GI - Oral Cavity; Salivary Glands; Esophagus; Stomach

Question 1

What is the technical term for a canker sore?

Answer 1

An aphthous ulcer

Question 2

Describe the initial and secondary mechanism of disease of aphthous ulcers.

Answer 2

1. Mononuclear infiltrate
2. Followed by secondary bacterial infection (neutrophilic infiltrate)

Question 3

How are aphthous ulcers treated?

Answer 3

Spontaneous resolution

(after ~7 days)

Question 4

What are the three S/Sy of Beçet syndrome?

Answer 4

1. Aphthous ulcers
2. Uveitis
3. Genital ulcers

Question 5

What is stomatitis?

Answer 5

Inflammation of the oral cavity and lips

Question 6

Most cases of herpetic stomatitis are caused by what?

Answer 6

HSV-1

(HSV-2 also possible)

Question 7

An eleven year old child presents with an abrupt onset of vesicles / ulcerations of the oral mucosa (particularly the gingiva) accompanied by lymphadenopathy, fever, anorexia, and irritability.

What is the cause?

Answer 7

Acute herpetic gingivostomatitis

(HSV-1)

Question 8

True/False.

The S/Sy of HSV-1 infection in children (acute herpetic gingivostomatitis) occurs in 10 - 20% of cases.

Answer 8

True.

Infection is asymptomatic in 80 - 90% of cases.

Question 9

How long do cases of viral reactivation and herpes labialis typically take to resolve in adults?

Is treatment typically necessary?

Answer 9

~7 days;

no

Question 10

Which premalignant lesions presents a more ominous prognosis, oral leukoplakia or oral erythroplakia?

Answer 10

Oral erythroplakia

Question 11

95% of cancers of the head and neck are what?

Answer 11

Squamous cell carcinomas

Question 12

Name two odontogenic tumors.

Answer 12

Ameloblastomas;

odontomas (more common)

Question 13

What term refers to inflammation of the salivary gland (induced by trauma, viral or bacterial infection, or autoimmune disease)?

Answer 13

Sialadenitis

Question 14

What subtype of sialadenitis is most common in fall-prone individuals in which trauma leads to either blockage or rupture of a salivary gland duct, with consequent leakage of saliva into the surrounding connective tissue stroma?

Answer 14

Mucocele

Question 15

An elderly patient presents with a fluctuant swelling of the lower lip that has a blue translucent hue.

What is the diagnosis?

Answer 15

Mucocele

Question 16

A(n) _________ is an epithelial-lined cyst that arises when the duct of the sublingual gland has been damaged.

Answer 16

A ranula is an epithelial-lined cyst that arises when the duct of the sublingual gland has been damaged.

Question 17

What autoimmune disorder leads specifically to xerostomia?

Answer 17

Sjögren’s syndrome

Question 18

_______ is the most common form of viral sialadenitis, in which the major salivary glands, particularly the parotids, are affected.

Answer 18

Mumps is the most common form of viral sialadenitis, in which the major salivary glands, particularly the parotids, are affected.

Question 19

Nonspecific bacterial sialadenitis: Decreased secretory function (usually due to stones or sialolithiasis) predisposes to secondary bacterial (______, ______) invasion. Presents as a ____lateral inflammation.

Answer 19

Nonspecific bacterial sialadenitis: Decreased secretory function (usually due to stones or sialolithiasis) predisposes to secondary bacterial (S. aureus, S. viridans) invasion. Presents as a unilateral inflammation.

Question 20

What is the most common salivary gland tumor?

Answer 20

Plemorphic adenoma (mixed tumor)

Question 21

Plemorphic adenomas (mixed tumor) typically present in which organ?

Answer 21

Parotid glands

Question 22

Describe the histology of plemorphic adenomas (mixed tumors).

Answer 22

A mixture of ductal (epithelial) and myoepithelial cells

Question 23

Pleomorphic adenomas (mixed tumors) are associated with chromosomal rearrangements involving ______ (gene).

Answer 23

Pleomorphic adenomas (mixed tumors) are associated with chromosomal rearrangements involving PLAG1.

Question 24

Are there any risk factors for pleomorphic adenomas (mixed tumors)?

Answer 24

Radiation exposure

Question 25

\_\_\_\_\_\_\_\_\_ tumor (\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_) is the second most common benign tumor of the salivary gland and arises exclusively in the parotid gland.

