Head & Neck - Oral Diseases

Question 1

dental caries

• cause
• presentation

Answer 1

• demineralization of teeth by acidic metabolites produced by bacterial fermentation

Question 2

gingivitis

• defintition

Answer 2

• inflammation of the gums that leads to accumulation of dental plaque (bacteria/proteins/epithelial cells)
• cause - poor oral hygeine

Question 3

periodontiis

Answer 3

inflammatory process effecting supporting structures of the teeth - peridontal ligaments, alveolar bone, cementum

Question 4

apthous ulcers

• presentation

Answer 4

• single ulceration on inner lip
  
  • erythematous halo surrounding yellow fibropurulent membrane
  • exceedingly painful

Question 5

irritation (traumatic) fibroma

• description
• location

Answer 5

• smooth pink exophytic nodule
• buccal mucosa

Question 6

pyogenic granuloma

• description
• location
• pathogenesis
• demographics

Answer 6

• erythematous, hemorrhagic mass
• gingival mucosa
• due to vascular proliferation
• demo: children / young adults / pregnant women
• sequelae: either regression or progress into –> peripheral ossifying fibroma

Question 7

what can a pyogenic granuloma progress into?

Answer 7

peripheral ossifying fibroma - gingival lesion

Question 8

Answer 8

peripheral giant cell granuloma

Question 9

• identify the presentation and describe itgs
  
  • pathogenesis
  • demographics

Answer 9

• HSV-1 (rarely, HSV-2) infection
  
  • vesicles –> ulcers
• clinical: abrupt onset
• demographics: children 2-4

Question 10

Answer 10

• presentation that happen when you are initially infected by HSV-1.
• cinical presentation: lymphadenopathy / fever / anorexia
  
  • gross: large bullae w/ clear, serous fluid on an erythematous base on vesicles
  • microscopic:
    
    • esionophillic intranuclear viral inclusions
    • +/- giant cells
    • • tzank test

Question 11

• what is the manifesetation
• demographics
• presentation (gross / microscopic)

Answer 11

• candidia albicans - pseudomembranous form
• see in immunocompromised (diabetics, broad spectrum antibiotics)
• presentation:
• gross: gray-white inflammatory exudate that can be READILY SCRAPED off

Question 12

• presentation
• pathogenesis

Answer 12

scarlett fever - “strawberry tongue”

• caused by group A strep (strep pyogenes)

Question 13

Answer 13

measles

koplik spots

Question 14

Answer 14

diptheria

psueodmembrane

Question 15

Answer 15

lichen planus

reticulate, lacelike, white keratotic

Question 16

Answer 16

pemphigus

vesicles / bullae prone to rupture

Question 17

• manifestation
• pathogenesis
• morphology

Answer 17

oral hairy luekoplakia

• EBV infections in immunocompromised patients
• morphology:
  
  • gross: white, confluent patches of hyperkeratotic thickenings that CANNOT be scaped off
  • microscopic: hyperkaratosis/anthracosis with balloon cells

Question 18

• presentation
• characteristics

Answer 18

white patch/plaque that cannot be scraped off

abnormal epithelium

Question 19

• presentation
• characteristics

Answer 19

erythoplakia

• red, velvity possibly eroded area
• atypical epithelium (highly malignant)

Question 20

• manifestation?
  
  • pathogenesis
  • demographics
  • associations
  • morphology

Answer 20

• squamous cell carcinoma
  
  • smoked tobacco/alcohol = major risk factors
  • presentation: often seen in the oropharynx (harbors HPV-17)
  • associations:
    
    • HPV-16
      
      • SSC more often see in locations w/ HPV-16
      • pts with HPV-16 + tumors have greater long term survival than those with HPV - tumors
  • morphology:
    
    • gross: ulcleration & induration of oral mucosa with irregular, rolled borders
    • microscopic: malignant keratinocytes invade underlying CT/skeletal msucle

Question 21

• manifestation
  
  • morphology
  • presentation
  • associations

Answer 21

• verrucous carcinoma
  
  • patho: SSCA (ssc antigen?)
  • morphology:
    
    • gross:
      
      • wart-like filiform appearance with insidious growth pattern.
      • extremely thick tumor

Question 22

• manifestation?
  
  • morphology
  • associations

Answer 22

• dentigerous cyst: a cyst that originates around the CROWN (top) of an erupted tooth
  
  • morphology:
    
    • radiographic: unilocular lesions most often associated with impaction of the third molar (wisdom) tooth

Question 23

• manifestation
  
  • morphology
  • pathogenesis
  • associations

Answer 23

• periapical cyst
  
  • cyst found at the apex (bottom, pointed portion) of the teeth

Question 24

• manifestation
  
  • presentation
  • morphology
  • associations

Answer 24

• odontonic keratocyst (OKC) - keratocystic odonotgenic tumor
  
  • presentation
    
    • m/c males 10-40
    • aggresive
  • morphology:
    
    • radiographically: well defined unilocular of multilocular radiolucencies often in the posterior mandible
    • associations: PTCH gene mutation (basal cell carincoma in ghorlin syndrome)

Question 25

what is the PTCH gene mutation associated with?

Answer 25

keratocystic odontogenic tumor (OKC)

Question 26

odontoma

• clinical
• morphology

Answer 26

• m/c odontogenic tumor (> than dentigerous cyst, periapical cyst, OKC)
• depositions of enamel & dentin