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Fellowship and boards study > Fellowship MC > Flashcards

Fellowship MC Flashcards

1
Q

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

A

Batson plexus

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2
Q

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

A

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

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3
Q

Metastatic disease to the jaw is typically via ______ spread

A

hematogenous

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4
Q

Location (s) of cleft in paraneoplastic pemphigus

A

subepithelial or intraepithelial

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5
Q

Location (s) of cleft in mucous membrane pemphigoid

A

subepithelial

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6
Q

Antibodies against ? are implicated in paraneoplastic pemphigus

A

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

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7
Q

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

A

CLL, lymphoma

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8
Q

What is bronchiolitis obliterans

A

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

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9
Q

Location (s) of cleft in angina bullosa hemorrhagica

A

subepithelial

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10
Q

Location (s) of cleft in epidermolysis bullosa acquisita

A

subepithelial

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11
Q

INheritance pattern of epidermolysis bullosa acquisita and autoantibodies implicated

A

Not inherited! (occurs in older adults)

autoantibodies to collagen type VII

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12
Q

Differentiate the DIF of MMP and epidermolysis bullosa acquisita

A

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

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13
Q

Location (s) of cleft in fogo selvage

A

fogo selvage aka endemic pemphigus foliaceus

intraepithelial clefting (IgG/C3)

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14
Q

Common feature of malignant acanthosis nigricans and Leser-Trelat sign

A

Gastrointestinal malignancy

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15
Q

Inheritance pattern of hereditary mucoepithelial dyspasia

A

autosomal dominant or sporadic

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16
Q

Inheritance pattern for incontinentia pigmenti

A

X-linked dominant so female predominant disease

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17
Q

Location (s) of cleft in warty dyskeratoma

A

suprabasilar cleft

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18
Q

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

A

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

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19
Q

Conditions with premature loss of teeth

A 
Sarcoidosis
hypophosphatasia
papillon-lefevre syndrome
Ehlers Danlos
Haim-Munk
Dentin dysplasia type 1
Swift-feer disease (Acrodynia)
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20
Q

Amianthoid fibers are characteristic of

A

Intranodal palisaded myofibroblastoma aka intranodal hemorrhagic spindle cell tumor with amianthoid fibers

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21
Q

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

A

nodular fasciitis

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22
Q

pattern-less round to spindle proliferation describes

A

solitary fibrous tumor

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23
Q

Short intersecting fascicles aka storiform pattern describes

A

fibrous histiocytoma

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24
Q

Nodular or multinodular (lobular) fibroblastic proliferation decribes

A

myofibroma

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25
Q

What molecular test can be used to distinguish lipoblastoma from liposarcoma

A

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

liposarc also CDK4+ MDM2+

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26
Q

Cells of origin for CEOT

A

stratum intermedium aka rests of the dental lamina

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27
Q

Entities that can originate from the rests of the dental lamina

A 
gingival cyst of the newborn
gingival cyst of the adult
LPC
Ameloblastoma (other things it can originate from too)
AOT
CEOT
SOT
OKC
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28
Q

entities that can originate from the rests of Malassez

A

SOT

Periapical cyst/radicular

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29
Q

The rests of malassez are derived from

A

hertwigs epithelial root sheath

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30
Q

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

A

Bacillary angiomatosis

Bartonella henselae

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31
Q

Most common cause of chronic regional LAD in children

A

Cat scratch disease

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32
Q

Features of unicystic ameloblastoma

A

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

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33
Q

EBV related malignancies

A

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

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34
Q

Increased levels of serum alpha-fetoprotein are seen in?

A

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

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35
Q

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

A

Wilm’s tumor: most common kidney cancer in children

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36
Q

What syndromes have Wilm’s tumor as a component

A

Beckwith weidemann
Hemifacial hyperplasia
Hyperparathyroidism jaw tumor syndrome

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37
Q

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

A

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

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38
Q

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

A

immature teratoma

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39
Q

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

A

Dysgerminoma

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40
Q

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

A

Malignant mixed mullerian tumor aka carcinosarcoma

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41
Q

Most commonly used diagnostic test for systemic sclerosis

A

Laboratory studies may be helpful to the diagnostic
process if anticentromere antibodies or anti-Scl 70 (topoisomerase
I) is detected. Anti-topoisomerase I antibodies are
seen more often with diffuse cutaneous systemic sclerosis
and development of pulmonary fibrosis; anticentromere
antibodies are usually associated with limited cutaneous
systemic sclerosis (including CREST syndrome

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42
Q

Antibodies against periplakin and envoplakin

outside of neville: also desmoglein 3, epiplakin, BP230

A

Paraneoplastic pemphigus

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43
Q

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

A

Mucous membrane pemphigoid

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44
Q

DIF linear deposition of only IgA along the

basement membrane zone

A

IgA bullous dermatosis

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45
Q

Most common CNS tumor

A

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

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46
Q

Most specific marker for wegner’s granulomatosis

A

c-ANCA (antineutrophil cytoplasm antibodies) aka PR3-ANCA

-less specific p-ANCA

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47
Q

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

A

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

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48
Q

Drugs for Crohns

A

mesalamine (5-aminosalicylic acid) or sulfasalazine

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49
Q

What autoantibodies are implicated in chronic ulcerative stomatitis

What tests are used for this diagnosis?

A

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

Direct immunofluorescence: IgG to the nuclei of the basal and parabasal region of the epithelium

Indirect immunofluorescence: stratified epithelium-specific antinuclear antibodies (SES-ANA)

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50
Q

Commissural lip pits are associated with?

A

high incidence of preauricular pits

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51
Q

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

A

Oral hairy leukoplakia

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52
Q

Hypochromic microcytic anemia is a finding of

A

Iron deficiency anemia

also plummer vinson which is just syndrome with iron def anemia

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53
Q

inability of the stomach to form intrinsic factor describes what disease

A

Pernicious anemia

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54
Q

Megaloblastic/Macrocytic anemia occurs in what conditions

A

Pernicious anemia
VitB12 def
Folate deficiency

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55
Q

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

A

Laminin

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56
Q

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

A

epithelial myoepithelial carcinoma

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57
Q

Oral bisphosphonates

A

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

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58
Q

IV bisphosphonates

A

Zometa (zolendronate)

Aredia (pamidronate)

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59
Q

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?

A
  • recurrent spontaneous epistaxis
  • AV malformations of lungs, liver, CNS
  • Rupture of vascular lesions in the GI frequently causes iron deficiency anemia
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60
Q

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

A

Verrucous carcinoma
SCC
PVL
Verruca vulgaris

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61
Q

Serologic tests for mono

A
  • Paul-Bunnell test OR rapid slide agglutination (Monospot) assay. Both look for heterophile antibodies
  • indirect immunofluorescence for viral capsid antigens and EBV nuclear antigens
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62
Q

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

A

Leukemic infiltrate
Wegners granulomatosis
scurvy
plasma cell gingivitis

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63
Q

Storiform pattern describes

A

Fibrous histiocytoma

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64
Q

Patients with what condition(s) have an increased propensity to develop aggressive form of fibromatosis

A

familial adenomatous polyposis, Gardner syndrome (a form of FAP)

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65
Q

Russell bodies can be found in what lesions?

What is another name for a russell body?

A

Russell body (aka a dutcher body): plasma cells with homogeneous immunoglobulin (Ig)-containing intranuclear inclusions usually found in cells undergoing excessive synthesis. Found in chronic infection and myeloma.

Bone marrow aspirates in myeloma
Periapical granulomas
Rosai Dorfman disease
Rhinoscleroma

Russell body is also called a Mott cell

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66
Q

Enameloid conglomerates occur in what entity?

What other histologic feature is common for this diagnosis?

A

Regional odontodysplasia

-Interglobular dentin

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67
Q

Hydroxychloroquine has been used in the treatment of what conditions?

A

Orofacial granulomatosis
Chronic ulcerative stomatitis
Lupus erythematosus

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68
Q

Coloboma affecting the eye is reported in what conditions?

A

NBCCS
Mandibulofacial dysostosis (treacher collins)
Otodental syndrome
(brief mention in regional odontodysplasia)

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69
Q

Michaelis Gutmann bodies are seen in

A

Malakoplakia

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70
Q

Syndromes associated with a lateral facial cleft

A
  • Treacher collins (mandibulofacial dysostosis)
  • Nager acrofacial dysostosis
  • Amniotic rupture sequence
  • Oculo-auriculo-vertebral spectrum (hemifacial microsomia)
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71
Q

Syndromes associated with a median cleft of the upper lip

A

oral-facial-digital syndromes

Ellis-van creveld syndrome

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72
Q

Libman-sacks endocarditis may be seen in patients with?

A

Systemic lupus erythematosus

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73
Q

What are the components of PHACES syndrome

A 
posterior fossa brain abnormality
hemangioma
arterial abnormalities
cardiac defects
Eye anomalies
sternal cleft
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74
Q

What is the dandy walker malformation?

A

the most common posterior fossa brain abnormality seen in PHACES syndrome

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75
Q

What syndrome characteristically has many types of dermal adnexal tumors including trichoepitheliomas

A

Brooke-spiegler syndrome

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76
Q

Development of a hoarse cry in infancy is characteristic of?

A

Lipoid proteinosis (Urbach-wiethe)

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77
Q

4 other clinical findings of sturge weber (aside from the port wine stain)

A 
Intellectual disability
Seizures
Leptomeningeal angiomas
Contralateral hemiplegia
Migraine headaches
stroke-like episodes
gyriform tramline calcifications
hyper or hypodontia
Ocular manifestations --> glaucoma
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78
Q

3 syndromes associated with taurodontism

A 
Down
ectodermal dysplasia
Klinefelters
Hypophosphastasia
tricho-dento-osseous syndrome
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79
Q

DDX for the clinical manifestations of paraneoplastic pemphigus

A

Erythema multiforme
Paraneoplastic pemphigus
Pemphigus vulgaris
Steven-Johnson syndrome

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80
Q

Signaling molecule of chemotaxis

A

C5a

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81
Q

Molecule involved in apoptosis

A

caspase

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82
Q

Biopsy of a posterior cervical lymph node shows
1) Reactive Follicular hyperplasia
2) clusters of proliferating epithelioid histiocytes, with a mixed lymphocytic and immunoblastic cell population
3) distension of marginal and cortical sinuses with epithelioid cells
DX?

A

Toxoplasmosis

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83
Q

What is the term for the toxoplasmosis organism you can rarely see on histology

A

tachyzoite

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84
Q

Widening of the periodontal ligament space DDX

A
  • Osteosarcoma
  • Metastatic carcinoma
  • Systemic sclerosis (present throughout the dentition)
  • HIV-associated NHL
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85
Q

A triangular elevation of the periosteum may be seen in _____, this finding is termed _____?

