in children and young women
describes?
Dysgerminoma
Biphasic, malignant tumor with high grade epithelial and sarcomatous components arising in the uterus describes what entity?
Malignant mixed mullerian tumor aka carcinosarcoma
Most commonly used diagnostic test for systemic sclerosis
anticentromere antibodies
anti-Scl70
Antibodies against periplakin and envoplakin
outside of neville: also desmoglein 3, epiplakin, BP230
Paraneoplastic pemphigus
DIF continuous band of IgG and C3 localized to the basement membrane zone
Mucosal membrane pemphigoid
DIF linear deposition of only IgA along the
basement membrane zone
IgA bullous dermatosis
Most common CNS tumor
Glioma (includes astrocytoma, ependymoma, glioblastoma, oligodendroglioma and various subtypes / combinations)
Most specific marker for wegner’s granulomatosis
c-ANCA (antineutrophil cytoplasm antibodies) aka PR3-ANCA
-less specific p-ANCA
serum antinuclear antibodies are a non-specific marker that can be seen in what conditions
Lupus, chronic ulcerative stomatitis, sjogren syndrome, lupus like drug reactions
Drugs for Crohns
mesalamine (5-aminosalicylic acid) or sulfasalazine
What autoantibodies are implicated in chronic ulcerative stomatitis
autoantibodies against 70-kD nuclear protein (ΔNp63α,) an isoform of p63
Commissural lip pits are associated with?
high incidence of preauricular pits
A layer of balloon cells just beneath the keratin layer in a biopsy is characteristic of?
Oral hairy leukoplakia
Hypochromic microcytic anemia is a finding of
Iron deficiency anemia
also plummer vinson which is just syndrome with iron def anemia
inability of the stomach to form intrinsic factor describes what disease
Pernicious anemia
Megaloblastic/Macrocytic anemia occurs in what conditions
Pernicious anemia
VitB12 def
Folate deficiency
Malignant epithelial cells have an increased number and wider distribution of what receptor?
Laminin
biphasic cell population represented by peripheral large, polygonal, clear cells and central cuboidal darkly staining cells with eosinophilic cytoplasm describes?
epithelial myoepithelial carcinoma
Oral bisphosphonates
Fosamax (alendronate)
Actonel (risedronate)
Boniva (ibandronate)
IV bisphosphonates
Zometa (zolendronate)
Aredia (pamidronate)
A patient presents with HHT, they have apparent telangiectasias of the oral cavity and facial skin. What other manifestations of this disease may affect your management?
- recurrent spontaneous epistaxis
- AV malformations of lungs, liver, CNS
- Rupture of vascular lesions in the GI frequently causes iron deficiency anemia
DDX large verrucous lesion of the buccal mucosa present for 6 months
Verrucous carcinoma
SCC
PVL
Verruca vulgaris
Serologic tests for mono
- Paul-Bunnell test OR rapid slide agglutination (Monospot) assay. Both look for heterophile antibodies
- indirect immunofluorescence for viral capsid antigens and EBV nuclear antigens
tender, inflamed, hemorrhagic gingiva with little response to oral hygiene for 2 month duration DDX (4)
Leukemic infiltrate
Wegners granulomatosis
scurvy
plasma cell gingivitis
