MD ORAL PATHOLOGY Flashcards

1
Q

Define cleft lip

A

lack of fusion b/w medial nasal process and maxillary process

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2
Q

define cleft lip

A

lack of fusion b/w palatal shelves

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3
Q

patient walks in with clefts and pits in lip:

what disease does he have?

A

Van Der Woude

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4
Q

fordyce granules made of what?

A

extopic sebaceous glands

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5
Q

ptnt walks in with whit lesion on buccal mucosa. dissipitated when cheeck is stretched

A

LEUKODEMIA

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6
Q

patient complains about hurting and burning. what is this and what is TX?

A

Geo tongue / migratory glossitis / erythema migrans

TX: none

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7
Q

patient walks in with fissured tongue and bels palsy

what syndrome does ptnt have?

A

MELKERSSON ROSENTHAL SYNDROME

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8
Q

what makes up an angioma?

A

blood vessels or lmyph vessels

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9
Q

what is this?

A

cherry angioma (vessel tumor)

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10
Q

child walks in with this. what is it?

A

HEMANGIOMA

( congenital proleferation of capillaries )

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11
Q

angioma of meninges (arachnoid and pia matter) + skin along distribution of trigeminal nerve

A

LYMPHANGIOMA ( congenital prolif of lymph vessels)

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12
Q

patient walks in with big cyst on midline of floor of mouth. contains structures such as hair and sebaceous glands with a doughy consistency

A

DERMOID CYST

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13
Q

Patient walks in with a lateral neck swelling. what is this and what causes it ?

A

epithelial cyst inside lymph node of neck

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14
Q

ptnt seen with these cysts along palatine and lingual tonsils. what is it?

A

oral lymphoepithelial cyst

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15
Q

R/L in posterior mandible. seems like it is below mandibular canal. what is this ?

A

STAFNE BONE DEFECT

below mandibular canal

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16
Q

heart shaped r/l in the ant. what is this cyst?

tx?

A

nasopalatine duct cyst

excision

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17
Q

This r/l is found b/w maxillary canine and lateral incisor

A

globulomaxillary cyst

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18
Q

a teenager gets hit really bad in foorball. R/L shows scalloping around roots.

what is this?

what is in the cyst?

A

TRAUMATIC BONE CYST

dead space in mandible no epithelial lining

no epithelial lining

aspirate it to diagnose

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19
Q

linea alba is made of what? how does it develop?

A

hyperkeratosis

chronic friction on mucosa

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20
Q

define erosion and ulcer

A

erosion: incomplete break through epithelium
ulcer: compelte break

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21
Q

what could have caused this chemical burn?

A

ASPIRIN

hydro perox

silver nitrate

phenol

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22
Q

patient is a pack a day smoker. what is this called and what is happeneing ?

is it malignant ?

A

nicotone stomatitis

inflammed salivary duct openings

only pre malignant is related to reverese smoking

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23
Q

patient is a pack a day smoke for past 20 years. what is going on with their gingiva?

what is tmnt?

A

smoking associated melanosis

tobacco chemicals stimulate melanocytes

tx: reverisble is smoking discontinues

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24
Q

ptnt walks in with pigmentation on mucosa. also has intestinal polyps. what disease do they have ?

A

PEUTZ JEGHERS SYNDROME ( PJ syndome)

sick from stomach ache at home wearing PJs and got spots on face

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25
Q

what product usually causes this tissue sloughing ?

suggestion for tmnt?

A

SLS ( sodium laural sulface)

toms of maine or rembrandt tooth paste

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26
Q

patient walks in with vesicles on vermillion border what is this disease?

tx?

A

HERPES SIMPLEX VIRUS

on keratinized tissue

ACYCLOVIR

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27
Q

shingles is what type of diseaes?

A

Recurrent varizella zoster virus (herpes zoster)

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28
Q

a patiet walks in with ramsay hunt syndrome. what disase causes this and what CN are affected?

A

HERPES ZOSTER (shingles)

CN 7 , 8 ( facial paralysis, vertigo, deafness)

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29
Q

a patient walks in and has paralysis, vertigo, and deafness. what diseae do they have and tx?

