head and neck

Question 1

Describe disease progression in clinical manifestation of Herpes Labialis

Answer 1

Herpes labialis (cold sores, febers blisters) like Herepes Stomatitis are caused by HSV1 and benin as painful inflammation of the affected mucosa, followed shortly by the formation of vesicles that later rupture and form shallow, painful ulcers.

Question 2

How do herpetic vesicles form?

Answer 2

Ballooning Degeneration of the epthelial ccells. Some epithelial cells show intranuclear ncluison bodies.

Question 3

What can be found at the edge of an ulcer of herpes labialis?

Answer 3

multinucleated epithelial cells with “ground glass” homogenized nuclei often exhibiting nuclear molding.

Question 4

Were does Ludwig Angina often originiate?

Answer 4

Submaxillary of Sublingula space- often extends locaaly to involve both

Question 5

Hairline fractures in the lingual cortex give microorganisms access to what space?

Answer 5

submaxillary space initially. If they follow the fascial planes, the infection may dissect into the parapharyngeal space and from there into the carotid sheath.

Question 6

What is the ultimate step of Sjogren syndrome progression?

Answer 6

Atrophy with fibrosis and fatty infiltration of the parenchyma

Question 7

What kind of exudate is seen in Aphthous stomatitis?

Answer 7

fibrinopurulent

Question 8

where are ppyogenic granulomas most frequent?

Answer 8

gingiva

Question 9

Describe the lesion of a pyogenic granuloma

Answer 9

Macroscopically: red-purple, smooth lobulated/ulcerated surface, elevated, soft mass Microscopically: Highly vascular granulation tissue with varying degrees of acute/chronic inflammation

Question 10

Describe a Vincent infection

Answer 10

Punched out erosions of the interdental papillae . Ulceration spreads to involve all gingival margins which become covered by a necrotic pseudomembrane.

Question 11

Describe the progression of dental caries.

Answer 11

1. Decalcificaiton of the interprimsatic substance 2. Disintegration of enamel prisms 3. Accumulation of debris and microorganisms (1-3 prdouces a small pit /fissure in the enamel). 4. Spread to dentinoenamel junction 5. Spread laterally, penetrates denitin along dentinal tubules (5 forms a flask-shaped lesion with a narrow orifice) 6. Invade vascular pump (Pulpitis inflamm. rxn occurs) 7. Apical granuloma form (chronically inflamed periapical granulation tissue_ or a Periapical abscess forms

Question 12

Excluding Mumps and Rubella, whatbiruses are suspected to cause labyrinthitis

Answer 12

Influenza, Parainflenza, EBV, HSV, Adenovirus

Question 13

Describe the characteristics of a Warthin tumor

Answer 13

Benign neoplasm of the parotid gland (can be B/L or multifocal in same gland), composed of cystic glandular spaces embedded in dense lymhoid tissue

Question 14

Most commmon monomorphic adenoma

Answer 14

Warthin tumor

Question 15

What is Pleomorphi adenoma (a biphasic appearance) composed of ?

Answer 15

epithelial and stromal elements

Question 16

Periapical granuloma

Answer 16

chronically inflamed periapical granulation tissue

Question 17

Describe a peripheral giant-cell granuloma’s microscopic characteristics

Answer 17

A non-encapsulated lesion with numerous multinucleated giant cells embedded in a fibrous stroma that also contains ovoid or spindle0shaped mesenchymal cells.

Question 18

Chronic Allergic Rhinitis etiology

Answer 18

Allergy, DM, CF, Infections, Aspirin Intolerance

Question 19

Describe a sinonasal polyp microscopically

Answer 19

lined externally by respiratory epithelium, and contain mucusou glands within a loose mucoid stroma, which is infiltrated by plasma cells, lymphocytes, and numerous eosinophils.

Question 20

How do tumor cells of an adenoid cysctic carcinoma organize themselves?

Answer 20

They grow in solid sheets or small groups, strands, or columns. Within these structures, the tumor cells interconnect to enclose cystic spaces, resulting in a solid, tubular or cribriform (sieve-like) arrangementk

Question 21

Why is Adenoid cystic carcinoma notorious?

Answer 21

It has a tendency to invade locally and recur after surgical resection. It is a malignant salivary gland tumor.

Question 22

What is Choleosteoma?

Answer 22

A mass of acumulated keratin and squamous epithelium from the exteeral ear canal through the perforated eardrum into the middle ear. Microscopically, they are identical to epidermal inclusion cysts and are surrounded by granulation tissue and fibrosis.

Question 23

What does a cell nest of an Ameloblastoma (Adamantinoma) tumor resemble?

Answer 23

The polyhedral cells are loosely arranged and they resemble Stellate Reticulum of the developing tooth. Microscopically, ameloblastoma resembles the enamel organ in its various stages of differentiation