Final Review Flashcards
Red area surrounded by white areas on tongue, buccal, floor of mouth, soft palate. geographic tongue on area of mouth, not just on tongue? dx is ?
Migratory mucositis
Migratory mucositis is usually associated with what?
Fissured tongue
Old patient, red/bluish/purple, elevated areas in ventral tongue. What test do you dofirst?
Pressure test
Old patient, red/bluish/purple, elevated areas in ventral tongue. what is it?
Variscosities
Patient with multiple, hard, growths on buccal/lingual, 30 yo, male. dx is
Exostosis
Young, 18 yo, white lesions in mouth, skin rash, concentric target lesions on palm and soles, dx in this case is ?
secondary syphilis
b/c syphilitic roseola and the skin rash, and the secondary lesions are common in syphilis and not in erythema multiforme ….
T/F -(target lesions are in secondary syphilis and erythema multiforme)
True
Asthma patient, using steroids inhaler, red, flat areas, commonly dorsum of tongue and palate. dx is?
atrophic candida
is usually red and flat (with or without white areas). commonly in steroid inhaler patients
uni- or bi-lateral, fissures, ulcerations in corner of mouth. also produced by candida. very few times associated with bacteria. produced by decreased vertical dimension.
angular chelitis
What is the tx of angular chelitis?
tx = antifungal (eg. nystatin).
Very young boy, vesicles (characteristic of viruses), fever, lymphadenopathy, on skin and mucosa. dx is ?
primary herpes simplex
b/c of age and located everywhere.
is unilateral. vesicles, on lip, typical vesicles, inside mouth = on palate or gingiva. on ATTACHED mucosa, NOT movable (movable is canker sore). usually can’t see vesicles in mouth b/c they break easily. group of ulcers on palate or gingiva. side note - herpes virus is DNA virus.
recurrent herpes (two cases, 1 inside the mouth on fixed mucosa and 1 on the lip)
Ulcers, crusts, vesicles, on part of face/mouth, unilateral, not cross midline, painful. dx is ?
herpes zoster (aka recurrent chickenpox)
Young boy, fever, large lymphadenopathy, petechia on palate. What does he have?
mononucleosis
What is the etiology of mononucleosis?
EBV
Male, fever, recurrent infections, candidiasis, herpes, skin lesions, brown spots. dx is ?
HIV/AIDS
Male, fever, recurrent infections, candidiasis, herpes, skin lesions, brown spots. brown spots on skin and mucosa. dx is ?
kaposi sarcoma.
sarcoma = malignant tumor of mesenchymal tissue. kaposi sarcoma is cancer of blood vessels? superficial multiple blood vessel cancer, etiology is AIDS HERPES 8
Osteoporosis patient, exposed bone, gingiva is broken. dx is ?
BON.
Put the patient on antibiotics and clean the area as much as you can NO AGGRESSIVE SURGERY
Brown lesion. take an x-ray, see amalgam. dx is ?
amalgam tattoo.
most common pigmented lesion. don’t actually need to have amalgam restoration since particles are in the mucosa.
Extreme pain on floor of mouth, two small ulcers white surrounded by red, inflamed tissue, on MOVABLE mucosa not fixed (ex gingiva). multiple and recurrent and painful dx is
aphthous ulcers
How do you tx aphthous ulcers ?
don’t usually treat, will go away on its own
Enlarged, red, firm, uniform, not bleeding (unless it’s plaque related). Dx?
allergic gingivitis
most common cause in mouth = ARTIFICIAL cinnamon.
White, verrucous, pedunculated, cauliflower-like. benign. pressure test on the red lesions, if blanches = benign blood vessel lesion (could also be varicosity or hemangioma but in this case its papilloma), malignant ones don’t blanch.
papilloma
etiology = HPV.
Young child, multiple, usually pink (sometimes white), slightly elevated lesions, on buccal mucosa, tongue, and lip. dx is ?
Heck’s disease/focal epithelial hyperplasia
is an HPV lesion. almost always in children, all over mouth, not painful, will heal by themselves but it takes a long time, benign, no tx needed
Single, small, is flat, uniformly pigmented, well circumscribed, in anywhere, freckle in mouth. dx is ?
focal melanotic macule
do biopsy
Elevated and usually on skin. pigmented, small, one, elevated, uniform, circumscribed, non-ulcerated
Nevus
Generalized,multiple, white, irregular, elevated, verrucous, old patient, disease of old people, 80% will be cancerous (pre-malignant). What is it?
proliferative verrucous leukoplakia (PVL)
What is the tx of Proliferative verrucous leukoplakia?
tx = remove the lesion, but usually comes back. most patients likely will get SCC.