A

RAMSAY HUNT SYNDROME (cn 7 and 8)

HERPES ZOSTER (shingles)

NOT SIMPLEX!!!

acyclovir

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30
Q

what are 2 types of herpes simplex virus?

what causes them?

A

Primary:

  • self limiting and childhood
  • tx: palliative

Recurrent (keratinized)

  • herpes labialis: vermillion border (cold sore, fever blister)
  • reucrrent introral herpes: attached gingiva, hard palate

cause : immunosupression, stress, sunglight

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31
Q

what is treatment for this and what type of herpes is it?

A

Recurrent keratanized

  • HERPES LABIALIS

TX: ACYCLOVIR in prodromal period

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32
Q

patient walks in with these vesicles in hard palate.

what is this?

tx?

A

HERPES SIMPLEX VIRUS

Recurrent intraoral herpes ( attched gingiva, hard palate)

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33
Q

dentist who was treating a herpes patient develops vesicles on his finger. what is this called and what type of virus is it?

A

herpetic whitlow

HSV!!

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34
Q

what are 2 types of Varicella Zoster Virus?

syndrome associated?

tx?

A

VARICELLA (CHICKENPOX) ZOSTER (shingles) virus

PRIMARY

  • varicella aka chickenpox
  • latent in trigeminal ganglion

RECURRENT:

  • herpes zoster aka shingles
  • ramsey hunt syndrome: herpes ZOSTER. rxn in geniculte ganglion affects cn 7 and 8 resulting in facial parylis, vertigo, deafness

acyclovir

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35
Q

hand-foot-mouth disease also called what?

A

coxsackie virus

(hand foot mouth cock sack)

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36
Q

people with kopliks spots on their cheek have what disease?

A

MEASLES

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37
Q

patient walks in and has this sessile proliferation on their skin. what is this called and what causes it ?

A

Papilloma (Wart)

HPV !!

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38
Q

Ptnt comes in with this very common skin wart. what is this and what causes it?

A

Verruca Vulgaris

HPV

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39
Q

this type of wart develops from genitals or sexual contact from someone who has genital warts. what is it?

A

condyloma acuminatum

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40
Q

patient has multiple small dome shaped warts on oral mucosa. what is this disease ?

tx?

A

focal epithelial hyperplasia (Hecks disease)

warts: HPV

excision w/ excellent prognosis

whole mouth goes to heck

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41
Q

white patch on lateral tongue does not wipe off.

virus that causes it ?

disease associated with?

A

Oral hairy leukoplakia

EBV

oppurtunistic infection associated with HIV

associated with burkitts lymphoma

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42
Q

a person with oral hairy leukoplakia also has an association with what other ailment?

A

BRUKITTS LYMPHOMA ( B-cell NHL)

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43
Q

patient has a chancre ulcer on their genital. what type of disease and stage is this associated with?

A

syphilius

Primary Lesion

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44
Q

what type of bacteria is syphilis associated with?

A

TREPONEMA PALLIDUM ( spirochete bacteria)

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45
Q

what are 3 characterestics with congenital syphilis

A

hutchinsons and mulberry molars

deafness

ocular keratitis

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46
Q

*** what are the stages of syphilis and what do they affect?

A

Primary: chancre (painless lesion)

Seocndary: oral mucous patch / rash

Tertiary: systemic, gumma CNS involvement CV involvement

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47
Q

how does one get TB and what bacteria causes it ?

A
  • inhalation
  • mycobacterium tuberculosis
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48
Q

3 stages of TB?

A

primary

  • ghon complex undergoes caseating necrosis

Secondary

  • lung infection with cavitation

Miliary

  • systemic spread
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49
Q

Tx for TB?

A

multidrug therapy

  • Isoniazid
  • rifampin
  • ethambutol

IRE

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50
Q

gohnorrhea caused by what bacteria?

A

Neisseria gonnorhea

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51
Q

actinomycosis is caused by what bacteria?

what is it made of ?

tx?

A

actinomyces israeilii ( filamentous not fungal)

sulfur granules in purulent exudate

PENICILLIN

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52
Q

ptnt walks into clinic with a tongue that looks like below:

what bacteria causes this?

what disease does this come from?

tx?