A

Osteosarcoma

Codman triangle

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86
Q

Hemorrhagic crusted lips and peri-oral tissues DDX

A

EM
Pemphigus
Paraneoplastic pemphigus
primary herpes

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87
Q

List the 3 criteria for diagnosis of Cowden syndrome

A
  1. Multiple facial trichilemommas
  2. Acral keratoses
  3. Multiple oral papules
    (2 of 3 for DX)
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88
Q

Aside from the major criteria for the diagnosis of Cowden name common other manifestations of the disease

A
  • Skin lesions: Cutaneous hemangiomas, neuromas, lipomas, xanthomas
  • thyroid disease
  • fibrocystic disease of the breast in women
  • breast cancer in up to 50% of women by 40
  • Benign hamartomatous polyps of the GI tract
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89
Q

Central ridges in the nails are termed ____ ____, and are characteristic of what disease process?

A

Beau lines

Mentioned in neville: Hand foot mouth disease

ALL conditions via outside sources: Conditions associated with Beau’s lines include uncontrolled diabetes and peripheral vascular disease, as well as illnesses associated with a high fever, such as scarlet fever, measles, mumps and pneumonia. Beau’s lines can also be a sign of zinc deficiency.

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90
Q

yellow/white pseudo membrane covering right tonsil DDX

A
  • Herpangina (acute lymphnodular pharyngitis)
  • Diphtheria
  • Strep tonsillitis
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91
Q

Entities that can cause saddle nose deformity

A
  • Congenital syphilis
  • Snorting cocaine
  • Wegner granulomatosis
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92
Q

Most common site of origin for nasopharyngeal carcinoma

A

lateral nasal wall

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93
Q

Which sinus is the most common site of origin for carcinoma of the paranasal sinuses

A

maxillary sinus

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94
Q

Typical population affected by Kimura disease

A

Young Asian males vs epithelioid hemangioma (females slightly older)

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95
Q

Two common tumors from the middle ear

A
  • Cholesteatoma

- Paraganglioma

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96
Q

Syndromes associated with paragangliomas

A

PGL1-4 (types 1&2 paternal inheritance) Associations: NF1, MEN 2, von Hippel-Lindau syndrome

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97
Q

Fontaine’s sign

A
  • carotid body tumors can be displaced laterally but not vertically
  • feel the carotid pulse move with the tumor
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98
Q

A dense lymphoplasmacytic infiltrate, Storiform fibrosis, and Obliterative phlebitis are the characteristic histologic features of what entity

A

IgG4 disease

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99
Q

Corps ronds and grains describe

A

dyskeratotic cells present in warty dyskeratomas and identical lesions of darier’s disease

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100
Q

Ochronosis occurs in what condition

A

Alkaptonuria
ochronosis: blue-black pigment that deposits in the skin/eyes as a result of not being able to process phenylalanine/tyrosine

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101
Q

Green pigmented teeth in a young child may be a result of what conditions at birth

A

Hyperbilirubinemia from: Erythroblastosis fetalis or

Biliary atresia

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102
Q

Testing to confirm behcets disease

A
  1. Biopsy with leukocytoclastic vasculitis

2. Positive pathergy test

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103
Q

All natural reservoirs for leprosy

A

Human
Chimp
Mangabey monkey
Armadillo

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104
Q

Fugal infection with 25:1 male to female predilection

A

paracoccidiomycosis

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105
Q

the rose bengal dye test is most helpful in the diagnosis of

A

sjogrens syndrome

dye is added to the eye and it is examined with a slit lamp

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106
Q

Elevated serum IgE, LAD, peripheral eosinophilia, vascular lesions are characteristic of

A

Kimura disease

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107
Q

the deposition of amorphous eosinophilic hyaline material around pathogenic organism seen in some fungal and parasitic diseases is a result of antigen-antibody rxn known as

A

Splendore–hoeppli phenomenon

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108
Q

Azzopardi effect

A

histomorphologic phenomenon of incrustation of blood vessel wall with basophilic nuclear material. It had been primarily described in small cell (neuroendocrine) carcinoma of lung

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109
Q

Jarisch-herxheimer reaction

A

a short-lived immunologic response to antimicrobial treatment of syphilis characterized by fever, onset of constitutional symptoms, and worsening of rash. It typically begins 2-8 hours after the initial dose of antibiotic is given and resolves spontaneously within 24 hours

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110
Q

What tumor originates from the dental lamina associated with the gubernacular cord

A

adenomatoid odontogenic tumor

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111
Q

Gorlin cyst is another name for

A

Calcifying odontogenic cyst

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112
Q

What is the other name for CEOT

A

Pindborg tumor

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113
Q

Frequently scalloped margins of a radiolucent cyst is associated with what entities

A

Simple bone cyst
Pindborg tumor
Myxoma

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114
Q

A triangular radiolucent defect is characteristic of

A

Squamous odontogenic tumor

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115
Q

35% of ameloblastic sarcomas occur in what scenario

A

recurrent ameloblastic fibroma (not fibro-odontoma)

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116
Q

S100 status for: Granular cell odontogenic tumor, granular cell tumor, and congenital granular cell lesion (congenital epulis)

A
  1. -
  2. +
  3. -
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117
Q

Soap bubble radiographic entities

A

Myxoma

Ameloblastoma

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118
Q

 Hypodactylia: absence of digits
 Hypoamelia: absence of limbs
 Microglossia
Are all features of what syndrome

A

Oro-mandibular-limb hypogenesis syndrome

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119
Q

5 features of Beckwith-Wiedemann Syndrome

A
  • Macroglossia
  • Wilms tumor
  • Omaphocele
  • Neonatal hypoglycemia
  • Gigantism
  • Other childhood tumors: hepatoblastoma, adrenal carcinoma, rhabdomyosarcoma, neuroblastoma
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120
Q

overgrowth of bone under a pontic is termed

A

subpontic osseous proliferation

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121
Q

Name 5 key clinical features of treacher collins

A
  • Lateral cleft palate
  • ear deformities
  • micrognathia
  • colomboma
  • salivary gland hypoplasia
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122
Q

Goldenhar syndrome is another name for

A

Oculo-auriculo-vertebral syndrome (one of the lateral cleft syndromes)

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123
Q

Palatal cyst of the newborn occurring in the midline

A

Epstein pearl

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124
Q

Dysontogenic Cysts is a category name that encompasses what 3 entities

A

Teratoma
Epidermoid cyst
Dermoid cyst

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125
Q

A soft tissue lesion removed from the oral cavity in an infant shows simple columnar epithelial cells organized in foveolar structures extending to the full depth of the lamina propria. What is the appropriate diagnosis?

A

Heterotopic oral gastrointestinal cyst or foregut duplication cyst

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126
Q

Name at least 5 conditions that may cause hemihyperplasia

A
  • Beckwith-Wiedemann syndrome
  • Neurofibromatosis
  • Klippel-Trénaunay-Weber syndrome
  • Proteus syndrome
  • McCune-Albright syndrome
  • Epidermal nevus syndrome
  • Triploid/diploid mixoploidy
  • Langer-Giedion syndrome
  • Multiple exostoses syndrome
  • Maffucci syndrome
  • Ollier syndrome
  • Segmental odontomaxillary dysplasia
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127
Q

Hemifacial atrophy is also called

A

Romberg or Parry-Romberg syndrome

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128
Q

What cranial nerves are impacted in eagle syndrome

A

CN 5, 7, 9, 10

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129
Q

Features of segmental odontomaxillary dysplasia

A
  • gingival hyperplasia
  • missing premolar
  • retained primary
  • vertical trabec of bone
  • sinus is smaller on the affected side
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130
Q

What branchial arches are affected in treacher collins

A

1st and 2nd

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131
Q

Neutrophil nitroblue tetrazolium reduction test is useful in? A negative test would indicate?

A

chronic granulomatous disease

A patient with CGD would have a NEGATIVE NBT test
Indicates a patients inability to produce ROS and therefore they have diminished ability to fight off infection

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132
Q

a predisposing factor for angioedema attacks precipitated by a dental procedure is

A

use of ACE inhibitors

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133
Q

Beta 2 microglobulin and albumin levels are a prognostic marker for

A

Multiple myeloma

*though they are also elevated in hemodialysis associated amyloidosis

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134
Q

Eosinophilic cuff like deposits around blood vessels is a common(though not entirely specific) histologic finding in what neoplasm?

A

CGCGs of cherubism

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135
Q

Erythema nodosum is most often idiopathic, however it can be a sign of systemic diseases such as?

A
  • Sarcoidosis (Lofgren syndrome)
  • strep throat infections
  • fungal and parasitic infections
  • IBD
  • behcets
  • malignancy
  • MANY conditions
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136
Q

What is the codman triangle and what does it occur in?

A

-triangular elevation of the periosteum

occurs in osteosarcoma

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137
Q

String sign is a term for?

A

the radiolucent line that corresponds to the periosteum attching a parosteal osteosarcoma to the cortex

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138
Q

Patients with what conditions are at higher risk for chondrosarcoma

A

Ollier

Maffucci

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139
Q

Most common oral manifestation of NF1

A

enlargement of the fungiform papillae

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140
Q

Common hemangioma treatment

A

propanolol (beta blockers)

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141
Q

A malignant peripheral nerve sheath tumor with rhabdomyosarcomatous differentiation is also called what?

A

Triton tumor

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142
Q

4 Conditions that may be more likely to have papillomatosis

A

Acanthosis nigricans
Down syndrome
Nevus unius lateris (large nevi only on 1 side of body)
Goltz-gorlin (aka focal dermal hyperplasia)

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143
Q

Verruca vulgaris HPV type

A

HPV 2

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144
Q

Characteristic features of Hecks disease papilloma

A

Club shaped rete ridges

Mitosoid cells

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145
Q

Overall most common site of sinonasal papilloma

A

Lateral nasal wall

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146
Q

Which sinonasal papilloma type almost always occurs on the nasal septum

A

fungiform sinonasal papilloma

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147
Q

A patient presents with multiple pruritic lesions that look similar to sebks, the lesions have been rapidly developing and increasing in size, what may this be a sign of?
-What condition does this frequently occur in conjunction with?

A

Leser-Trelat sign
Concerning for “internal malignancy”

-Malignant acanthosis nigricans

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148
Q

Kamino bodies are a histologic feature of?

A

Spitz nevus

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149
Q

2 inherited conditions that increase the risk of oral SCC

1 acquired condition that increases the risk of oral SCC

A

Inherited: -Dyskeratosis Congenita
-Fanconi Anemia

Acquired: HIV/AIDS (2x)

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150
Q

Cell of origin in sinonasal undifferentiated carcinoma

A

-Schneiderian membrane or olfactory epithelium

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151
Q

Demographic of patient affected by nasopharyngeal carcinoma

A

Young, southern chinese men– typically the undifferentiated form of the disease

-thought to be environmental: salt fish diet high in N-nitrosamines, EBV infection, Vit C def

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152
Q

Most common cancer of all

A

basal cell carcinoma

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153
Q

What systemic immunotherapy may be considered for Gorlin syndrome pts with many BCCs

A

Vismodegib

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154
Q

Water brash defintion

A

sialorrhea that occurs in patients with GERD

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155
Q

What salivary gland tumor has a specific subtype that appears inherited?

A

Membranous types of basal cell adenoma

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156
Q

membranous type basal cell adenoma frequently occurs in conjunction with what other lesions? What syndrome may it also be associated with?