Crown prep the day before. injected anesthesia with epi. today, painful, ulceration, on hard palate, after dental treatment. What is dx?
necrotizing sialometaplasia
due to epi b/c of vasoconstriction of blood vessels. tx = none needed b/c will heal by itself. can do biopsy if unsure
Blistering conditions. autoimmune, bilateral, buccal mucosa. What do you do?
do biopsy = one in formalin solution and one in mischel solution. immunofluorescence
Blistering condition, biopsy in formalin, epithelium destroyed, autoimmune, more common in females. antibodies against DESMOSOMES. blisters are INTRA-epithelium (+). Dx is?
pemphigus vulgaris
Sessile, covered by normal mucosa, on cheek. dx is ?
traumatic fibroma
most common diagnosis
Appears as long hair on tongue, can be white or brown. Dx is?
hairy leukoplakia
etiology = EBV. condition of HIV/immunocompromised patients.
Baby with mass on alveolar ridge, newborn, growth on gingiva. dx is ?
congenital epulis/epulis of the newborn
tx = will go away by itself, but remove via excision b/c parents
Pressure test is positive, baby born with irregular, red mark on face, congenital. Dx is?
hemangioma
It’s a benign tumor of blood vessels.
Antibodies against HEMIDESMOSOMES (34) on basement membrane. SUB-epithelial vesicle (+). Dx is?
pemphigoid
RED/erythematous. most commonly in floor of mouth, not usually painful, old people. do biopsy (if not hemangioma or trauma). hyperchromatic cells, diff shapes, looks malignant, but only within epithelium/no vessels/ no metastasis if left untreated becomes invasive via blood or lymphatic vessels (not yet broken basement membrane to CT), old people.
carcinoma in situ.
Etiology = HPV, radiation, chemicals, tobacco, alcohol, genetics. if metastasizes, it travels through lymph vessels, first on unilateral side, later to contralateral side. most common location for SCC = lateral border of tongue. (answer most likely all the above) (mentioned genetics is most important) (37).
SCC.
Old patient, blurring of vermillion border, produced by the SUN, diffuse, ulceration, scar, crater. dx is ?
actinic cheilitis
Not inside mouth, produced by sun, crater-like ulcer, rarely metastasizes, UV radiation is a risk factor
basal cell carcinoma
All is true regarding basal cell carcinoma EXCEPT: answer would be “inside the mouth” (since it’s false) (39)
Hyperchromatism (appear black), Pleomorphism, Keratin pearls , Alteration, Cytoplasm:Nucleus ratio, Atypical mitosis, Dyskeratosis, Disorganization of cells, Lack of cohesiveness. This is histology of what?
Squamous cell carcinoma
Not uniform, not flat, no hair, satellite lesions, different colors, irregular borders, ulcerations, may not always be pigmented (variation of colors), may arise from a previous nevus. most common place on palate. prognosis worse in mouth than skin. also, prognosis is worse going posteriorly. vertical growth indicator of aggressiveness and malignancy.
melanoma
Most common salivary gland tumor in KIDS, most commonly inside bone, most common malignant salivary gland tumor, ulcerated.
mucoepidermoid carcinoma
- Most common of all salivary gland tumor is what?
pleomorphic adenoma/mixed tumor
malignancy: sublingual = 99% (43), submandibular = 60%, palate = 50%, parotid = 30%. no salivary gland tumor in gingiva or in midline of palate. benign tumors of salivary gland are less benign than any other benign tumor. cancer of salivary gland tumors are less aggressive than other cancers
Where are salivary glands NOT found?
NO SALIVARY GLAND TUMORS IN GINGIVA or midline of palate (44). gingiva doesn’t have salivary glands
Patient with lots of tissue coming out from under denture. usually due to ill-fitting denture. can also be associated with fungus and palatal papillomatosis as well.
Epulis fissuratum (aka Inflammatory fibrous hyperplasia)
Patient bit lower lip, translucent, bluish look now. Dx is?
Mucocele
What are the 3 P’s of red lesions?
- pyogenic granuloma
- peripheral ossifying fibroma
- peripheral giant cell granuloma
You did an extraction and now patient has a mass near area of surgery,–> the nerve start growing and become a mass covered by normal mucosa. Nerve was cut. What is the dx?
traumatic neuroma
tx = usually remove
Patient has anemia, infections, bleeding, Radiolucency in bone. Dx?
multiple myeloma
What is a malignancy seen as in an X-ray?
diffuse and radiolucent