A

SCARLET FEVER

Group A strep coccus pyogens

throat becomes systemc infection

PENCICILLIN

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53
Q

what happens to tongue papilla of strawberry tongue>

A

inflammed fungiform papillae

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54
Q
A
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55
Q

patient has white patch on tongue that rubs off. what is this ?

tx?

A

CANDIDIASIS:

pseudomembranous (white rubs off)

median rhomboid glossitis ( loss of lingual papillae

when on corner of mouth: angular cheilitis

TX:

antifungal (azole or statin)

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56
Q

patient walks in with multiple apthous on oral cabity and genitals. they also have inflmmation of their eye. what syndrome does patient have?

tx?

sturger weber sybdroma

ramsay hunt syndrome

behcets syndrome

plummer vinsom syndrome

A

Behcets syndrome (autoimmune disease)

TX: corticosteroids

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57
Q

apthous ulcers vs herpes

A

apthous: non keratin
herpes: keratin

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58
Q

patient walks in with mulitple red lesions all over lips. what is this called?

what are the 2 types?

A

erythema multiforme

Minor: herpes simplex hypersensitivty

major (also called steven johnson syndrome) : drug sensitivty

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59
Q

patient comes to clinic with swelling on his lip. states he ate something he was allerfic to. what is this and what is the tx?

Leukoedema

Lymphedema

Angioedema

A

ANGIOEDEMA (blood - swelling)

mast cell release IgE and histamines

TX: antihistamines

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60
Q

patient walks into clinic. what is the name of the gingivitis he has.? what causes it? what is tx?

A

STRAWBERRY GINGIVITIS

wegeners granulomatosis

allergic to inhaled antigen (angioedema allergix rxn to touching or eating)

TX: corticosteroid (prednisone) and cyclophosphoamide

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61
Q

patient has white striations on the cheek. Histologically it has these “saw tooth” rete ridges.

what is this ?

how to tx?

A

LICHEN PLANUS (wickham striae)

T lymphocytes target and destroy BASAL keratinocytes

tx: corticosteroids

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62
Q

patient walks in with discoid shaped lesions across his face,

what does this patient have?

how is it tested?

tx?

A

LUPUS ERYTHEMATOSUS

Discoid Chronic type:

  • facial lesions
  • oral lesions mimic erosive liuchen planus

SYSTEMIC acute type:

  • multiple organs

butterfly rach

test: ANA TEST ( autoantibodies test)
tx: corticosteroids

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63
Q

hardening of skin and CT nand unifrom widerning of PDL space is called what?

A

scleroderma

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64
Q

patient walks in with the disease pemphigus vulgaris

what part of histology is being damged?

what are the autoantibodies attacking?

test for this diseae?

tx?

A

suprabasilar layer

desmosomes beign attacked

POSITIVE NIKOLSKYS SIGN ( skin finding in which the top layers of the skin slip away from the lower layers when rubbed.)

tx: corticosteroids (autoimmune)

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65
Q

difference between PEMPHIGUS VULGARIS and MUCOUS MEMBRANE PEMPHIGOID

  • what are autoantibodies attacking?
  • where is it taking place histologically ?

tx?

A

PV:

  • suprabasilar

Antibodies against DESMOSOMES

tx: corticosteroids

MMP:

  • subasilar
  • AA against BASEMENT MEMBRANES
    tx: corticosteroids

pemhpigus= U-bove

pemphigoid= beloiw

LICHEN PLANUS: SAWTOOTH RETE RIDGEs: DESTROYS BASAL KERATINOCYTES

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66
Q

patient has white patch on their tongue that is not wiping off.

what does patient have?

what must be done to know forsure?

A

LEUKOPLAKIA

candidiasis = (wipes off)

tx: BIOPSY

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67
Q

What is this?

what causes this?

what can this lead to?

A

PROLIFERATIVE VERRUCOUS LEUKOPLAKIA

HPV 16 and 18

MALIGNANT TRANSOFORMATION TO SSC or verrucous carcinoma

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68
Q

abnormal red lesion of the mouth was found. usually by leukoplakias.

what is this

what is tx?

A

ERYTHROPLAKIA (red patch)

its a clinical description not diagnosis

HIGHER RISK than leukoplakia

TX: biopsy !!

