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AU'18 Oral Path II > HPV-Related Cancers - part I > Flashcards

HPV-Related Cancers - part I Flashcards

1
Q

human papilloma viruses (HPV’s) are a group of how many related viruses?

A

more than 130

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2
Q

T/F: all HPV types are sexually transmitted

A

false, some types are not sexually transmitted

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3
Q

which HPV types cause squamous papillomas?

A

HPV 6, 11

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4
Q

which HPV type causes non-genital warts?

A

HPV 2

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5
Q

which HPV types causes venereal warts (condyloma acuminatum)?

A

HPV 6, 11

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6
Q

which HPV types have a low risk for cancer?

A

HPV 2, 6, 11

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7
Q

which HPV types have a high risk for cancer?

A

HPV 16, 18, 31, 33

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8
Q

which HPV type causes verruca vulgaris?

A

HPV 2

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9
Q

which HPV types are sexually transmitted?

A

HPV 6, 11, 16, 18

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10
Q

who is affected by squamous papilloma?

A

any age

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11
Q

squamous papilloma can affect any location but what are the common intraoral sites?

A
  1. tongue
  2. uvula
  3. soft palate
  4. lip
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12
Q

what is the most common soft tissue mass arising from the soft palate?

A

squamous papilloma

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13
Q

clinical features of squamous papilloma

A
  1. usually solitary
  2. usually pedunculated, but can be sessile
  3. exophytic with fingerlike projections giving a “cauliflower” or “wart-like” appearance
  4. projections can be pointed or blunted
  5. soft
  6. painless
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14
Q

squamous papilloma has low what?

A

low infectivity, low virulence

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15
Q

color of squamous papilloma depends on what?

A

amount of keratin

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16
Q

tx of squamous papilloma

A

conservative excision

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17
Q

T/F: recurrence of squamous papilloma is common

A

false, unlikely

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18
Q

T/F: spontaneous remission of sqamous papilloma is possible

A

true

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19
Q

verruca vulgaris is a dermatologic term for what?

A

common wart

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20
Q

is verruca vulgaris contagious?

A

yes

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21
Q

how is verruca vulgaris contagious?

A

via self-inoculation

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22
Q

who does verruca vulgaris affect?

A

any age especially children

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23
Q

where is verruca vulgaris extremely common?

A

on skin especially hand

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24
Q

where is verruca vulgaris is infrequently located?

A

on oral mucosa

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25
Q

clinical features of verruca vulgaris

A
  1. pedunculated or sessile
  2. painless papule(s)
  3. papillary projections or rough surface
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26
Q

where does verruca vulgaris typically appear intraorally?

A
  1. vermilion border
  2. labial mucosa
  3. anterior tongue
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27
Q

tx for verruca vulgaris on skin

A
  1. topical therapies

2. surgery

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28
Q

tx for verruca vulgaris intraorally

A
  1. surgery
  2. laser
  3. cryotherapy
  4. electrosurgery
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29
Q

can verruca vulgaris recur?

A

yes

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30
Q

is spontaneous remission possible for verruca vulgaris?

A

yes

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31
Q

what is the most common sexually transmitted infection in the US?

A

HPV

32
Q

more than 40 HPV types spread through what?

A

direct sexual contact

33
Q

T/F: some HPV types can be spread by close skin-to-skin contact

A

true

34
Q

condyloma acuminatum has what type of risk?

A

low

35
Q

T/F: although condyloma acuminatum is considered low risk, it is possible to have co-infection with high risk type

A

true

36
Q

which HPV types are considered high risk and are implicated in cancers?

A

HPV 16 and HPV 18

37
Q

clinical features of venereal warts (condyloma acuminatum)

A
  1. contagious
  2. sessile, pink
  3. short, blunted
  4. non-tender, exophytic
  5. larger than papillomas (~1 cm but up to 3 cm)
  6. often multiples
38
Q

where can venereal warts (condyloma acuminatum) occur?

A
  1. anogenital region
  2. mouth
  3. larynx
39
Q

all ages can be affected by venereal warts (condyloma acuminatum) but who is most affected?

