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GI block > GI Goljan oral cavity, salivary disorders > Flashcards

GI Goljan oral cavity, salivary disorders Flashcards

1
Q

What is the most common congenital disorder of oral cavity?

A

cleft lip and palate (50%);
cleft lip alone (25%)
cleft palate alone (25%)

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2
Q

Who is cleft lip and palate most common in?

A

whites > blacks;
lip alone- male > female
palate alone- female > male

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3
Q

Genetics involved in cleft lip and palate?

A

recurrence in subsequent siblings (3%)

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4
Q

complications of cleft lip and palate?

A

malocclusion;
eustachian tube dysfunction => chronic otits media
speech problems

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5
Q

pathogenesis of cleft lip and palate?

A

failure of fusion of facial processes

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6
Q

Tx for cleft lip and palate?

A

surgery

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7
Q

What 4 oral manifestations of HIV are found?

A

candidiasis;
apthous ulcers (stomatitis, canker sores);
hairy leukoplakia;
kaposi’s sarcoma

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8
Q

what is the most common oral infection associated w/ HIV?

A

candidiasis

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9
Q

what is the origin of apthous ulcers?

A

unknown but virus vs immunologic and often

STRESS INDUCED

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10
Q

define apthous ulcers

A

painful ulcers covered by shaggy gray membrane

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11
Q

define hairy leukoplakia

A

glossitis due to EBV

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12
Q

What is kaposi’s sarcoma caused by? where is the most common location?

A

HHV-8;

location: hard palate

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13
Q

what is the causative agent of dental caries? how does it lead to dental caries?

A

streptococcus mutans produces sucrose fermentation => acid erodes enamel to expose underlying dentine

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14
Q

What aids in prevention of dental caries? what happens if there is too much of this substance?

A

fluoride;

chalky discoloration of teeth

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15
Q

what are 4 noninfectious ulcerations in oral cavity?

A

pemphigus vulgaris & mucus membrane pemphigoid => immunologic
erythema multiforme;
apthous ulcers
Behcets syndrome

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16
Q

What will cause erythema multiforme?

A

HSR against Mycoplasma or drugs (sulfonamides);

Stevens-Johnson syndrome when it involves the mouth

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17
Q

Epidemiology of Behcet’s syndrome

A

environmental and genetic factors;
HLA-B51, HLA-B27;
precipitated by HSV or parvovirus;
high incidence in Turkey and east mediterranean

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18
Q

pathophys of Behcet’s syndrome

A

immune complex small vessel vasculitis

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19
Q

clinical findings of Behcet’s syndrome

A

recurrent apthous ulcers, genital ulcerations;
uveitis, erythema nodosum;
attacks last 1-4 wks

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20
Q

Tx of Behcet’s syndrome

A

anti-inflam Rx;
corticosteroids;
colchicine;
thalidomide

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21
Q

3 oral pigmentation abnormalities

A

Peutz-Jeghers syndrome;
Addison’s disease;
Lead poisoning

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22
Q

How does Peutz Jeghers syndrome present?

A

Melanin pigmentation of lips and oral mucosa

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23
Q

Where does addison’s disease present in the mouth? What causes it?

A

melanin pigmentation of buccal mucosa => increased ACTH stimulates melanocytes

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24
Q

A person suffering from lead poisoning will present where?

A

lead deposits along gingival margins in adults w/ gingivitis

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25
Q

What can cause tooth discoloration?

A

tetracycline;
excess fluoride
congenital erythropoietic porphyria

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26
Q

Who is tetracycline not recommended for? why?

A

children under 12 due to coloring of newly formed teeth

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27
Q

How does congenital erythropoietic porphyria present?

A

porphyrins deposit in teeth => reddish brown discoloration

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28
Q

What are 5 possible causes of macroglossia (enlarged tongue)?

A 
myxedema (severe 1' hypothyroidism);
down syndrome;
acromegaly;
amyloidosis;
mucosal neuromas in MEN IIb
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29
Q

define glossitis (inflammation of tongue)

A

sore, beefy red tongue w/ or w/o papillary atrophy

30
Q

What are the 6 causes of glossitis?

A 
long standing Fe deficiency;
Vit B12 or folate deficiency;
scurvy (vit C deficiency);
pellagra (niacin deficiency);
scarlet fever;
EBV assoc hairy leukoplakia
31
Q

What is leukoplakia? rate to oral cancer?

A

white patch;

30% rate of progression to oral cancer

32
Q

what is erythroplakia? rate of oral cancer?

A

red patch;

60% rate of progression to oral cancer

33
Q

Leukoplakia and erythroplakia are due to what? risk for cancer?

A

lesions due to squamous hyperplasia of epidermis;

increased risk for squamous dysplasia or invasive squamous cancer

34
Q

What are 4 causes of leukoplakia and erythroplakia?

A

chronic irritation (dentures);
all forms of tobacco use;
alcohol abuse;
HPV

35
Q

what are the 4 locations of leukoplakia and erythroplakia? give most common

A

vermilion border lower lip (most common site);
buccal mucosa;
hard and soft palates;
floor of mouth

36
Q

what should be done if leukoplakia and/or erythroplakia is suspected?