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69
Q

blisters on lip

what is this ?

what causes this?

A

ACTINIC CHEILITIS

actinic = solar

UVB rays

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70
Q

patient who uses tobacco products walks in with this whitish looking lesion. what is this and what type of tobacco ?

A

smokeless tobacco associated lesion

white mucosal changes in vestibule = SMOKELESS TOBACCO (dip)

71
Q

cancer types:

carcinoma : ET

Sarcoma : CT

Leukemia: blood

lymphoma: lymphatic

A
72
Q

what are the stages of cancer?

when is something considered malignant??

A

hyperplasia -> dysplasia -> cancer in situe -> invasice cancer

invades past BASEMENT MEMBRANE

local invasion : CT

metastasis: blood, lymph etc

73
Q

WHAT IS THIS?

what are the causes ? 2 factors

what develops into this disease ?

tx?

A

Verrucous Carcinoma

cause : _TOBACCO **_ and HPV 16 and 18 (wart)

comes from verrucous LEUKOPLAKIA!!!

tx: excision

74
Q

what is the cause of squamous cell carcinoma ? **

HPV accosiated with it ?? **

5 - year survival ? **

TX? **

A

oncogenes or inactivation of tumor suppresssor genes

HPV 16 and 18 (same as verrucous carcinoma and verrucous leukoplakia)

5 year: 50%

tx: excision and radiation

75
Q

a patient has disease with clinical symptoms includign mucosal atrophy, dysphagia (difficulty swallowing) and iron deficiency anemia. what is this disease and what is it associated with ?

A

PLUMMER VINSON SYNDROME (SSC)

76
Q

BASAL CELL CARCINOMA:

cause?

danger?

tx?

A

SUN DAMAGE

rarely metastisizes

surgery

77
Q

patient walks in with this lesion:

what is it?

what is going on histologically?

survival rate after 5 years?

A

ORAL MELANOMA

malignancy of MELANOCYTES

high risk on palate and gingiva

5year:

>65% for skin

<20% for oral lesions

78
Q

what is this?

cause?

A

FIBROMA (benign)

chronic trauma or irritation

fibrous hyperplasia of oral mucosa

79
Q

what 3 meds caused gingival hyperplasia ?

tx?

A

Ca+ Channel blockers

Dilantin (anticonvulsant)

cyclosporine (immunosuppressant)

TX: gingivectomy and discontinue drug

80
Q

what is this called and what causes it ?

A

EPULIS FISSURATUM

over extended flange

81
Q

What is this and what is this called?

A

papillary hyperplasia ( palate)

poorly cleaned or fitted denture

82
Q

this neuroma is most common by mental forament. what is this and what causes it ?

traumatic neuroma

neurofibroma

mortons neuroma

A

TRAUMATIC NEUROMA

caused by injury to nerve

83
Q

what is this called?

what structures make up this lesion?

pyogenic granuloma

nodular fasciitis

fibromatosis

granular cell tumor

A

PYOGENIC GRANULOMA

hyperplasia of capillaries: red

trauma induced

84
Q

nodular fasciitis is neoplasm of what cells?

tx?

A

neoplasm of FIBROBLASTS

surgical excision ( easy to eradicate)

85
Q

fibromatosis is neoplasm of what?

A

Fibroblasts

difficult to eradicate and ofter recurs

86
Q

granular cell tumor:

neoplasm of what cells?

what does it mimic?

most ocmmon location ?

A

SCHWANN CELLS

most common on dorsal tongue

pseudoepitheliomatous hyperplasia (PEH)

mimics SCC

87
Q

patient gets a biopsy for this tumor. this is what it looks histologically.

what type of tumo is this?

what cells is it affecting?

A

SCHWANNOMA (neurilemmomma)

neoplasm of SCHWANN CELLS

what is being circled is Acellular verocay bodies ( empty spaces surrounded by spindle cells aka line of scrimmage)

88
Q

*** NEUROFIBROMA:

neoplasm of what cells?

what is disease asociated with it?

transforms into what if not treated?

