Fellowship MC

Question 1

Metastases to the jaws bypassing filtration through the lungs occurs via the ?

Answer 1

Batson plexus

Question 2

Following chemotherapy for leukemia a patient has a recurrence. What region of the body may still harbor neoplastic cells for recurrence and why?

Answer 2

Recurrence may spread from the brain because the blood brain barrier is not crossed by traditional chemotherapy agents

Question 3

Metastatic disease to the jaw is typically via ______ spread

Answer 3

hematogenous

Question 4

Location (s) of cleft in paraneoplastic pemphigus

Answer 4

subepithelial or intraepithelial

Question 5

Location (s) of cleft in mucous membrane pemphigoid

Answer 5

subepithelial

Question 6

Antibodies against ? are implicated in paraneoplastic pemphigus

Answer 6

plakin family of desmosomal components including periplakin and envoplakin (also sometimes desmoglein 1 &3)

Question 7

What internal malignancy(ies) are most commonly associated with paraneoplastic pemphigus?

Answer 7

CLL, lymphoma

Question 8

What is bronchiolitis obliterans

Answer 8

sloughing occuring in the bronchioles that can obstruct the airway, listed as a clinical feature of paraneoplastic pemphigus

Question 9

Location (s) of cleft in angina bullosa hemorrhagica

Answer 9

subepithelial

Question 10

Location (s) of cleft in epidermolysis bullosa acquisita

Answer 10

subepithelial

Question 11

INheritance pattern of epidermolysis bullosa acquisita and autoantibodies implicated

Answer 11

Not inherited! (occurs in older adults)

autoantibodies to collagen type VII

Question 12

Differentiate the DIF of MMP and epidermolysis bullosa acquisita

Answer 12

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

Question 13

Location (s) of cleft in fogo selvage

Answer 13

fogo selvage aka endemic pemphigus foliaceus

intraepithelial clefting (IgG/C3)

Question 14

Common feature of acanthosis nigricans and Leser-Trelat sign

Answer 14

Gastrointestinal malignancy

Question 15

Inheritance pattern of hereditary mucoepithelial dyspasia

Answer 15

autosomal dominant or sporadic

Question 16

Inheritance pattern for incontinentia pigmenti

Answer 16

X-linked dominant so female predominant disease

Question 17

Location (s) of cleft in warty dyskeratoma

Answer 17

suprabasilar cleft

Question 18

what is Papyraceous healing and what population does it occur in?

Answer 18

“crumpled cigarette paper” look to the skin after it heals in Ehlers Danlos, occurs with minor injury

Question 19

Conditions with premature loss of teeth

Answer 19

Sarcoidosis
hypophosphatasia
papillon-lefevre syndrome
Ehlers Danlos
Haim-Munk
Dentin dysplasia type 1
Swift-feer disease (Acrodynia)

Question 20

Amianthoid fibers are characteristic of

Answer 20

myofibroblastoma aka intranodal hemorrhagic spindle cell tumor with amianthoid fibers