A

Trichoepitheliomas
Dermal cylindromas

-WHO lightly suggests some BCAs may be associated with Brooke-spiegler syndrome

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157
Q

Recurrence rate for membranous basal cell adenoma

A

25%- much higher than typical BCA

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158
Q

What lesion is the salivary analogue of cutaneous syringocystadenoma papilliferum

A

Sialadenoma papilliferum

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159
Q

Most common inherited bleeding disorder

A

von willebrand disease

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160
Q

Injection of what medication is recommended 1 day before oral surgery and 7-10 days after in patients with significant Factor 8 deficiency

A

epsilon-aminocaproic acid

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161
Q

In patients with >5% factor 8 what medication can be given right before surgery to aid in clotting

A

Desmopressin (DDAVP)- releases bound F8 to create a transient increase in its plasma availability

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162
Q

What causes hemoglobin H disease

A

3 deleted alpha chain of hemoglobin encoding genes

-results in hemolytic anemia and splenomegaly

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163
Q

What is given as an iron chelating agent. What is a typical clinical scenario for this drug? What type of infection might this patient also be more prone to?

A
  • deferoxamine
  • iron overload from blood transfusions
  • mucormycosis
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164
Q

What two conditions have an increased risk for aplastic anemia as a component of disease?

A

Fanconi anemia

Dyskeratosis congenita

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165
Q

Cell count threshold to be considered neutropenic?

A

below 1500 cells/mm3

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166
Q

Agranulocytosis is?

A
  • cells of the granulocyte lineage are absent, particularly affects neutrophils
  • typically drug induced but can be congenital
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167
Q

What type of leukemia predominantly affects children

A

ALL- acute lymphoblastic leukemia

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168
Q

tumor like growths of leukemic cells are called

A

myeloid sarcoma

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169
Q

Epidermotropism definition

A

propensity to invade the epidermis of the skin; such as in mycosis fungoides

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170
Q

What test for wegners granulomatosis

A

-indirect immunofluorescence for c-ANCA also called PR3-ANCA

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171
Q

Pattern of INDIRECT immunofluorescence in lichenoid drug reaction

A

IgG in a string of pearls pattern at the basement membrane

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172
Q

Kleeblattschadel deformity occurs in?

A

-means cloverleaf skull
Apert
Crouzan

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173
Q

What is the plexus of myelinated nerve in the odontoblast layer that transmits pain sensation called?

A

raschkow plexus

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174
Q

What might a striae of retzuis indicate

A

these are the normal lines of enamel deposition which could be altered during systemic disturbances

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175
Q

Ochronosis is another term for?

What is the cause?

A

Alkaptonuria

-blue-black pigmentation in CT, sclera, teeth, cartilage caused by build up of homogentisic acid

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176
Q

Hurler, Scheie, Hunter, Sanfilippo A/B, Morquio A/B, Maroteaux-Lamy are all forms of?

A

Mucopolysaccharidosis

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177
Q

Loss of the distal tooth of each type is associated with what mutation

A

MSX1

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178
Q

List all of the genes associated with hypodontia of various patterns

A
  • AXIN2 (associattion with colorectal carcinoma)
  • MSX1 (distal tooth of each type missing)
  • He-Zao deficiency
  • LTBP3 (Pakistani)
  • EDA
  • PAX9
  • WNTI0A
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179
Q

3 syndromes associated with taurodontism

A

Down syndrome
ectodermal dysplasia
ellis-van crevald
Klinefelter

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180
Q

systemic factors associated with hypercementosis

A
  • Acromegaly and pituitary gigantism
  • Arthritis
  • Calcinosis
  • Paget disease of bone
  • Rheumatic fever
  • Thyroid goiter
  • Gardner syndrome
  • Vitamin A deficiency (possibly)
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181
Q

Common local factors that may cause hypercementosis

A
  • occlusal forces
  • unopposed teeth
  • adjacent inflammation
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182
Q

TX for chronic sclerosing osteomyelitis

A

debridement and antibiotic tx

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183
Q

Medications associated with gingival hyperplasia

A 
Anticonvulsants:
• Carbamazepine
• Ethosuximide
• Ethotoin
• Felbamate
• Mephenytoin
• Methsuximide
• Phenobarbital
• Phensuximide
• Phenytoin
• Primidone
• Sodium valproate
• Vigabatrin
Calcium channel blockers:
• Amlodipine
• Bepridil
• Diltiazem
• Felodipine
• Nifedipine
• Nitrendipine
• Verapamil
Cyclosporine 
Erythromycin
Oral contraceptives
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184
Q

Premature loss of teeth occurs in?

A 
acatalasia
acrodynia
oxalosis
AIDS
All blood issues: leukemia, cyclic neutropenia etc
DM
hemochromatosis
langerhan cell disease
sarcoid
trisomy 21
Cohen
Crohns
Dyskeratosis congenita
More but I tried to pick the weird surprising ones
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185
Q

Treponema pallidum may escape lethal antibiotic effect by being confined within?

A

lymph nodes

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186
Q

Massons trichrome stains?

A

keratin: red
collagen: blue
muscle: red

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187
Q

Spontaneous gingival hemorrhage, petechiae, and ecchymosis are signs of?

A
  • Thrombocytopenia:
  • most commonly caused by medications
  • immune/idiopathic thrombocytopenia purpura (ITP)
  • Thrombotic thrombocytpenia purpura
  • malignant infiltration of the BM or chemotoxicity
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188
Q

What is the term for anemia caused by malignant infiltration of the bone marrow

A

myelophthisic anemia

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189
Q

Genetic disorders that predispose you to leukemia

A 
Down syndrome
Bloom syndrome
Neurofibromatosis type 1
Schwachman (Schwachman-Diamond) syndrome
Ataxia-telangiectasia syndrome
Klinefelter syndrome
Fanconi anemia
Wiskott-aldrich syndrome
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190
Q

About how many cases of hodgkin lymphoma per year?

A

9000 vs 54000 non-hodgkin

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191
Q

Ann Arbor System for Classification of

Hodgkin Lymphoma

A
  1. ONE site
  2. 2+ lymph nodes on one side OR a lymph node + some non-lymph node site
  3. Lymph nodes on both sides of diaphragm +/- other sites
  4. Diffuse disease, LNs, organs etc +/- patient symptoms
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192
Q

Disorders that predispose you to non-hodgkin lymphoma

A 
Wiskott-Aldrich
Common variable immune deficiency
AIDs
organ transplant
SLE
RA
Sjogrens
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193
Q

Cell implicated in mycosis fungoides

A

CD4 T cell

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194
Q

Preliminary screening procedure for Crohns?

A

hematologic eval for evidence of malasorption: low albumin, calcium, iron etc

  • Leukocyte scintigraphy 99mTc-HMPAO
  • endoscopy
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195
Q

Two screening tests for sarcoidosis

A
  1. serum angiotensin converting enzyme

2. chest x-ray for hilar LAD

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196
Q

Preliminary screening tests for TB

A

Skin test

chest x-ray

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197
Q

American college of rheumatology criteria for diagnosis of Wegner Granulomatosis

A
  • Oral ulcers or nasal discharge
  • nodules, cavities on chest xray
  • abnormal urinary sediment (RBC casts)
  • Granulomatous inflammation on bx
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198
Q

Serum markers used to monitor multiple myeloma

A

Beta 2 microglobulin

Albumin

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199
Q

What percent of patients with mucocutaneous candidiasis as a part of APECED will go on to develop oral or esophageal cancer?

A

~10%

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200
Q

Pitting of the palms and soles can occur in?

A
  • NBCCS

- Dariers disease

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201
Q

What component of amalgam is usually responsible for contact stomatitis

A

mercury

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202
Q

Why does C1-INH deficiency result in angioedema

A

C1 cleaves C2 and C4 which results in angioedema from only minor trauma

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203
Q

High levels of antigen-antibody complexes may be seen in?

A

Lupus
Bacterial infections
C1-INH deficiency

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204
Q

List 3 causes of angioedema

A
  1. Allergic reaction to something contacted
  2. ACE-I use
  3. C1-INH deficiency (hereditary or acquired)
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205
Q

Hereditary forms of angioedema are caused by? What is the preferred treatment

A
  • C1-INH deficiency or dysfunctional

- TX: attenuated androgens (induce hepatic production of C1-INH), infusions of C1-INH

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206
Q

Witkopp-von sallman is another name for?

A

hereditary benign intraepithelial dyskeratosis

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207
Q

Non-melanoma skin cancer in patients with xeroderma pigmentosum occurs at a rate ____x higher

A

10,000x

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208
Q 
Explain the secretion method:
Merocrine
Holocrine
Apocrine
Endocrine
A

Merocrine aka Eccrine: excrete via a duct
Holocrine: cell ruptures and releases its contents
Apocrine: apical portion of the cell pinches off to release contents
Endocrine: secrete molecules directly into the blood

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209
Q

Most common site for palisaded encapsulated neuroma

A

face (nose and cheek)

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210
Q

Perivascular deposits of basement membrane material are a feature of

A

lipoid proteinosis

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211
Q

Thickened periodontal ligament may be seen in?

A 
Systemic sclerosis
osteosarcoma
periapical abscess
orthodontic tooth movement
increased occlusal function
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212
Q

Generalized loss of lamina dura can be seen in what conditions?

A

hyperparathyroidism
osteomalacia
pagets disease of bone
fibrous dysplasia

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213
Q

Causes of premature exfoliation of teeth not related to a syndrome

A 
trauma
aggressive periodontitis
AIDs
DM
cyclic neutropenia
langerhan cell histiocytosis 
DD type 1
scurvy
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214
Q

Syndromes associated with melanin pigmentation of oral mucosa

A 
peutz-jeghers
mccune albright
LEOPARD
Laugier-hunziker
cronkite-canada syndrome
bloom syndrome
dyskeratosis congenita
carney complex
XP
Addisons
rothmund thompson
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215
Q

Chronic exposure to high levels of polychlorinated bephenyls produces oral pigmentation and is termed?

A

Yusho

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216
Q

Systemic medications that cause pigmentation in the oral mucosa

A

chloroquine
phenolphthalein- additive in laxatives
estrogen
AIDs-related medications

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217
Q

Types of developmental nevi

A 
epidermal nevus
nevus sebaceous
nevus flammeus
basal cell nevus
white sponge nevus
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218
Q

Enlarged LNs featuring necrosis with nuclear debris surrounded by histiocytes, aggregates of lymphocytes and large numbers of plasmacytoid monocytes in a young male with a fever and leukopenia are characteristic of what disease?

A

Kikuchi-fujimoto disease

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219
Q

Lymphangiomyomatosis is seen exclusively in what population

A

women of child bearing age

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220
Q

Lesions of uremic stomatitis may mimic what other clinically entity

A

oral hairy leukoplakia

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221
Q

The most frequent cardiac complication of lupus is?

A

pericarditis

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222
Q

Sterile warty vegetations affecting the heart valves in SLE patients is termed?