A

Schwann cells AND fibroblasts (neuro cells and fibrin cells)

Neuofibromatosis type 1 / Von recklinghausens disease

( skin freckles, axillary freckles, iris freckles)

Neurofibrosarcoma

89
Q

patient with neurofibromatosis type 1 / con recklinghausen has what clinical feature?

A

cafe au lait spots ( skin freckles)

also have axillary freckles (underarm) and iris freckles

90
Q

BENIGN CT TUMORS:

Leimyoma: neoplasm SM cells

rhabdomyoma: neoplasms: skelatal muscle cells
lipoma: neoplasm of fat cells

A
91
Q

fibrosarocma:

malignancy of what?

cells it affects?

A

CT cancer

malignant proliferation of fibroblasts (malignant ct disease)

92
Q

what is neurofibrosarcoma?

A

malignant proliferation of schwann cells ( neuro = schwann cells)

also known as malignant peripheral nerve sheath tumor

93
Q

Kaposis sarcoma:

affects what cells ?? ***

caused by what cell?

A

malignant proliferation of ENDOTHELIAL CELLS (lines organs and blood) (still malignant ct disease)

HHV8 (human herpesvirus 8)

purple lesion

94
Q

mucocele vs ranula: *****

trauma to what??

how do you get them?

their location?

tx?

A

salivary duct (mucous cyst)

Mucocele : LOWER LIP ( contains mucous)

Ranula : FLOOR OF MOUTH

tx: complete excision

95
Q

*** MUCOUS RETENTION CYST:****

what causes it?

how is it different than mucocele and ranula ?

A

caused by BLOCKAGE of salivary duct by sialolith filled with mucous

ranula and mucocele caused by trauma of salivary duct filled with saliva

same as ranula and muc but TRUE CYST ( lined by epithelium)

96
Q

**** rapidly expanding and ulcerative lesion due to ischemic necrosis of salivary gland:

what is it?

what causes necoris ?

tmnt?

A

NECROTIZING sialometaplasia

cause: TRAUMA or LA !!

heals on own in 6-10 weeks

97
Q

this is a blockage of glands in sinus of mucosa:

what is it called?

tx?

A

sinus retention cyst

none

98
Q

this is a type of pulmonary disease that also affects salivary glands and mucosa.

what is an oral clinical feature ?

tx?

A

SARCOIDOSIS

XEROSTOMIA

corticosteroids

99
Q

patient with dry mouth, bilateral hilar lymphadenopathy and arthirits comes in. what do they have?

A

sarcoidosis

100
Q

***SJOGRENS SYNDROME:

cells associated with?

what glands does it affect?

Primary vs Secondary?

TX:

A

autoimmune: lymphocytes mediated

salivary and tear glands

PRIMARY: keratoconjunctivitits sicca (dry eyes) and xerostomia

SECONDARY: everything above + another autoimmune diseae (RA)

tx: symptomatic

101
Q

MOST COMMON BENIGN SALIVARY GLAND TUMOR?

monomorphic adenemoa

pleomorphic adenoma

adenoid cystic carcinoma

polymorphous low grade adenocarcinoma

A

PLEOMORPHIC ADENOMA (most common parotid tumor)

102
Q

patient comes in with a firm and rubbery swelling in the mouth. this lesion is found on patients palate and ear.

what is this?

what cells make this up?

monomorphic adenemoa

pleomorphic adenoma

adenoid cystic carcinoma

polymorphous low grade adenocarcinoma

A

PLEOMORPHIC ADENOMA

Epithelial + CT cells ( why its called mixed tumor)

most ocmmon BENIGN salivary gland tumor

most common site palate for minor salivary gland or ear for parotid gland

103
Q

this benign tumor is composed of single cell type

tx?

A

MONOMORPHIC ADENOMA (single cell type)

benign salivary gland

exccision

104
Q

a 70 year old man walks in with a tumor near his parotid gland.

what type of tumor does this man have?

what cells does it encompass?

