GI Flashcards
Painful, superficial ulceration of the oral mucosa characterized by a grayish base (granulation tissue) surrounded by erythema?
Aphthous ulcer
Clinical triad of Behcet’s syndrome?
Recurrent aphthous ulcers + genital ulcers + uveitisPatients may also present with erythema nodosum = painful, red, subcutaneous, elevated nodules, typically located over the anterior aspect of the tibia.
Pathophysiology of Behcet’s syndrome?
Immune complex small vessel vasculitis
Pathophysiology of cleft lip/palate?
Failure of fusion of the facial processes/prominences
Vesicular lesions of the oral mucosa that rupture, resulting in shallow, painful red ulcers?
Oral herpes
Viral cause of oral herpes?
HSV-1
Oral herpes - primary infection vs. re-infection?
Primary infection presents with fever and lymphadenopathy, re-infection does not.
Site of HSV-1 latency?
Cranial sensory ganglia (trigeminal ganglia) HSV-1 virus remains dormant in trigeminal nerve sensory ganglia until stress/sunlight/menses precipitates reactivation and re-infection.
Bacterial cause of dental caries?
Streptococcus mutans
Pathophysiology of dental caries?
Streptococcus mutans produces acid from sucrose fermentation, which erodes enamel.
Inflammatory skin condition characterized by erythematous macules/papules that resemble target lesions (“bull’s eye lesions”) that can become bullous?
Erythema multiforme
Erythema multiforme that involves the mouth = ?
Stevens-Johnson syndrome
Melanin pigmentation present on the buccal mucosa?
Addison disease
Pathophysiology of melanin pigmentation on the buccal mucosa in Addison disease?
Increased ACTH stimulates melanocytes
Melanin pigmentation of the lips and oral mucosa?
Peutz-Jeghers syndrome
Glossitis a/wbilateral white excrescences on the lateral border of the tongue?
Hairy leukoplakia (pre-AIDS defining lesion)
Viral cause of hairy leukoplakia?
EBV
Histology of leukoplakia/erythroplakia?
Squamous hyperplasia of the epidermis
Which of the following 4 may progress to oral cancer? Oral candidiasis, hairy leukoplakia, leukoplakia, erythroplakia
Leukoplakia and erythroplakia - May progress into squamous dysplasia or invasive squamous cell carcinoma (SCC)Erythroplakia > leukoplakia re: progression to oral cancer
Wickham striae (fine, white, lacy lesions) on the buccal mucosa?
Lichen planus
Most common benign tumor in the oral cavity?
Squamous papilloma(Exophytic tumor with a fibrovascular core)
Major risk factors for squamous cell carcinoma of the oral cavity?
Tobacco and alcohol (synergistic)HPV
Squamous cell carcinoma of the oral cavity site of metastasis?
Tonsillar node (superior jugular node)
Most common cancer of upper lip?
Basal cell carcinoma
Most common cancer of lower lip?
Squamous cell carcinoma
Malignancy of the oral cavity associated with UV-B light expsure?
Basal cell carcioma
Malignancy of the oral cavity a/w smokeless tobacco?
Verrucous carcinoma
Major salivary glands?
Parotid, submandibular, and sublingual
Mumps clinical features?
Bilateral parotitisUnilateral orchitis/oophoritisPancreatitisMeningoencephalitis(Sterility is rare b/c of unilateral involvement of testes/ovaries, but more common in adolescence and adulthood. Childhood mumps rarely involves testes/ovaries).
Laboratory finding in mumps?
Elevated serum amylase 2/2 parotitis and/or pancreatitis
Bacterial inflammation of a major salivary gland?
Sialdenitis
Bacterial cause of sialdenitis?
Staphylococcus aureus
MCC sialdenitis in post-op patients?
Inflammation of major salivary gland 2/2 calculus (stone) obstructing the duct (sialolithiasis)
Clinical triad of Sjogren syndrome?
Keratoconjunctiva sicca (dry eyes), xerostomia (dry mouth), and an associated connective tissue disease (most often rheumatoid arthritis)
Pathophysiology of Sjogren syndrome?
Autoimmune destruction of the minor salivary and lacrimal glands
Sjogren syndrome is a/w increased incidence of what cancer?
Lymphoma
Presents as a mobile, painless, circumscribed mass at the angle of the jaw?
Pleomorphic adenoma
Salivary gland tumors:Epithelial cells intermixed with myxomatous and cartilaginous stroma
Pleomorphic adenoma (mixed tumor) - BenignMost common tumor of salivary glands
Salivary gland tumors:Heterotopic (ectopic) salivary gland tissue trapped in a lymph node
Warthin tumor (papillary cystadenoma lymphomatosum) - Benign- Cystic tumor with abdundant lymphocytes and germinal centers (cystic glandular structures locayed within benign lymph node tissue).
Salivary gland tumors:Mixture of neoplastic squamous cells and mucus-secreting cells
Mucoepidermoid carcinoma - MalignantMost common malignant tumor of salivary glands
Sign that pleomorphic adenoma has transformed into a malignant carcinoma?
Facial nerve involvement/damage (facial nerve runs through parotid gland)