A

Libman-sacks endocarditis

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223
Q

p63 fun facts

  • where is it located
  • what does it do
A
  • On chromosome 3
  • In the same family as p53 but not a tumor suppressor
  • It is essential for epidermal-mesenchymal interaction in development
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224
Q

Calretinin facts

  • what is it?
  • what does it stain (nuclear, cytoplasmic, membranous)
  • Positivity in an oral tumor?
A
  • Vitamin D dependent calcium-binding protein
  • Positive in both cytoplasm and nuclei
  • positive in ameloblastoma
  • Positive in multiple malignancies: synovial sarcoma, liposarcoma etc
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225
Q

About how many new cases of oral cancer are diagnosed annually?

how many oral and oropharyngeal cases are diagnosed annually?

A

27,000

54,000

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226
Q

Multiple hamaratoma syndromes with a PTEN mutation

A
  • Cowden syndrome (aka PTEN syndrome)
  • Lhermitte-Duclos
  • Bannayan-Riley-Ruvalcaba
  • proteus-like syndrome
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227
Q

What procedure is most commonly used for the removal of an antral pseudocyst?

A

Caldwell-Luc operation

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228
Q

Oral lesions as the “first to show last to go” is a characteristic features of what disease

A

Pemphigus vulgaris

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229
Q

List the types of pemphigus. Which type is most common?

A
  • Pemphigus vulgaris
  • Pemphigus foliaceous
  • Pemphigus vegatans
  • Pemphigus erythematosus
  • Most common is vulgaris
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230
Q

Most common autoimmune blistering disease

A

Bullous pemphigoid

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231
Q

eosionphils within a blister is characteristic off

A

bullae of bullous pemphigoid

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232
Q

Bullous pemphigoid antigens

A

BP180 and BP230

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233
Q

Teeth are described as conical in what two conditions

A

Incontinentia pigmenti

ectodermal dysplasia

234
Q

Snow-capped pattern (white opaque enamel) of alteration to the enamel of teeth is characteristic of what

A

Hypomaturation amelogenesis imperfecta

235
Q

What defines acute GVHD

A

-being within the first 100 days of the transplant

236
Q

What lesion is evidence of GVHD affecting the minor salivary glands?

A

Superficial mucoceles

237
Q

Psoralen and ultraviolet A (PUVA) therapy has shown to improve cutaneous and oral lesions of what conditions?

A

GVHD, psoriasis

238
Q

“Well-demarcated, erythematous plaque with silvery scale” describes lesions of what condition?

A

psoriasis

239
Q

Most common collagen-vascular/connective tissue disease in the US

A

Lupus erythematosus

240
Q

Entropion refers to

A

inward turning of the eyelids from scarring that occurs in MMP

241
Q

What term describes vaginal lesions associated with MMP

A

Dyspareunia

242
Q

Histologic mimics of MMP include?

A

linear IgA bullous dermatosis
angina bullosa hemorrhagica
epidermolysis bullosa acquisita

243
Q

Palmoplantar pustulosis is a feature of what diseases

A
  • Celiac
  • Psoriasis
  • SAPHO
  • strep tonsilitis
  • TNF-alpha inhibitors etanercept
  • Type 1 DM
244
Q

Describe Blashkow’s lines and what do they occur in

A

Blaschko’s lines are lines of normal cell development in the skin. These lines are invisible under normal conditions. They become apparent when some diseases of the skin or mucosa manifest themselves according to these patterns

Become visible in: Goltz syndrome aka focal dermal hypoplasia
as welll as other diseases: incontinentia pigmenti, vitiligo and others

245
Q

Indirect immunofluorescence finding for cases of MMP with diffuse disease

A

autoantibodies to epiligrin aka laminin-5

246
Q

MMP that only affects the oral cavity is associated with what indirect immunofluorescence finding

A

autoantibodies to alpha-6-integrin

247
Q

triggers for erythema multiforme

A
  • recurrent herpes simplex
  • mycoplasma pneumoniae
  • drugs
248
Q

Munro abscesses occur in

A

psoriasis or geographic tongue

249
Q

Mucosal diseases that increase the risk of Oral SCC

A
  • GVHD (small increase risk)
  • Erosive LP
  • Dyskeratosis congenita
  • Fanconi anemia
  • HIV (2x increase)
  • oral submucous fibrosis (19x)
  • Alcohol
  • Vitamin A def
  • Tertiary syphilis (4x, particularly the tongue)
250
Q

Shaggy, granular band of C3 at the basement membrane on DIF is characteristic of

A

Lupus erythematosus

251
Q

The strongest contributing factor to mortality in systemic sclerosis is involvement of what organ

A

Lungs

252
Q

What systemic medications are associated with benign acanthosis nigricans

A
  • corticosteroids

- birth control pills

253
Q

Most common internal malignancy associated with malignant acanthosis nigricans

A

GI adenocarcinoma

**note the cutaneous lesions themselves are still benign

254
Q

Syndrome associated with benign acanthosis nigricans

A

Crouzan

255
Q

development of the face begins at what week of gestation

A

4 weeks

256
Q

Cleft lip occurs from the failure of fusion of what two processes

A

median nasal process

maxillary process

257
Q

Cleft palate only is associated with a syndrome in what % of cases

A

50%

258
Q

Maternal behaviors and risk factors that increase the probably of an infant with cleft lip/palate

A
  • tobacco and alcohol
  • folic acid deficiency
  • anticonvulsant therapy (phenytoin = 10x increased risk)
259
Q

Acquired macroglossia causes

A
  • Amyloidosis
  • Edentulism
  • Myxedema (adult hypothyroid)
  • angioedema
  • acromegaly (excessive growth hormone usually from a tumor)
  • tumors
260
Q

Congenital/hereditary causes of macroglossia

A
  • Beckwith-weidemann
  • Hemihyperplasia
  • NF 1
  • lymphangioma
  • hemangioma
  • down syndrome
  • muccopolysaccharidosis
  • Cretinism (childhood hypothyroid)
261
Q

Most cases of microglossia are related to what syndrome?

A

oromandibular- limb hypogenesis syndrome

262
Q

Ectopic thyroid tissue represents a patients only thyroid tissue in what percentage of cases

A

70%

263
Q

Lingual thyroid tissue is more common in which sex?

Which sex are they more prone to malignant transformation?

A

4-7x more females

more common malignant transformation in males`

264
Q

Lines of Zahn describe?

A

Concentrically layered platelets and RBCs in a thrombus

265
Q

Most common site of caliber persistent artery

A

lip

266
Q

Coronoid hyperplasia is more common in ___ (M vs F) and results in deviation towards _______ upon opening..

A

Males

Jaw deviates towards the affected side

267
Q

Painless limited opening occurring in a young male may be the result of what?

A

coronoid hyperplasia

268
Q

Condylar hyperplasia is more common in ___ (M vs F) and results in deviation towards _____ upon opening

A

Females

deviates towards the unaffected side

269
Q

Condylar hypoplasia is associated with what syndromes?

A

Goldenhar syndrome (oculoauriculovertebral syndrome)
Mandibulofacial dysostosis
hemifacial microsomia

270
Q

what is the term for a bony growth that occurs under a pontic

A

subpontic osseous proliferation

reactive subpontic exostosis

271
Q

People will palatal tori may be more prone to what medication related bony disturbance?

A

medication related osteonecrosis

272
Q

Distinguish between Classic eagle syndrome vs carotid artery syndrome

A
  • classic is caused by tonsillectomy
  • carotid artery syndrome: unrelated to tonsillectomy. Impingement on the internal and external carotid arteries and sympathetic fibers. neck pain- often radiates on movement
273
Q

Stafne defect occurs in what sex 90% of the time

A

Males

274
Q

Is staphne defect present at birth?

A

No, not congenital

usually develops in middle aged and older adults

275
Q

elevation of the ala of the nose and eliminating mucolabial fold is characteristic of?

A

nasolabial cyst

276
Q

Most common non-odontogenic cyst of the oral cavity

A

nasopalatine duct cyst

277
Q

Vomeronasal organ function

A

aka organ of Jacobson

  • accessory olfactory function though is typically a vestigial organ
  • in the area of the nasal septum
278
Q

Inverted pear or heart shaped radiolucency of the anterior maxilla is characteristic of? What is the size cut off to be considered pathologic?

A

Nasopalatine duct cyst

6 mm or less is within normal range
>6 mm pathologic

279
Q

What malignant entity might you consider on the differential for a neck mass that appears like a branchial cleft cyst but is in an older adults (50s male)

A

cystic metastasis from an HPV+ SCC of the oropharynx

280
Q

En coupe de sabre is characteristic of what condition? What other condition may it occur in?

A

Morphea- localized systemic sclerosis

Can also occur in parry-romberg/progressive hemifacial atrophy

281
Q 
Define Craniosynostosis.
What condition (s) does this occur in
A

Premature fusing of the cranial sutures

Crouzan, Apert

282
Q

A prominent antegonial notch seen on PAN is common finding in what condition

A

Treacher collins syndrome

283
Q

Rate of enamel deposition

A

0.023mm/day

284
Q

What specific genetic finding is associated with increased risk (5.6 x) of root resorption during orthodontic treatment

A

homozygosity for IL-1 beta allele

285
Q

Name causes of intrinsic tooth staining and the resultant color alteration seen.

A
  • IV cipro to infants: greenish
  • Tetracycline: brown; bright yellow fluorescence
  • Minocycline: grey
  • congenital erythropoietic porphyria (Gunther dz): red
  • alkaptonuria: blue-black
  • hyperbilirubinemia: green
286
Q

What is the most commonly ankylosed tooth

A

mandibular primary first molar

287
Q

Syndromes associated with both hyperdontia and hypodontia

A
  • Down
  • Ehlers danlos
  • Incontinentia pigmenti
  • Sturge-Weber
  • Orofacial digital syndrome type 1
  • Crouzan
288
Q

Hypodontia only syndromes

A
  • Ectodermal dysplasia
  • Gorlin syndrome
  • Goldenhar
  • lipoid proteinosis
  • Hurler
  • Progeria
  • turner
  • Ellis van crevald
289
Q

most common site of dental transposition

A

maxillary premolar and canine switched

290
Q

Natal teeth vs neonatal teeth

A 
natal = present at birth
neonatal = arising within the first 30 days
291
Q

Name the three types of accessory cusps and where they are located

A
  • cusp of carabelli (ML cusp max molar)
  • talon cusp (1/2 distance CEJ to incisal edge to count)
  • dens evaginatus (buccal cusp, central groove, lingual ridge of the molar or premolar)
292
Q

There is an increased prevalence of dilaceration in what syndromes

A
  • Smith-Magenis syndrome
  • Ehlers Danlos
  • Axenfeld-Rieger syndrome
  • Congenital ichthyosis
293
Q

“Denture dipped in white paint” is used to describe?