A

WARTHINS TUMOR: (old age + parotid gland)

Oncocytes ( epithelial cell w/ excessive # of mitochondria) + lymphoid cells

105
Q

MOST COMMON MALIGNANT SALIVARY GLAND?

monomorphic adenemoa

pleomorphic adenoma

Mucoepedermoid carcinoma

adenoid cystic carcinoma

polymorphous low grade adenocarcinoma

A

MUCOEPUDERMOID CARCINOMA

Mucous + epithelial cells

106
Q

second most common salivary gland malignancy for minor salivary glands?

monomorphic adenemoa

pleomorphic adenoma

Mucoepedermoid carcinoma

adenoid cystic carcinoma

polymorphous low grade adenocarcinoma

A

PLGA ( polymorphous low-grade adenocarcinoma)

first is mucoepidermpod carcinoma

107
Q

after taking biopsy it is show that histolgy has a swiss cheese pattern

what is this?

5 year and 15 year survival rate?

A

ADENOID CYSTIC carcinoma

5year: 70%

15 year: 10%

108
Q

*** HODKINS LYMPHOMA:

affects what cells?

tx?

A

REED-STERNBERG CELLS = malignant B cells

chemo/radio

rmbr: LYMPHOMA = all lymphoids are malignant b/c cancer spread to lymph

109
Q

NONHODGKINS LYMPHOMA:

cell type?

tx?

A

Neoplasm: B or T cells

chemo / radio

rmbr: LYMPHOMA = all lymphoids are malignant b/c cancer spread to lymph

110
Q

*** what type of disease is BURKITTS lymohoma associated with?

what happens during it?

A

NONHODKINGS LYMPHOMA B CELL TYPE

bone marrow

B cell Bone marrow Burkitt

lip paresthesia, tooth mobility, halts root development

111
Q

*** punched out R/L in the skull ***

what is this disease and what causes punched out lesions?

cells it effects?

tx?

A

***MULTIPLE MYELOMA**

caused by plasma cells accumulating in bone

amyloidosis due to accumulation of amyloid protein

  • B cells (PLASMA Cells) thats why its also called plasma cell myeloma
  • chemotherapy !*
  • poor prognosis*
112
Q

***LEUKEMIA****:

cells ?

classification is based on what 2 things?

3 clinical signs ?

A

NEOPLASM OF BONE MARROW CELLS

cell lineage ( myeloid [bone marrow] or lymphoid [lymph system] )

Acute or chronic

ALL (acute lymphocytic lekemia) > CML > AML > CLL (chronic lymphocytic leukemia)

BLEEDING, FATIGUE, INFECTION (PLATELETS, RBC, WBC)

113
Q

least dangerous to most dangerous leukemia

CLL

CML

AML

ALL

A

ALL (acute lymphocytic lekemia) > CML (chronic myeloid (bone marrow) lymphocytic leukemia > AML > CLL (chronic lymphocytic leukemia)

ALL Children Are ChiLL

114
Q

what is the most common ODONTOGENIC cyst?

A

radicular cyst

115
Q

what is this?

vital or non vital?

what happens in acute vs chronic stage?

tx?

A

RADIUCLAR CYST ( odontogenic cyst)

  • nonvital

necrotic pulp causes inflammation

acute: abscess

chronic: granuloma

rct apicectomy or extraction with curettage

116
Q

RADICULAR CYST does damge to what part of tooth?

A

EPITHELIAL RESTS OF MALASSEZ (ERM) from Hertwigs epithelial root sheath (HERS) in pockets of inflmation encapsulated resulting foramtion of a cysts

117
Q

EPITHELIAL RESTS OF MALASSEZ FROM HERTWIGS EPITHELIAL FUNCTION and what happens when get inflammed?

A

Epithelial cell rests of Malassez (ERM) are quiescent epithelial remnants of the Hertwig’s epithelial root sheath (HERS) that are involved in the formation of tooth roots.

RADIUCLAR CYST:

root tissue infection = PARL

118
Q

what is this called?

area most common in?

what is this made of?

tx?

A

DENTIGEROUS CYST aka eruption cyst bc occurs over children erupting teeth

canine and third molars

fluid b/w crown and reduced enamel epithelium

excision

119
Q

Dentigerous cyst:

wehre is r/l?

A

CEJ of impacted tooth

120
Q

what is this cyst found mostly in mand premolar region ?

vital or nonvital?

tx?

A

LATERIAL PERIODONTAL CYST

vital tooth

mandibular premolar region

121
Q

ptnt walks in with this cyst but it is not showing on radiograph. what is it?

tx?