Question 21

“tissue culture-like” and “feathery” growth describe

Answer 21

nodular fasciitis

Question 22

pattern-less round to spindle proliferation describes

Answer 22

solitary fibrous tumor

Question 23

Short intersecting fascicles aka storiform pattern describes

Answer 23

fibrous histiocytoma

Question 24

Nodular or multinodular (lobular) fibroblastic proliferation decribes

Answer 24

myofibroma

Question 25

What molecular test can be used to distinguish lipoblastoma from liposarcoma

Answer 25

lipoblastoma (occurs in infants) = recurrent rearrangement that includes PLAG1

Question 26

Cells of origin for CEOT

Answer 26

stratum intermedium aka rests of the dental lamina

Question 27

Entities that can originate from the rests of the dental lamina

Answer 27

``` gingival cyst of the newborn gingival cyst of the adult LPC Ameloblastoma (other things it can originate from too) AOT CEOT SOT OKC ```

Question 28

entities that can originate from the rests of Malassez

Answer 28

SOT | Periapical cyst/radicular

Question 29

The rests of malassez are derived from

Answer 29

hertwigs epithelial root sheath

Question 30

Infectious process resulting in a subcutaneous vascular proliferation recognized in patients with AIDS is termed? causative organism?

Answer 30

Bacillary angiomatosis | Bartonella henselae

Question 31

Most common cause of chronic regional LAD in children

Answer 31

Cat scratch disease

Question 32

Features of unicystic ameloblastoma

Answer 32

younger age group 90% in mandible, usually posterior Classified with vickers gorlin criteria treated with enucleation with only 10-20% recurrence

Question 33

EBV related malignancies

Answer 33

extranodal NK/T cell lymphoma, sinonasal type Some nasopharyngeal carcinomas Hodgkin lymphoma (significant # of cases) Burkitt lymphoma lymphomatoid granulomatosis salivary lymphoepithelial carcinoma Plasmablastic lymphoma

Question 34

Increased levels of serum alpha-fetoprotein are seen in?

Answer 34

hepatocellular carcinoma, ovarian cancer, germ cell tumor of the testes

Question 35

Hypertension, gross hematuria, fever, and Abdominal pain in a child may be indicative of?

Answer 35

Wilm's tumor: most common kidney cancer in children

Question 36

What syndromes have Wilm's tumor as a component

Answer 36

Beckwith weidemann Hemifacial hyperplasia Hyperparathyroidism jaw tumor syndrome

Question 37

Angiomyolipoma and cardiac rhabdomyoma are less common features of what condition? -What are the major features of this condition?

Answer 37

Tuberous sclerosis -Major: ash leaf spots, shagreen patches, facial angiofibromas, gingival fibromas, ungual and periungal fibromas, hamartomas of the CNS --> intellectual disability, seizures

Question 38

Primitive mesenchymal cells, cartilage, muscle, necrosis and foci of neuroepithelial differentiation describes

Answer 38

immature teratoma

Question 39

Most common malignant ovarian germ cell tumor Female counterpart to testicular seminoma Most common in children and young women describes?

Answer 39

Dysgerminoma

Question 40

Biphasic, malignant tumor with high grade epithelial and sarcomatous components arising in the uterus describes what entity?

Answer 40

Malignant mixed mullerian tumor aka carcinosarcoma

Question 41

Most commonly used diagnostic test for systemic sclerosis

Answer 41

anticentromere antibodies | anti-Scl70

Question 42

Antibodies against periplakin and envoplakin | outside of neville: also desmoglein 3, epiplakin, BP230

Answer 42

Paraneoplastic pemphigus

Question 43

DIF continuous band of IgG and C3 localized to the basement membrane zone

Answer 43

Mucosal membrane pemphigoid

Question 44

DIF linear deposition of only IgA along the | basement membrane zone

Answer 44

IgA bullous dermatosis

Question 45

Most common CNS tumor

Answer 45

Glioma (includes astrocytoma, ependymoma, glioblastoma, oligodendroglioma and various subtypes / combinations)

Question 46

Most specific marker for wegner's granulomatosis

Answer 46

c-ANCA (antineutrophil cytoplasm antibodies) aka PR3-ANCA | -less specific p-ANCA

Question 47

serum antinuclear antibodies are a non-specific marker that can be seen in what conditions

Answer 47

Lupus, chronic ulcerative stomatitis, sjogren syndrome, lupus like drug reactions

Question 48

Drugs for Crohns

Answer 48

mesalamine (5-aminosalicylic acid) or sulfasalazine

Question 49

What autoantibodies are implicated in chronic ulcerative stomatitis

Answer 49

autoantibodies against 70-kD nuclear protein (ΔNp63α,) an isoform of p63

Question 50

Commissural lip pits are associated with?

Answer 50

high incidence of preauricular pits

Question 51

A layer of balloon cells just beneath the keratin layer in a biopsy is characteristic of?

Answer 51

Oral hairy leukoplakia

Question 52

Hypochromic microcytic anemia is a finding of

Answer 52

Iron deficiency anemia | also plummer vinson which is just syndrome with iron def anemia

Question 53

inability of the stomach to form intrinsic factor describes what disease

Answer 53

Pernicious anemia

Question 54

Megaloblastic/Macrocytic anemia occurs in what conditions

Answer 54

Pernicious anemia VitB12 def Folate deficiency

Question 55

Malignant epithelial cells have an increased number and wider distribution of what receptor?

Answer 55

Laminin

Question 56

biphasic cell population represented by peripheral large, polygonal, clear cells and central cuboidal darkly staining cells with eosinophilic cytoplasm describes?

Answer 56

epithelial myoepithelial carcinoma

Question 57

Oral bisphosphonates

Answer 57

Fosamax (alendronate) Actonel (risedronate) Boniva (ibandronate)

Question 58

IV bisphosphonates

Answer 58

Zometa (zolendronate) | Aredia (pamidronate)

Question 59

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?

Answer 59

- recurrent spontaneous epistaxis - AV malformations of lungs, liver, CNS - Rupture of vascular lesions in the GI frequently causes iron deficiency anemia

Question 60

DDX large verrucous lesion of the buccal mucosa present for 6 months

Answer 60

Verrucous carcinoma SCC PVL Verruca vulgaris

Question 61

Serologic tests for mono

Answer 61

- Paul-Bunnell test OR rapid slide agglutination (Monospot) assay. Both look for heterophile antibodies - indirect immunofluorescence for viral capsid antigens and EBV nuclear antigens

Question 62

tender, inflamed, hemorrhagic gingiva with little response to oral hygiene for 2 month duration DDX (4)

Answer 62

Leukemic infiltrate Wegners granulomatosis scurvy plasma cell gingivitis