A

snow capped hypomaturation pattern of amelogenesis imperfecta

294
Q

What two systemic conditions should you consider if a patient has generalized delayed eruption, impacted teeth, and generalized thin hypoplastic enamel

A
  • Renal failure
  • nephrocalcinosis
    If neither is present then the tooth findings are just amelogenesis imperfecta
295
Q

4 syndromes that produce dental findings similar to dentionogenesis imperfecta

A

osteogenesis imperfecta
ehlers danlos
Goldblatt syndrome
Schimke immuno-osseous dysplasia

296
Q

Mutations in DSPP have been described in what conditions

A

Dentin dysplasia type 2

dentinogenesis imperfecta

297
Q

What are the defining features of the brandywine isolate

A

“dentinogenesis imperfecta type 3”

Shell teeth with multiple pulp exposures, seen mostly in deciduous teeth

298
Q

Whorls of tubular dentin with peripheral normal dentin that appears as a “stream flowing around boulders” describes the histology of what condition

A

dentin dysplasia type 1

299
Q

What pathoses are seen more frequently/in association with patients with regional odontodysplasia

A
  • Ectodermal dysplasia
  • Epidermal nevi
  • Hydrocephalus
  • Hypophosphatasia
  • Ipsilateral facial hypoplasia
  • Neurofibromatosis
  • Orbital coloboma
  • Rh factor incompatibility
  • Vascular nevi
300
Q

Enameloid conglomerates are seen on histology of what two conditions

A
  • regional odontodysplasia

- amelogenesis imperfecta

301
Q

What tests are used to assess for mucopolysaccharidosis?

A
  • elevated levels of glycosaminoglycans
    in the urine
  • Deficiencies of the specific
    enzymes in the patient’s leukocytes and fibroblasts
302
Q

Name all of the mucopolysaccharidoses syndromes

A
  • Hurler
  • Scheie
  • Hunter
  • Sanfilippino A/B
  • Morquio I/II
  • Maroteaux-Lamy
303
Q

List all types of lipid reticuloendothelioses

A
  • Gaucher disease
  • Neimann Pick disease
  • Tay-sachs disease
304
Q

Icterus is another term for

A

jaundice

305
Q

Causes of excess bilirubin?

A
  • higher breakdown of RBCs: sickle cell anemia, hemolytic anemia
  • liver dysfunction : decreased conjugation of bilirubin, swelling of hepatocytes, obstructions
306
Q

What type of biopsy is most commonly used to confirm systemic amyloidosis?
What oral biopsy shows positivity in 80% of cases?

A
  • rectal biopsy

- minor salivary gland

307
Q

Common medications for systemic amyloidosis (not multiple myeloma associated)

A

colchicine, prednisone, melphalan

308
Q

Vitamin B6 deficiency is most commonly caused by

A

drug isoniazid for TB

309
Q

In a patient with prolonged scurvy what is the mechanism of death?

A

Untreated leads to death by intracranial hemorrhage

310
Q

Deficiency of vitamin E in children is most commonly caused by

A

chronic cholestatic liver disease- severe impairment of all fat soluble vitamins

311
Q

Vit K is necessary for which clotting factors

A

clotting factors II, VII, IX, X

312
Q

Patients with plummer vinson syndrome have a high frequently of what type(s) of malignancy

A

Both oral and esophageal

313
Q

Hypochromic microcytic anemia is found in what condition (s)

A
  • iron deficiency anemia

- plummer vinson

314
Q

Macrocytic/ megaloblastic anemia is found in what condition(s)

A
  • pernicious anemia (B12 def)
  • folate deficiency
  • tx of B12 def with folate will resolve oral symptoms but CNS damage continues
315
Q

The Schilling test compares what? Was once used in the diagnosis of?

A

absorption and secretion of radiolabeled cobalamine

-used previously to diagnose pernicious anemia

316
Q

Patients with pernicious anemia have a 7x higher risk of developing what type of malignancy?

A

gastric carcinoma

317
Q

The posterior pituitary releases what hormones

A

oxytocin

ADH

318
Q

The anterior pituitary releases?

A 
ACTH
TSH
LH
GH
Prolactin
MSH
FSH
319
Q

abnormally short stature with normal body proportions is characteristic of?

A

pituitary dwarfism

320
Q

Most common cause of gigantism?
What radiographic feature might this produce?
What syndrome may cause up to 20% of cases of gigantism?

A
  • functional pituitary adenoma
  • enlarged sella turcica
  • Mccune albright syndrome
321
Q

Excess production of growth hormone after closure of the epiphyseal plates, describes what disease process?

A

acromegaly

322
Q

What test do they employ in the diagnosis of acromegaly

A
  1. glucose challenge
    - normally GH decreases in the face of a glucose challenge but in acromegaly it remains the same
  2. MRI to assess for pituitary adenoma
323
Q

Hypothyroidism in childhood is termed?

Hypothyroidism with onset in adulthood is termed?

A 
children = cretinism
adults = myxedema
324
Q

Parathyroid hormone functions

A
  • PTH causes resorption of calcium in the kidney

- PTH acts directly on osteoblasts causing them to produce cytokines that result in osteoclasts breaking down bone

325
Q

Syndromes that may be associated with hypoparathyroidism

A
  • Digeorge syndrome

- APECED/APS-1

326
Q

Describe Chvostek sign and what condition it may indicate

A

Chvostek sign= twitching of the upper lip when the facial nerve is tapped just below the zygomatic process

  • it is a sign of tetany
  • occurs in hypocalcemia that can results from hypoparathyroidism
327
Q

Syndromes associated with hyperparathyroidism

A

hyperparathyroidism jaw tumor syndrome
MEN2a
MEN1

328
Q

A striking enlargement of the jaws that have a ground glass appearance on radiology may be a sequela of what systemic disease

A

end stage renal disease because of secondary hyperparathyroidism

329
Q

stones bones abdominal groans refers to the symptoms associated with what?

A

hyperparathyroidism

330
Q

generalized loss of lamina dura is seen in what condition (s)?

A

hyperparathyroidism, osteomalacia, pagets disease, fibrous dysplasia

331
Q

Long standing browns tumors of hyperparathyroidism may undergo fibrosis and degeneration. This process is described as?

A

Osteitis fibrosa cystica

332
Q

What is the typical abdominal finding in patients with abdominal groans of hyperparathyroidism?

A

duodenal ulcers

333
Q

What is the difference between cushing syndrome and cushing disease

A

Cushing syndrome: hypercortisolism from an inside or outside source
Cushing disease: a specific type of cushing syndrome in which a pituitary adenoma produces excess cortisol

334
Q

What test may be used in the diagnosis of hypercortisolism resulting from pituitary adenoma secreting ACTH or a functional adrenal corticol tumor

A

dexamethasone challenge- patients ACTH and cortisol levels should drop in response normally but patients with hypercortisolism do not

335
Q

Addisonian crisis

A

Patients chronically receiving corticosteroids begin to produce less ACTH which then makes them unable to produce an adequate response in a time or stress producing an acute hypoadrenocortisolism = addisonian crisis

336
Q

Clinical features of addison’s disease are not present until ___% destruction of the gland

A

90%

337
Q

What causes the bronzing of the skin seen in addisons disease

A

increased levels of beta-lipotropin or ACTH which stimulate melanocytes

338
Q
A

18

339
Q

Common systemic complications of DM

A
  • microangiopathy, peripheral vascular disease
  • predisposition to infection
  • neutrophil dysfunction
  • kidney disease
  • retinal involvement –> blindness
340
Q

Common oral sequela of DM

A
  • delayed eruption
  • perio dz
  • diabetic sialadenosis
  • enlargement and erythema of the gums
  • candidiasis
  • poorly controlled type 1 :mucor
341
Q

Acute angle branching and septations are characteristics of what organism

A

fungal hyphae of aspergillosis

342
Q

Decreased blood levels of ________ and increased blood and urinary levels of ________ are characteristic of hypophosphatasia

A

decreased alk phos

increased phosphoethanolamine

343
Q

Bony changes in hypophosphatasia resemble what other process

A

Rickets

344
Q

The premature exfoliation of teeth in hypophosphatasia is a direct result of what?

A

Lack of cementum present on the teeth inhibiting the attachment of PDL fibers

345
Q

Vitamin D resistant rickets is caused by a lack of?

A

1-alpha-hydroxylase; converts vitD to activated form

346
Q

Large pulp chambers, pulp horns extending almost to the DEJ is a characteristic dental finding of what systemic condition?
-What does this process often present as clinically?

A

vitamin D resistant rickets

-Clinical presentation: childhood abscesses

347
Q

Interglobular dentin and scattered enameloid conglomerates are characteristic of?

A

regional odontodysplasia

348
Q

Globular dentin in a child with pulpal extensions to the surface and abscesses is characteritic of

A

vitamin d resistant rickets

349
Q

Numerous areas of interglobular dentin and radicular dentin that is atubular, amorphous, and hypertrophic is characteristic of?

A

dentin dysplasia type 2

350
Q

whorls of tubular dentin and atypical osteodentin forming the appearance of a stream flowing around boulders is characteristic of?

A

Dentin dysplasia type 1

351
Q

Medications for the treatment of mild crohns

A

Mesalamine or sulfasalazine

352
Q

intraepithelial eosinophilic abscesses are a characteristic histologic finding in what inflammatory condition

A

pyostomatitis vegetans in patients with IBD

353
Q

A mucosal biopsy shows: Subepithelial abscesses, mixed inflammatory cellular infiltrate composed of epithelioid histiocytes, eos, neutrophils, multinucleated giant cells, often obscured by extensive extravasation of red blood cells. This histology is characteristic of?

A

Wegners granulomatosis

354
Q

What hormone is implicated in pregnancy gingivitis

A

progesterone

355
Q

An isolated patch of exteriorized junctional or sulcular epithelium is thought to be the cause of what condition? What immunohistochemical marker is commonly positive in this type of epithelium?

A

Localized juvenile spongiotic gingivitis

CK19

356
Q

atypical gingivostomatitis is another term for?

A

plasma cell gingivitis

357
Q

Histology: Psoriasiform hyperplasia and spongiosis, exocytosis and dense chronic inflammatory infiltrate composed predominantly of plasma cells. Dx?

A

Plasma cell gingivitis

358
Q

Gingival fibromatosis occurs in many syndromes including?

A
  • Byars-Jurkiewicz syndrome
  • Costello syndrome
  • Cross syndrome
  • Infantile systemic hyalinosis
  • Jones-Hartsfield syndrome
  • Murray-Puretic-Drescher syndrome
  • Ramon syndrome
  • Rutherford syndrome
  • Zimmerman-Laband syndrome
359
Q

A 10 year old patient is diagnosed with gingival fibromatosis. What tx would you recommend?

A

Wait to remove excess tissue until all teeth have erupted and rigorous hygiene

360
Q

What bacteria is predominantly implicated in vincent infection

A

aka NUG

Fusobacterium nucleatum

361
Q

Most common cause of tooth loss in adults over 35

A

chronic periodontitis

362
Q

What bacteria is implicated in localized aggressive periodontitis?

A

A. actinomycetemcomitans

363
Q

What bacteria is implicated in generalized aggressive periodontitis

A

P. intermedia, P. gingivalis, tannerella forsythia, fusobacterium nucleatum, treponema denticola, campylobacter rectus

364
Q

What bacteria is implicated in papillon lefevre

A

A. actinomycetemcomitans

365
Q

Physiologic secondary dentin deposition is associated with an increased prevalence of what common systemic conditions

A 
HTN
arthritis
gout
kidney stones
atherosclerosis
gall stones
366
Q

Early widespread formation of secondary dentin is associated with?

A

Progeria

367
Q

Prominent pulpal calcifications are a finding in what conditions/syndromes?