A

teenagers, young adults

40
Q

where intraorally does venereal warts (condyloma acuminatum) usually affect?

A
  1. labial mucosa
  2. lingual frenum
  3. soft palate
41
Q

tx of venereal warts (condyloma acuminatum)

A
  1. excision
  2. cryotherapy
  3. laser
42
Q

what is the concern about using lasers to tx venereal warts (condyloma acuminatum)?

A

airborne virus

43
Q

what is used to tx anogenital venereal warts (condyloma acuminatum)?

A

topical agents

44
Q

anogenital condylomata infected with HPV 16, 18 have a higher risk for malignant transformation to what?

A

SCC

45
Q

T/F: oral condyloma has shown to have a higher risk for malignant transformation to SCC when infected with HPV 16, 18

A

false

46
Q

when are virtually all sexually active individuals exposed to HPV?

A

by early 20’s

47
Q

what is the prevalence of any GENITAL HPV in American adults aged 18-59 according to the CDC?

A

~45%

48
Q

how does HPV enter epithelial cells?

A

via mucosa and skin

49
Q

what type of cells does HPV infect?

A

basal cells

50
Q

what is an HPV infection?

A

terminal differentiation infected keratinocytes

51
Q

what does an HPV infection comprise of?

A
  1. viral shedding

2. mutations leading to pre-cancerous then cancerous transformation

52
Q

T/F: most HPV infections are asymptomatic and resolve spontaneously

A

true

53
Q

over 90% of HPV infections are cleared by the body within how many years?

A

2-3 years

54
Q

T/F: some cells infected with HPV may remain latent for decades

A

true

55
Q

how can some infected cells remain latent for decades?

A
  1. low level replication
  2. minimal viral protein expression
  3. lack of immune clearance
56
Q

how long can a persistent HPV infection last?

A

up to 20 years

57
Q

as infected cells grow, what occurs?

A

mutations occur leading to pre-cancerous then cancerous transformation

58
Q

how does high-risk HPV types cause cancer?

A

high-risk HPV types make proteins E6, E7 and L1, L2

59
Q

what does E6, E7 allow?

A

cell to grow in uncontrolled manner and avoid cell death

60
Q

what does L1, L2 comprise?

A

comprise the virus capsid (shell) required for virus transmission, spread and survival

61
Q

which proteins causes the virus assembly and release?

A

L1, L2, E4

62
Q

which proteins causes cell proliferation and high level episomal replication occur?

A

E1, E2, E4, E5, E6, E7

63
Q

which proteins causes latent infection and low evel episomal replication occur?

A

E1, E2

64
Q

a persistent infection may be a result of what?

A

infected cells are not destroyed

65
Q

T/F: shed epithelial cells in oral rinses can be used to identify a latent infection

A

false, cannot

66
Q

shed epithelial cells in oral rinses cannot discriminate between what?

A

an oral and oropharyngeal infection

67
Q

what percent of oropharyngeal cancer is caused by HPV?

A

~70%

68
Q

what percent of cervical cancer is caused by HPV?

A

~70%

69
Q

what percent of anal cancer is caused by HPV?

A

~95%

70
Q

what percent of vaginal cancer is caused by HPV?

A

~65%

71
Q

what percent of vulvar cancer is caused by HPV?

A

~50%

72
Q

what percent of penile cancer is caused by HPV?

A

~35%

73
Q

oral and oropharyngeal cancer are both what?

A

head and neck squamous cell carcinomas (HNSCC)

74
Q

where is oral squamous cell carcinoma (OSCC) typically occur?

A

anterior to tonsillar pillars

75
Q

what percent of oral squamous cell carcinoma (OSCC) are HPV-related?

A

<5%

76
Q

T/F: there is consistent evidence that HPV is a risk factor for OSCC

A

false

77
Q

where does oropharyngeal squamous cell carcinoma (OPSCC) typically occur?

A
  1. base of tongue
  2. soft palate
  3. palatine tonsils
  4. pharyngeal wall

AU'18 Oral Path II (31 decks)

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