A

always biopsy bc of high risk for progression to oral cancer

37
Q

Define lichen planus of oral cavity and what it is associated w/

A

fine, white, lacy lesions assoc w/ Wickham’s stria on buccal mucosa;
may be assoc w/ squamous cell carcinoma

38
Q

what does dentigerous cyst derive from?

A

epithelial elements of dental origin => odontogenic origin

39
Q

What 2 associations are found in dentigerous cyst?

A

crown of an unerupted or impacted 3rd molar tooth

ameloblastomas in 15-30% of cases

40
Q

What are 2 benign tumors of oral cavity excluding salivary gland?

A

squamous papillomas;

ameloblastoma

40
Q

What are 2 benign tumors of oral cavity excluding salivary gland?

A

squamous papillomas;

ameloblastoma

41
Q

What is the most common benign tumor of oral cavity?

A

squamous papillomas

41
Q

What is the most common benign tumor of oral cavity?

A

squamous papillomas

42
Q

what is an exophytic tumor w/ fibrovascular core?

A

squamous papillomas

42
Q

what is an exophytic tumor w/ fibrovascular core?

A

squamous papillomas

43
Q

Where does squamous papillomas occur?

A

tongue, gingiva, palate or lips

43
Q

Where does squamous papillomas occur?

A

tongue, gingiva, palate or lips

44
Q

where does ameloblastoma arise from?

A

enamel organ epithelium or dentigerous cyst

44
Q

where does ameloblastoma arise from?

A

enamel organ epithelium or dentigerous cyst

45
Q

Where is the ameloblastoma located? how does it present?

A

mandible;
radiolucency in bone w/ “soap bubble” appearance;
locally invasive but do NOT metastasize

45
Q

Where is the ameloblastoma located? how does it present?

A

mandible;
radiolucency in bone w/ “soap bubble” appearance;
locally invasive but do NOT metastasize

46
Q

What are the 6 risk factors for malignant tumors of oral cavity? most common factor

A

smoking (most common-pipe, cigarettes, chew);
alcohol abuse (synergistic w/ smoking);
synergism bw smoke & alcohol excess increase 30x;
HPV;
chronic irritation from dentures;
lichen planus

46
Q

What are 4 salivary gland disorders?

A

Sjogren’s syndrome;
pleomorphic adenoma;
Warthin’s tumor;
Mucoepidermoid carcinoma

47
Q

who is malignant tumor of oral cavity most common?

A

well-differentiated squamous cell carcinoma;

men > women

47
Q

who is malignant tumor of oral cavity most common?

A

well-differentiated squamous cell carcinoma;

men > women

48
Q

What are the 3 most common malignant tumor sites of oral cavity?

A

1) lower lip (vermilion border)
2) floor of mouth
3) lateral border of tongue

49
Q

Where do malignant tumors of oral cavity metastasize?

A

tonsillar node => superior jugular node

50
Q

What is a specific malignant tumor of oral cavity associated w/ smokeless tobacco?

A

verrucous carcinoma

51
Q

what is most common cancer of upper lip? what is associated with?

A

basal cell carcinoma;

UVB exposure

52
Q

Tx for squamous cancer of oral cavity?

A

surgery / radiation;

CTX in advanced cases

53
Q

What are 4 salivary gland disorders?

A

Sjogren’s syndrome;
pleomorphic adenoma;
Warthin’s tumor;
Mucoepidermoid carcinoma

54
Q

define sjogren’s syndrome

A

female dominant AI destruction of minor salivary and lacrimal glands

55
Q

What AI disease is associated with Sjogren’s syndrome?

A

rheumatoid arthritis

56
Q

what is most common site of salivary gland tumor?

A

parotid gland

57
Q

which salivary glands tumors are benign? malignant?

A

major salivary gland tumors => benign

minor salivary gland tumors => malignant

58
Q

What is most common benign tumor of major and minor salivary glands? most common site?

A

pleomorphic adenoma;

parotid gland

59
Q

define pleomorphic adenoma

A

female dominant; painless, moveable mass at angle of jaw

60
Q

How does pleomorphic adenoma present on histology? what causes increase risk of recurrence?

A

epithelial cells intermixed w/ myxomatous & cartilaginous stroma;
projections through capsule increase recurrence

61
Q

What is a sign of malignancy of pleomorphic adenoma?

A

facial nerve involvement

62
Q

What is a male dominant benign tumor of parotid gland?

A

Warthin’s tumor => papillary cystadenoma lymphomatosum

63
Q

define warthin’s tumor

A

heterotopic salivary gland tissue trapped in lymph node => cystic glandular structures

64
Q

Define mucoepidermoid carcinoma (location, epidemiology)

A

most common malignant salivary gland tumor;
parotid gland;
mixture of neoplastic squamous and mucus-secreting cells

GI block (11 decks)

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