A 
Dentin dysplasia type 1
Dentin dysplasia type 2
Pulpal dysplasia
Ehlers-danlos
Tumoral calcinosis
Calcinosis universalis
ESRD
368
Q

3 types of pulpal calcifications

A

Pulp stones
denticles
diffuse linear calcifications

369
Q

Phoenix abscess

A

secondary acute inflammation in a periapical granuloma

370
Q

What is a russell body

A

scattered eosinophilic globules of gamma globulin

371
Q

Rushton bodies

A

linear or arch-shaped calcifications in periapical cyst epithelial lining

372
Q 
Hyaline bodies (pulse granuloma, giant-cell
hyaline angiopathy) are frequently found where?
A

In the walls of inflammatory cysts

373
Q

The ability of odontogenic epithelium to transform into multiple cell types is termed?

A

Prosoplasia

374
Q

Woody tongue and bull neck and two clinical features of what process

A

Ludwig angina

375
Q

Involucrum

A

fragments of necrotic bone that becomes surrounded by new vital bone

376
Q

Most common cause of ostemyelitis in the US/Europe? Does this differ from third world countries?

A

US/Europe: dental infection or trauma

3rd world: NUG

377
Q

What lesions has a propensity for posterior to the first molar on the mandible and anterior to the maxillary first molar

A

odontogenic fibroma

378
Q

The palatal mucosa that overlies the tumor occasionally may exhibit a defect or groove, is a feature of?

A

central odontogenic fibroma

379
Q

Most frequent location of alveolar soft part sarcoma
Most frequent head and neck sites?
Age group?

A

lower extremity
Orbit and tongue
Childhood tumor

380
Q 
A diagnosis of pancytopenia is characterized by at
least two of the following findings:
• Fewer than \_\_\_\_\_\_\_ granulocytes/μL
• Fewer than \_\_\_\_\_\_\_ platelets/μL
• Fewer than \_\_\_\_\_\_\_ reticulocytes/μL
A
  • Fewer than 500 granulocytes/μL
  • Fewer than 20,000 platelets/μL
  • Fewer than 20,000 reticulocytes/μL
381
Q

For many years a regimen known as __________ was widely used to treat Hodgkin lymphoma. Because significant long-term side effects can be associated with this chemotherapy, another regimen known
as _________

A

MOPP (mechlorethamine, Oncovin, procarbazine, prednisone)

ABVD (Adriamycin, bleomycin, vinblastine, dacarbazine[DTIC])

382
Q

Radiopaque objects superimposed on the midportion of the mandibular ramus is characteristic of?

A

Tonsilloliths

383
Q

What is the natural reservoir for C. diphtheriae

A

only humans

384
Q

Lues is another name for?

A

Syphilis

385
Q

What is the natural reservoir for syphilis

A

only humans

386
Q

Saddle nose is described in what conditions

A
  • congenital syphilis

- drug abuse

387
Q

Higoumenakis sign. Define and what condition does it occur in?

A

Congenital syphilis

-unilateral enlargement of the sternal end of the right clavicle in patients with congenital syphilis

388
Q

What tests would you order for suspected syphilis

A
  • RPR: rapid plasma reagin
  • Biopsy
  • The fluorescent treponemal antibody absorption (FTA-ABS) test
  • dark field microscopy (not really done)
389
Q

Treponema pallidum can escape antibiotic treatment when found where?

A

lymph nodes and the CNS

390
Q

Most common reportable bacterial infection in the US

A

Gonorrhea

391
Q

Gonorrhea infection passed to an infant on delivery will present as?

A

gonococcal ophthalmia neonatorum

392
Q

Worldwide prevalence of tuberculosis

A

2 billion people; 1/3 population

393
Q

What are Ghon complexes?

A

classic lesions of primary tuberculosis- calcified lesions seen on radiographic studies at sites of healed infection and in the local nodes

394
Q

A different protocol termed _________ is used for patients who have a positive PPD skin test but no signs or symptoms of active disease.

A

chemoprophylaxis

395
Q

What test can be used for diagnosis of certain types of leprosy? What are the findings in each type of leprosy?

A

Lepromin test: inject heat killed bacteria from armadillo
Tuberculoid leprosy: lepromin positive (high immune function)
Lepromatous leprosy: lepromin negative (low immune fn)

396
Q

Incubation period for leprosy

A

Tuberculoid: 2-5 years
Lepromatous: 12-15 years

397
Q

The WHO defines paucibacillary (which includes what categories of leprosy?) as ______ organisms on biopsy VS multibacillary(which includes what categories of leprosy?) which has ____ organsims on biopsy

A

Pacibacillary <2
Pauci = Tuberculoid and borderline-tuberculoid
Multi >2
Multi = borderline-borderline, borderline-lepromatous, lepromatous

398
Q

Predisposing illness most commonly implicated in the initiation of NOMA

A

Measles

Others: HSV, TB, malaria, varicella

399
Q

Causative organisms in NOMA

A

Key: Fusobacterium necrophorum, Prevotella intermedia

Others: Actinomyces pyogenes, Bacillus cereus, Bacteroides fragilis, Fusobacterium nucleatum, and Prevotella melaninogenica

400
Q

What type of organism is Actinomyces israeli

A

filamentous, branching, gram positive anaerobic bacteria

401
Q

Club-shaped with a radiating rosette pattern is descriptive of what organism on histology

A

Actinomycosis

402
Q

How would you treat a suspected actinomycosis infection

A

Confirm with culture (bx is not entirely specific)

-debride and long term antibiotics

403
Q

What are the natural reservoirs for bartonella henselae

A

Cats***via fleas
dogs, monkeys, thorns
no human to human transmission

404
Q

Intranodal area of necrosis surrounded

by a band of epithelioid histiocytes and lymphocytes describes what disease

A

catch scratch disease

405
Q

Brown-hopps method of gram staining is used for detection of what organisms?

A
  • Bartonella henselae

- Leishmaniasis (protozoa)

406
Q

What confirmatory test would you perform in a suspected case of catch scratch disease

A

indirect fluorescent assay (IFA) or enzyme linked
immunosorbent assay (ELISA) for detecting antibodies
to B. henselae

407
Q

Chronic sinusitis is defined as?

A

symptomatic sinus disease for longer than 3 months

408
Q

Maxillary sinusitis may be triggered by a dental infection in as many as ___% of cases

A

30%

409
Q

chronic lip licking, thumb sucking, chronic use

of petrolatum-based salves in patients with angular cheilitis may result in what condition?

A

cheilocandidiasis- all the perioral skin infected

410
Q

perleche is another term for?

A

angular cheilitis

411
Q

Chairside assessment for candidal infection can be achieved using what test?

A

10-20% potassium hydroxide (KOH) preparation

412
Q

Culture of candida should be performed using what medium? what is the appearance of the resulting colonies?

A

-Sabouraud agar slant

C. albicans will grow as creamy, smooth-surfaced colonies after 2 to 3 days of incubation at room temperature.

413
Q

Most common SYSTEMIC fungal infection in the US

A

histoplasmosis

414
Q

Histoplasmosis is endemic in what area

A

ohio-mississippi river valley

415
Q

What size are the yeasts of histoplasmosis

A

1-3um

416
Q

Which fungal infection is up to 15x more common in males and why?

A

paracoccidiomycosis because female hormone beta-estradiol appears protective

417
Q

Calcified masses in the lungs is a typical finding of what infectious processes?

A

Histoplasmosis

Tuberculosis

418
Q

A patient presents with symptoms suggestive of pulmonary infection. A chest xray shows diffuse lung infiltrates without evidence of calcification. What is the suspected diagnosis?

A

Blastomycosis

419
Q

Buzz histologic features of blastomycosis

A
  • doubly refractile cell wall
  • overlying pseudoepitheliomatous hyperplasia
  • large yeasts 8-20um
  • broad attachment between daughter yeasts
420
Q

Animal reservoir for histoplasmosis

A

bird and bat

421
Q

In animal models interactions between _________ infection and ________ mutations can produce a pagetic phenotype.

A

measles virus infection and SQSTM1 mutations

thought that maybe interacting with farm animals could be linked to pagets disease

422
Q

Animal reservoir for paracoccidiomycosis

A

nine-banded armadillo

423
Q

Which fungus exists as a yeast form in both nature and when infecting a human host

A

cryptococcus neoformans

424
Q

What animal reservoir is mentioned in association with cryptococcus

A

pigeons

425
Q

A prominent mucopolysaccharide capsule is a key feature of what infectious organism? What does it stain positively with?

A

cryptococcus; mucicarmine

426
Q

During surgical removal of tissue infected with mucormycosis evaluation of surgical margins is aided by what process ?

A

calcofluor white and fluorescence microscopy

427
Q

Describe the organisms of mucormycosis

A

6-30um 90 degree branching, non-septate hyphae

428
Q

Second most common opportunistic fungal infection

A

aspergillosis (1st is candida)

429
Q

Allergic fungal sinusitis is most commonly caused by?

A

aspergillosis

430
Q

Charcot-Leyden crystals are a feature of?

A

allergic fungal sinusitis; also in asthma or other allergic processes

  • formed from the breakdown of eosinophils
  • pink/red refractive, and form long needle-like structures
431
Q

What is TORCH

A
  • an acronym for a group of diseases that cause congenital conditions if a fetus is exposed to them in the uterus
  • toxoplasmosis, other (such as syphilis, varicella, mumps, parvovirus, and HIV), rubella, CMV, HSV
432
Q

What is the natural host for toxoplasmosis

A

Multiplies in the gut of a cat

433
Q

Accumulation of eosinophilic macrophages within a lymph node macrophages encroaching on
the germinal centers and accumulating within the subcapsular and sinusoidal regions of the node is a microscopic description common for?

A

toxoplasmosis infection

434
Q

Per neville what two infectious diseases are caused by protozoa?

A

Toxoplasmosis

Leishmaniasis

435
Q

Transmission of leishmaniasis occurs via what animal vector(s)?

A

Dogs and other mammals are the primary reservoir

Transmission occurs via the sandfly

436
Q

Kala-azar is caused by?

A

Visceral leishmaniasis infection

437
Q

A volcano lesion is a sequelae of what disease?

A

Cutaneous leishmaniasis

438
Q

The only natural reservoir for herpes viruses is?

A

Humans

439
Q

What is the structure of human herpes viruses

A

double stranded DNA viruses

440
Q

HHV6 and 7 frequently establish latency in what location and what cell

A

Latency in salivary glands and specifically in CD4 t lymphocytes

441
Q

The major cell of latency for HHV8

A

Circulating B lymphocytes appear to be the major cell of latency

442
Q

HHV8 obviously is linked to kaposi sarcoma but what other diseases is it linked to as well?