A

GINGIVAL CYST OF ADULT

same as lateral periodontal cyst except NO R/L

excision

122
Q

NEW BORN GINGIVAL CYST:

what is one on midlien called?

one on lateral plate called?

what tissue causes this?

A

LATERAL PLATE: bohns nodule

epstein pearls: midline plate

rests of dental lamina

BLEM

tx: none

123
Q

what is this?

most common location ?

A

PRIMORDIAL CYST

develops where tooth would have formed

mand 3rd molar region

complete removal

124
Q

agressive and recurrent that is usually found in posterior ascending ramus

what is this ?

tx?

Calcifying odontogenic cyst

Keratocystic odontogenic tumor

Ameloblastoma

Calcifying epithelial odontogenic tumor

central ossifying fibroma

A

KCOT (keratocystic odtongenic tumor)

thin corrugated parakeratinized epithellim

agressive enucleation !!

125
Q

patient comes in and has multiple KCOTS, BCCS and calcfiged falx cerebri. what does this person have? ***

sturger weber sybdroma

Gorlins syndrome

ramsay hunt syndrome

behcets syndrome

plummer vinsom syndrome

A

GORLIN SYNDROME

126
Q

gorlin syndrome associated with what clinical features?

A

KCOTS

BCC

CALCIFIED FALX CEREBRI

127
Q
A
128
Q

this type cyst is associated with ghost cells

Calcifying odontogenic cyst

Keratocystic odontogenic tumor

Ameloblastoma

Calcifying epithelial odontogenic tumor

A

COC (calcifying odontogenic cyst) aka GORLIN CYST

ghost cell : empty space where nucleus is filledw ith keratin

129
Q

what is this agressive multilocular disease?

tx?

likely to come back ?

Calcifying odontogenic cyst

Keratocystic odontogenic tumor

Ameloblastoma

Calcifying epithelial odontogenic tumor

A

AMELOBLASTOMA ***

benign but agressive

wide escision or resection,

high recurrence if too conservative

130
Q

MULTILOCULAR DIFFERENTIAL DIAGNOSIS?

A

AMELOBLASTOMA: benign but agressive and recurring/wide escision or resection

KCOT: agressive and recurring / aggressive enucleation.

CGCG

COF

131
Q

this r/l has a driven snow calcification ( white flecks)

tc?

Calcifying odontogenic cyst

Keratocystic odontogenic tumor

Ameloblastoma

Calcifying epithelial odontogenic tumor

A

CEOT aka pindborg tumor

surgical excision, good prognosis

132
Q

what lesion is accosiated with histological liesegang rings? **

Calcifying odontogenic cyst

Keratocystic odontogenic tumor

Adenomatoid odontogenic tumor

Ameloblastoma

Calcifying epithelial odontogenic tumor

A

CEOT aka PINDBERG TUMOR

133
Q

this is found over the anterior maxilla over an impacted canine

tx?

Calcifying odontogenic cyst

Keratocystic odontogenic tumor

Adenomatoid odontogenic tumor

Ameloblastoma

Calcifying epithelial odontogenic tumor

A

ADENOMATOID ODONTOGENIC TUMOR (AOT)

mostly in ant maxilla and over impacted canine

TX: surgical excision good prognosis

134
Q

this has messy r/l with unclear borders honeycomb pattern ‘

tx?

monomorphic adenemoa

pleomorphic adenoma

Mucoepedermoid carcinoma

Odontogenic myxoma

adenoid odontogenic carcinoma

polymorphous low grade adenocarcinoma

A

ODONTOGENIC MYXOMA aka mycofibroma

myxomatous connective tissue: SLIMY STROMA

surgical excision

135
Q

well definied multiocular r/l what is this called ?

lesion made of ?

monomorphic adenemoa

pleomorphic adenoma

Mucoepedermoid carcinoma

Central odontogenic fibroma

Odontogenic myxoma

adenoid odontogenic carcinoma

polymorphous low grade adenocarcinoma

A

CENTRAL ODONTOGENIC FRIBROMA (COF)

dense collagen with strands of epithelim

central: bone, well definined multioculat r/l

peripheral = gums

136
Q

here is a well circumscribed r/o mass

what is this called?

tx?