Answer 25

**_Warthin_** tumor (**_papillary cystadenoma lymphomatosum_**) is the second most common benign tumor of the salivary gland and arises exclusively in the parotid gland.

Question 26

Warthin tumors exhibit a mix of ________ and ________ cells.

Answer 26

Warthin tumors exhibit a mix of **_epithelial_** and **_lymphoid_** cells.

Question 27

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ are the most common malignant tumors of the salivary glands composed of variable mixtures of squamous cells, mucus-secreting cells, and intermediate cells.

Answer 27

**_Mucoepidermoid carcinomas_** are the most common malignant tumors of the salivary glands composed of variable mixtures of squamous cells, mucus-secreting cells, and intermediate cells.

Question 28

Mucoepidermoid carcinomas of the salivary glands are associated with what genetics?

Answer 28

A balanced (11;19) (q21;p13) chromosomal translocation that creates a fusion gene composed of portion of the ***MECT1*** and ***MAML2*** genes

Question 29

Name the rare malignant tumor that has a poor prognosis and sometimes presents in the minor salivary glands.

Answer 29

Adenoid cystic carcinoma

Question 30

Sliding or paraesophageal hernias are both subtypes of ________ hernia.

Answer 30

Sliding or paraesophageal hernias are both subtypes of **_hiatal_** hernia.

Question 31

Achalasia (a failure of the lower esophageal sphincter to relax) is typically caused by a degeneration of _________ \_\_\_\_\_\_\_\_\_ within the esophageal wall.

Answer 31

Achalasia (a failure of the lower esophageal sphincter to relax) is typically caused by a degeneration of **_inhibitory_** **_neurons_** within the esophageal wall.

Question 32

Describe the histology of reflux esophagitis.

Answer 32

Erythema and edema of mucosa; basal zone (epithelium) hyperplasia and lamina propria papillae elongation

Question 33

What is the most common subtype of esophageal atresia?

Answer 33

Atresia with distal tracheo-esophageal fistula

Question 34

What are esophageal webs?

Answer 34

Thin, protruding membranes of normal esophageal tissue

Question 35

Acquired esophageal webs are much ______ common than congenital webs and are mainly observed in Plummer–Vinson syndrome

Answer 35

Acquired esophageal webs are much **_more_** common than congenital webs and are mainly observed in Plummer–Vinson syndrome

Question 36

Zenker's diverticulum is an outpouching of the lower pharyngeal mucosa and submucosa caused by inadequate relaxation of the ____________ and subsequently increased intraluminal pressure

Answer 36

Zenker's diverticulum is an outpouching of the lower pharyngeal mucosa and submucosa caused by inadequate relaxation of the **_superior esophageal sphincter_** and subsequently increased intraluminal pressure

Question 37

What form of esophageal inflammation results due to food allergens and is characterized by eosinophilic infiltrate in the inflammed tissue?

Answer 37

Eosinophilic esophagitis

Question 38

What term refers to a failure of recanalization of the duodenum? What term refers to a gastric outflow obstruction due to hyperplasia of the pyloric muscle?

Answer 38

Duodenal atresia; pyloric stenosis

Question 39

Gastric heterotopia refers to ectopic GI tissue most commonly found in the __________ as an inlet patch.

Answer 39

Gastric heterotopia refers to ectopic GI tissue most commonly found in the **_esophagus (in upper 1/3)_** as an inlet patch.

Question 40

What are the two main etiologies of chronic gastritis?

Answer 40

**Autoimmune**; ***H. pylori*** (more common)

Question 41

What are the two more common causes of peptic ulcer disease?

Answer 41

1. *H. pylori* 2. NSAID use

Question 42

Gastric carcinomas are most common in _____ (gender) in the _____ decade of life in the stomach ________ (location).

Answer 42

Gastric carcinomas are most common in **_males_** in the **_7th_** decade of life in the stomach **_antrum_** **(lesser curvature \> greater curvature)**.

Question 43

PPI use is associated with ___________ formation (more commonly in women) that has no increased risk for gastric malignancy.

Answer 43

PPI use is associated with **_fundic polyp_** formation (more commonly in women) that has no increased risk for gastric malignancy.

Question 44

Gastric adenomas have an increased risk of adenocarcinoma formation when \> ___ cm in size.

Answer 44

Gastric adenomas have an increased risk of adenocarcinoma formation when \> **_2_** cm in size.