A

Lymphoma and Castleman disease

443
Q

Ballooning degeneration refers to

A

HSV-infected epithelial cells exhibiting acantholysis, nuclear clearing, and nuclear enlargement

444
Q

Potential presentations and sequelae of herpes zoster

A
  • Zoster sine herpete (symptoms w/o rash)
  • Ramsay-Hunt: reactivation in geniculate ganglion
  • Post herpetic neuralgia
  • Granulomatous angiitis: potentially fatal ischemic stroke syndrome that can develop weeks to months after rash resolution
445
Q

Soft palate petechiae are a common finding in what infectious processes

A
  • Infectious mononucleosis
  • “Upper respiratory infections”
  • Forchheimer’s sign is only listed under Rubella (aka german measles) but these are just small palatal petechiae
  • scarlet fever seems reasonable too
446
Q

a dewdrop on a rose petal describes a lesion of what disease?

A

Varicella

447
Q

VZV establishes latency in the ________________?

A

Dorsal root ganglion

448
Q

Hutchinson sign

A

Lesion of vzv at the tip of the nose which is a sign that the nasociliary nerve is affected which increases the risk for ocular involvement

449
Q

Most common non-hereditary cause of sensorineural hearing loss in infants

A

CMV

450
Q

Diagnostic tests for CMV

A

> 10% atypical lymphocytes
50% lymphocytosis
HETEROPHILE antibody NEGATIVE
-Bx of lesions: intracytoplasmic inclusions, owl eye nuclei

451
Q

molluscum contagiosum virus is a member of what family of viruses

A

poxvirus family

452
Q

p53 is located on what chromosome

A

17p

453
Q 
Cytogenetic studies have suggested that loss
of heterozygosity (LOH) of chromosome arms \_\_\_\_\_\_\_\_\_\_\_ is associated with increased risk of malignant transformation in SCC
A

3p and 9p

454
Q

Loss of p53 gene is involved in which stage of the adenoma-carcinoma sequence in colorectal cancer

A

late adenoma –> carcinoma

455
Q

The activation of the p53/p21 pathway triggers?

A

momentary G1 cell cycle arrest or lead to a chronic state of senescence or apoptosis

456
Q

P53 levels are negatively regulated by _____

A

MDM2

457
Q

Verruca plana HPV types

A

3, 10

458
Q

palmarplantar wart HPV type

A

1,4

459
Q

butcher wart hpv type

A

2, 7

460
Q

Of the currently discovered genes (pertaining to amelogenesis imperfecta), _________ is associated with the highest prevalence of disease and the most severe enamel alterations.

A

FAM83H

461
Q

Hypodontia that particularly affects the molars is seen with what mutation?

A

PAX9

462
Q

Hypodontia, colon polyps, and colorectal carcinoma are associated with what mutations

A

AXIN2

463
Q

Diffuse macrodontia is seen in what condition(s)

A

otodental syndrome, gigantism, XYY males, pineal hyperplasia

464
Q

Atubular dentin and pulp stones are common histologic findings for what condition(s)

A

dentin dysplasia type 2

dentinogenesis imperfecta

465
Q

Enteroviruses are a genus that encompass what viral types

A

Echoviruses
coxsackie A & B
polioviruses

466
Q

What three clinical patterns are characteristic of enterovirus infection

A
  • Herpangina
  • Hand foot mouth disease
  • acute lymphonodular pharyngitis
467
Q

Hand foot mouth disease is caused most commonly by?

A

coxsackie virus A16

468
Q

Herpangina is most commonly caused by?

A

coxsackie viruses A1-A6

469
Q

The nodules of acute lymphonodular pharyngitis if biopsied would show?

A

Hyperplastic lymphoid aggregates

470
Q

Rubeola is another name for?

What is the causative virus?

A

Measles

-paramyxoviridae

471
Q

Koplik spots if biopsied would show?

A

hyperparakeratotic epithelium with spongiosis, dyskeratosis, and epithelial syncytial giant cells

472
Q

As late as 11 years after infection with measles patients can develop a rare complication called?

A

subacute sclerosing pan excephalitis (SSPE)- degenerative CNS disorder that can lead to death

473
Q

What adjunct tests can confirm a diagnosis of measles?

A

IgM antibody assay on serum sample

Viral culture

474
Q

Rubella is also called?

A

German measles or the 3 day measles

475
Q

The causative agent for rubella is?

A

togavirus of the genus ribivirus

476
Q

Discrete red papules of the soft palate in addition to palatal petechiae are features of what infectious disease? What is the term for this presentation

A

Rubella, german measles

Forchheimer sign

477
Q

What is the causative agent in mumps?

A

paramyxovirdae genus: rubulavirus

478
Q

What testing can be used to confirm suspected mumps diagnosis

A

-mumps-specific IgM
-mumps specific IgG titers
-Swab of secretions obtained from parotid or other affected salivary gland ducts can be used for
viral culture or real-time reverse transcription PCR testing.

479
Q

In the “EC-Clearinghouse Classification of the Oral Manifestations of HIV Disease in Adults” what lesions are considered strongly associated aka GROUP 1 with HIV infection

A
  • Oral hairy leukoplakia
  • Periodontal diseases: NUG/NUP, linear gingival erythema,
  • Non-hodgkin lymphoma
  • Kaposi sarcoma
  • Candidiasis
480
Q

What lymphomas are most commonly occurring in HIV-positive patients?

A

primary effusion lymphoma and plasmablastic lymphoma

481
Q

Atypical patterns of periodontal disease that are associated strongly with HIV infection include?

A

linear gingival erythema
NUG
NUP

482
Q

AIDS-Defining Conditions

A
  1. Bacterial infections, multiple or recurrent*
  2. Candidiasis of bronchi, trachea, lungs, esophagus
  3. Cervical cancer, invasive†
  4. Coccidioidomycosis, disseminated or extrapulmonary
  5. Cryptococcosis, extrapulmonary
  6. Cryptosporidiosis, chronic intestinal (more than 1 month duration)
  7. CMV disease (other than liver, spleen, or nodes), onset at age of more than 1 month
  8. CMV-induced retinitis (with loss of vision)
  9. Encephalopathy, HIV-related
  10. Herpes simplex: Chronic ulcer or ulcers (more than 1 month duration) or bronchitis, pneumonitis, or esophagitis
  11. Histoplasmosis, disseminated or extrapulmonary
  12. Isosporiasis, chronic intestinal (more than 1 month duration)
  13. Kaposi sarcoma (KS)
  14. Lymphoid interstitial pneumonia or pulmonary lymphoid hyperplasia complex*
  15. Lymphoma, Burkitt, Immunoblastic, primary of the brain
  16. Mycobacterium infections that are disseminated or extrapulmonary or avium type
  17. Pneumocystis jiroveci pneumonia
  18. Pneumonia, recurrent†
  19. Progressive multifocal leukoencephalopathy
  20. Salmonella septicemia, recurrent
  21. Toxoplasmosis of brain, onset at age of more than 1 month
  22. Wasting syndrome attributed to HIV
483
Q

What conditions are part of the AIDS-related complex (ARC) (period of time before a person converts to overt AIDS)

A

period of chronic fever, weight loss, diarrhea, oral candidiasis, herpes zoster, and/or oral hairy leukoplakia (OHL)

484
Q

HIV predominantly infects ______ cells, however it can also infect (3) other cell types

A
  • CD4 helper t cells

- macrophages, dendritic cells, microglia

485
Q

acute retroviral syndrome (aka the first few weeks of a patient becoming infected with HIV) symptoms resemble what other infectious disease?

A 
infectious mononucleosis (e.g., generalized lymphadenopathy, sore throat, fever, maculopapular rash, headache, myalgia, arthralgia, diarrhea, photophobia, and peripheral
neuropathies). Oral changes may include mucosal erythema and focal ulcerations.
486
Q

Progressive encephalopathy in patients diagnosed with AIDS is known as?

A

AIDs dementia complex

487
Q

What is the most common intraoral presentation of HIV infection?

A

Candidiasis
1/3 of HIV pts are infected at some point
90% of AIDs patients develop at some point

488
Q

In HIV infected patients with CD4 count above 50 cells/mm3 what is the recommended antifungal regimen? What about in patients below 50

A

above 50: Clotrimazole

below 50: systemic therapy; fluconazole

489
Q

Balloon cells with nuclear beading is a histologic hallmark for?

A

Oral hairy leukoplakia

490
Q

candidal virulence factor known as ____________ is inhibited by cART therapy

A

secreted aspartic proteinase

491
Q

Most common malignancy among the AIDS population in the United States

A

Non-hodgkin lymphoma

492
Q

Most common intraoral site for TB infection

A

tongue

493
Q

What diseases can secondarily produce Addison’s disease or an addisonian presentation?

A
  • Disseminated infections associated with HIV/AIDs
  • disseminated histoplasmosis
  • paracoccidiomycosis

*not talked about in neville: sarcoidosis

494
Q

What condition represents an uncommon manifestation of HIV infection characterized by CD8+ lymphocytosis with diffuse lymphocytic infiltration

A

DILS: diffuse infiltrative lymphocytosis syndrome

495
Q

Increased prevalence of oral HPV lesions in HIV+ patients treated with cART is thought to be caused by

A

immune reconstitution syndrome

496
Q

Some patients who receive antiretroviral therapy during advanced stages of disease develop a paradoxical worsening of their condition—termed?

A

immune reconstitution syndrome: hyper-inflammatory response to pathogens and pathogenic
antigen

497
Q

Persistent reservoirs in the body that allows HIV to evade complete resolution include?

A

peripheral blood and lymphoid tissues

498
Q

Persistence of HSV for ______ in a patient with HIV is indicative of AIDS

A

> 1 month

499
Q

Criteria for the diagnosis of AIDS?

A

AIDS criteria:

  • CD4 count <200
  • CD4 % <14% of all lymphocytes
  • Presence of an AIDs defining illness
500
Q

Burton line is caused by?

A

bacterial hydrogen sulfide reaction on lead in the gingival sulcus creating a precipitate of lead sulfide

501
Q

A rare subset of TUGSE contain atypical cells which react strongly with _____. As a result of this immuno finding it is thought that these may represent the oral counterpart of what disease? What are these lesions called?

A

-CD30 (a marker in lymphomatoid papulosis and anaplastic large cell lymphoma)
- primary cutaneous CD30+ lymphoproliferative
disorder
-atypical eosinophilic ulceration

*people are confused if this is a true low grade lymphoma or not. These lesions seem to heal spontaneously and patients do not show disseminated disease

502
Q

A presentation similar to Riga-Fede disease can be the initial finding in a variety of neurologic conditions related to self-mutilation, such as?

A
  • familial dysautonomia(Riley-Day syndrome)
  • Congenital indifference to pain
  • Lesch-Nyhan syndrome
  • Gaucher disease
  • cerebral palsy
  • Tourette syndrome
503
Q

Local factors associated with dysgeusia

A 
Oral candidiasis
Oral trichomoniasis
Desquamative gingivitis
Oral galvanism
Periodontitis or gingivitis
Chlorhexidine rinse
Oral lichen planus
Xerostomia
504
Q

Systemic factors associated with dysgeusia

A 
Vitamin deficiencies
Food allergy
Sjogrens
Nerve damage
eating disorders
Posionings
Mental disorders
Medications
505
Q

Flattening of the articular surface, osteosclerosis and osteolysis of bone beneath the cartilage, radiolucent subchondral cysts, and ossification within the synovial membrane (ossicles) are all features of?

