Gastrointestinal pathology - Oral cavity Flashcards
A 20 year old sophomore studying for her finals comes to the student clinic presenting with complaints of painful ulceration in the mouth. What usually causes it? What would you tell her? How would you characterize it?
She has aphthous ulcer caused by stress and resolves spontaneously. Characterized by grayish base surrounded by erythema.
What causes cleft lip and palate? Which is more common - isolated or together?
It is due to the failure of facial prominences to grow and fuse together to form the face. Together is more common
A 37 year old dancer comes to the derm clinic complaining of painful ulcers in his mouth. Upon physical exam, you note that he also has ulcers on the genitals. When doing the vision test, you notice that his eyes are red and he is sensitive to light. What does he have? What is causing it? He mentioned that he recently had an infection. Do you guess it is viral or bacterial?
He has Behcet syndrome which are recurrent aphthous ulcers, genital ulcers and uveitis. It is due to immune complex vasculitis involving small vessels. Can be seen after Viral infection.
A 27 year old musician comes for his annual checkup presenting with painful red ulcers that are shallow and which rupture. He has been worried about his latest album sales. What does he have? When is the primary infection for this? Where does the virus hang out? What usually reactivates the virus?
He has oral herpes usually due to HSV 1. Primary infection occurs during childhood and lesions heal. Virus remains dormant in ganglia of the trigerminal nerve. Stress and sunlight can cause reactivation of the virus.
A 56 yo retired teacher with a 27 year pack history of smoking and two stints at an alcohol rehab center presents to your clinic for a checkup. When checking his tongue you see red plaques. What carcinoma is he at risk of? What do the red plaques suggest? Where does this usually present? What are some precursor lesions?
Squamous cell carcinoma with malignant neoplasm of squamous cells lining the oral mucosa. Floor of the mouth is the most common location. Red plaques suggest erythroplakia which are indicative of squamous cell dysplasia. Do a biopsy to rule out squamous cell carcinoma.
What is the difference between oral candidiasis and hairy leukoplakia?
Oral candidiasis is a white deposit on the tongue which is easily scraped away. Usually seen in immunocompromised states.
Hairy leukoplakia is a white, rough hairy patch that arises on the lateral tongue. Usually seen in AIDS patients and is due to EBV induced squamous cell hyperplasia. It is not premalignant.
What is the difference between oral leukoplakia and erythroplakia?
Oral and erythroplakia cannot be scraped away. Erythroplakia is vascularized an is highly suggestive of squamous cell carcinoma.