A

osteoarthritis

506
Q

The most specific serologic marker for RA is

A

Anti-cyclic citrullinated protein antibodies (ACPAs or ACCPs)

507
Q

Synovial membrane biopsy shows: small whitish villi fragments composed of cellular debris admixed with fibrin and collagen. What is the term for this finding and what condition is it seen in?

A

rice bodies

RA

508
Q

Most common site affected by giant cell arteritis

A

Superficial temporal artery

509
Q

Polymyalgia rheumatica is a symptom of?

A

Giant cell arteritis

510
Q

Erethism

A

Neurologic symptoms of mercury poisoning including: excitability, tremors, memory loss, insomnia, shyness, weakness, and delirium.

511
Q

Ideal amount of fixative to tissue?

A

10:1

512
Q

Lewy bodies are a feature of what disease?

A

Parkinsons

513
Q

Fixation of tissue should take place for a minimum of __hrs and a max of ___ hrs

A

6 hours

48hrs

514
Q

Krukenberg tumor is what?

A

bilateral metastatic gastrointestinal neoplasia to the ovaries

515
Q

Rokitansky-ASchoff sinuses are a frequent feature of?

A

chronic cholecystitis

516
Q

What syndrome is a result of paternal deletion of 15q12

A

Prader-Willi syndrome

517
Q

What viral glycoproteins are critical for HIV infection/entry into host cell

A

gp120 and gp41

518
Q

Which light chain type is more common in amyloidosis

A

lambda (even though kappa is overall more prevalent normally)

519
Q

Most common immunoglobulin subtype in multiple myeloma

A

IgG

520
Q

Eczema herpeticum is a rare life-threatening manifestation of what disease? What populations are at increased risk?

A

HSV infection

-Dariers, eczema, newborns, pemphigus

521
Q

Significant drug interactions with fluconazole may occur with what drugs?

A

phenytoin
warfarin
sulfonylureas
cyclosporine

522
Q

Palmar and plantar pits are caused by?

A

localized impairment of the maturation of basal epithelial cells

523
Q

Marquis sign on histology refers to?

A

organisms lining up around the edge of vacuoles of leishmaniasis

524
Q

Erethism is the term for?

A

Neurologic symptoms of mercury poisoning

525
Q

Black foot disease is a manifestation of?

A

Arsenic poisoning causing dry gangrene

526
Q

What is Chrysiasis and what does it occur as a result of?

A
  • slate-blue discoloration of skin exposed to sun

- exposure to gold/gold toxicity
- historically given as treatment for RA or TB
- also effects sclera of eyes. Rarely oral

527
Q

A 12 year old presents with multiple nonvital teeth with associated parulides in the absence of caries or trauma. What is this characteristic of?

A

Vitamin D resistant rickets

Pulp horns extend to the DEJ

528
Q

Micro: no cementum associated with the root surface of an exfoliated tooth is a finding of?

A

Hypophophatasia

529
Q

A propensity for skin lesions to appear at a site of previous trauma is termed __________. What disease(s) do we frequently see this occur in?

A
  • Kobner phenomenon

- lichen planus, vitiligo, psoriasis, halo nevus

530
Q

Onionskin periosteal reaction is a feature of?

A

Ewing sarcoma

531
Q

Onionskin-like reaction can be seen in what benign process

A

Osteomyelitis with proliferative periostitis

532
Q

Rhomboid shaped PAS-D positive crystals are a feature of?

A

alveolar soft part sarcoma

533
Q

What are the American college of RA criteria for Sjogren syndrome?

A

Patients have at least 2 of the 3 major features

  • Positive autoantibodies (SSA and/or SSB, OR + RF AND + ANA titer >1:320)
  • Labial minor gland biopsy with >1 focus score/4mm^2
  • Keratoconjunctivities sicca with ocular staining score >/= 3
534
Q

What are the two eye tests used in the diagnosis of Sjogrens syndrome

A

Rose bengal dye test: stain the eye and then examine under a slit lamp
Schirmer test: filter paper over the lower eye lid and measure <5mm in 5 minutes

535
Q

Granules within oncocytes are mitochondria which can be seen with ________ stain

A

PTAH(phosphotungstic acid hematoxylin)

536
Q

The differential for acinic cell carcinoma is frequently what other salivary entity?

A

secretory carcinoma

537
Q

The amorphous material seen in a biopsy of plasminogen deficiency will stain positive with?

A

Fraser-lendrum stain

538
Q

How do you treat lesions of plasminogen deficiency

A
  • Topical heparin and prednisone combined

- Surgical excision + systemic doxy, topical chlorhexidine, systemic warfarin

539
Q

Symmetric intracranial calcifications of the medial temporal lobes is a feature in 70% of people with what condition?

A

Lipoid proteinosis

540
Q

PAS positive congo red negative amorphous material depositing in a lamellar configuration around blood vessels is the micro description of?

A

lipoid proteinosis

541
Q

Ziehl-Neelson is a specific type of what stain?

A

acid-fast stain used to see mycobacterium like TB

542
Q

What fluorescent stain is now frequently used to identify tuberculosis?

A

auramine-rhodamine stain

fluorescent stain for mycobacterium

543
Q

A fite stain is used for the visualization of?

A

mycobacterium leprae of leprosy

544
Q

The protozoa of leishmaniasis are stained with?

A

Giemsa

Brown-hopps (tissue gram stain)

545
Q

What would be on your differential with neurothekeoma? What stains could you use to distinguish between these entities?

A

Nerve sheath myxoma
Maybe melanoma

Neurothekeoma= S100 NEGATIVE; MITF +, CD63+, Melan A negative
Nerve sheath myxoma: S100+,

546
Q

Sydenham chorea is a manifestation of?

A

Acute rheumatic fever

= involuntary jerking movements that can occur for up to months after infection

547
Q

What populations are most greatly affected by salivary lymphoepithelial carcinoma

A

Eskimos, Chinese, Taiwan

548
Q

Follicular hyperplasia of lymph node= germinal centers are BCL2 _____
Follicular lymphoma = germinal centers are BCL2 _____

A

follicular hyperplasia GC: BCL2 negative

Lymphoma GC: BCL2 positive

549
Q

Normal lymphoid follicles show positivity for what markers within GC ______; what maker is positive in the mantle cells and T cells?
Other positive general follicle markers include

A

CD10, BCL6 GC markers
BCL2 positive in mantle and T cells surrounding

Follicles are just B cells: CD19, CD20, CD22, and CD79a

550
Q

Infiltrative spindle cell neoplasm in the myometrium that has prominent myxoid stroma and a dense lymphoplasmacytic infiltrate. It is positive for desmin, smooth muscle actin and ALK by immunohistochemistry and shows ALK rearrangement by FISH. What is the most likely diagnosis?

A

Inflammatory myofibroblastic tumor

551
Q

H3F3A and H3F3B were found in 85% of _________ and 88% of ______.

A

giant cell tumors of bone

chondroblastomas

552
Q

The following micro description is for what lesion: The neoplastic round and polygonal cells are chondroblasts positive for S-100. Multinucleated giant cells are of different cell line and stain positive for histiocytic markers (CD68). “Chicken-wire” calcifications.

A

Chondroblastoma

553
Q

Medullary thyroid carcinoma is a malignancy of what cell type?

A

C cells aka parafollicular cells of the thyroid

554
Q

Leukocytoclastic vasculitis is a histologic pattern seen in what conditions

A

Discussed in neville: Behcets, Wegners

ALSO: Includes drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, amyloidosis, antiphospholipid syndrome, atrial myxoma, Behcet disease, Churg-Strauss syndrome, granulomatosis with polyangiitis, Henoch-Schonlein Purpura, urticarial vasculitis, ITP and more

555
Q

Argyrophilic granules of merkel cell carcinoma can be seen with______ stain

A

Grimelius

(or any silver stain for that matter Argyro = Ag aka silver)

556
Q

soap bubble radiolucency has been used to describe what lesion(s)

A

Ameloblastoma
myxoma
intrabony vascular malformations

557
Q

DILS represents a positive or negative prognostic marker in HIV infection?

A

Positive prognostic though increased risk of lymphoma

558
Q

Laminated basophilic calcifications in sarcoidal granulomas are called _____ and composed of _____

A

Schaumann bodies

made of degenerated lysosomes

559
Q

__________ are composed of reduplicated basement membrane and cytoplasmic processes

A

verocay bodies

560
Q

loose bodies(joint mice) are a feature of

A

synovial chrondromatosis

561
Q

round bodies are another name for? what are these a histologic feature of

A

corp ronds

-warty dyskeratoma

562
Q

Auer rods are a feature of what disease(s)

A

(or Auer bodies)
large, crystalline cytoplasmic inclusion bodies sometimes observed in myeloid blast cells during acute myeloid leukemia, MDS, or CML

563
Q

Marquee sign on histology refers to?

A

organisms lining up around the edge of vacuoles of leishmaniasis

564
Q

Old person, sun-damaged skin, spindle cell tumor of the head and neck area. What is the most likely diagnosis

A

Angiosarcoma

565
Q

Benign Lymphoepithelial Lesion are associated with what disease/condition?

A

Sjögren Syndrome.

Defined as: Lymphocytic infiltrate with an associated epimyoepithelial island.

566
Q

Neonatal hypoglycemia is a feature of?

A

Beckwith wiedemann syndrome

567
Q

Subperiosteal resorption of phalanges of index and middle finger are features of?

A

hyperparathyroidism

568
Q

What lesion originates in Fossa of rosenmuller?

A

Nasopharyngeal carcinoma

569
Q

Organ dysfunction caused by infiltration by LCH is considered low risk when involving what organs?

A

skin, bone, lymph node, pituitary gland

570
Q

anti-Saccharomyces cerevisiae antibodies (ASCA) are used to distinguish between which two conditions? If present what do you favor?

A

Crohns and Ulcerative colitis

-ASCA+ favors Crohns

571
Q

p-ANCA antibodies in the setting of IBD symptoms is most specific for?

A

Ulcerative colitis

572
Q

____ is the 2nd most common primary malignant bone tumor in children after osteosarcoma

A

Ewing sarcoma

573
Q

Benign, vascular tumor of spleen arising from red pulp is called?

A

Littoral cell angioma

574
Q

Cerebriform nucleus of sezary cells seen on _______ _______ sections

A

semithin embedded

575
Q

Tumors with Glycogen

A

Ewing Sarcoma
Oncocytoma
Clear cell odontogenic carcinoma
Leiomyosarcoma

576
Q

Syndromes associated with neutropenia

A

Schwachman-Diamond Syndrome
Severe congenital neutropenia
Dyskeratosis congenita
Cartilage-hair syndrome

577
Q

Hamman’s Crunch

A

Crepitus synchronous with heartbeat in cervicofacial emphysema with mediastinal involvement

578
Q

Cell of origin for renal cell carcinoma

A

proximal convoluted tubule

579
Q

Most significant risk factor for RCC

A

Smoking

580
Q

Most common type of RCC and its genetic alteration

A

Clear cell

-deletion of short arm of chromo 3 harboring VHL gene

581
Q

Denosumab mechanism of action and common drug names

A

RANK ligand inhibitor

Prolia, Xgeva

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