A

CEMENTOBLASTOMA !! **

ball of cememntum and cementoblasts replacing TOOTH ROOT

tx: surgical excision (cutting out) and extraction

137
Q

a 8 year old boy walks in and radiograph shows this in post madnible.

what is this ?

what is it made of ?

tx?

monomorphic adenemoa

pleomorphic adenoma

Mucoepedermoid carcinoma

Central odontogenic fibroma

Odontogenic myxoma

adenoid odontogenic carcinoma

Ameloblastic fibroma

polymorphous low grade adenocarcinoma

A

AMELOBLASTIC FIBROMA (mixed benign tumor)

children in teens

mostly post mandible

MYXOMATOUS CT

surgical excision

138
Q

what is this called ?

A

COMPOUND odontoma

(bunch of minature teeth)

139
Q

what is this r/o mass called that is blocking eruption?

A

COMPLEX odontoma

mostly posterio (conglomerate mass of hard tissue)

140
Q

Clinical features of GARDNER SYNDROME?**

A

multiple odontomas + intestinal polyps

multiple teeth bits buried in a garden that causes intestinal problems if eaten

141
Q

this lesion is composed of fibroblastic stroma where foci of mienralized products are formed.

what is it?

tx?

pleomorphic adenoma

Mucoepedermoid carcinoma

Central ossifying fibroma

Odontogenic myxoma

adenoid odontogenic carcinoma

Ameloblastic fibroma

polymorphous low grade adenocarcinoma

A

CENTRAL OSSIFYING FIBROMA

rmbr: central = middle of bone (very similar to odontogenic tumor )

surgical excision

142
Q

this has a ground-glass appearance.

what is this ?

A

FIBROUS DYSPLASIA (fiber glass)

stops growing after puberty

143
Q

what disease is associated with fibrous dysplasia>

A

mcCune Albright syndrome:

polyostotic fibrous dysplasia + cafe au lait + endocrine abnormalities (precocius puberty)

144
Q

40 year old black woman shows this on her radiograph in her mand anteriors.

what is it?

vital or non vital?

tx?

A

PCOD ( periapical cemento osseous dysplasia) ***

apices mand ant/ middle aged black women

vital

rmmbr: odontogenic tumor

none

145
Q

here we see a circumscribed opaque mass of bone and osteoblasts.

what is this ?

tx?

Calcifying odontogenic cyst

Keratocystic odontogenic tumor

Adenomatoid odontogenic tumor

Ameloblastoma

Osteoblastoma

Ameloblastic fibroma

A

osteoBLASTOMA ( Oblasts)

surgical excision

146
Q

patient walks in with big purple legion mass in ant mandible.

you can see thin wispy septationt in the r/l

what is this?

tx?

osteoblastoma

CGCG

PCOD

COF

AOT

CEOT

KCOT

A

_CGCG (central giant cell *granuloma*)_

rmbr: central= middle of bone

central” r/l with thin wispy septations

peripheral: gums; red purple gingival mass
tx: excision

147
Q

multiocular r/l is shown in post mandible. it is expansile. turns out it is filled with blood

what is this?

Calcifying odontogenic cyst

Keratocystic odontogenic tumor

Aneurysmal bone cyst

Osteoblastoma

Ameloblastic fibroma

A

ANEURYSMAL bone cyst

-pseudo cyst filled with blood

rmbr: aneurysm: bulge filled with blood

tx: excision

148
Q

ptnt has multiple bone lesions

tests show elevated alkaline phophatase

what is this ?

what disease associated with?

A

HYPERPARATHYROIDISM

^ PTH = ^ alkaline phosphates (too much bone breakdown)

von recklinghausen disease *of bone* : hyperparathyoridsm

von recklinghausen disease: neurofromitosis 1

149
Q

what is brown tumor associated with?

A

HYPERPARATHYROIDISM

^ osteoclast activity = ^ bone breakdown

150
Q

child with radiograph shows multilocuilar r/l

bilateral swellings and expansile

stops growing after puberty

A

CHERUBISM

151
Q

punched out ice cream scoop lesions show floating teeth

what is this disease?

tx?

Calcifying odontogenic cyst

Keratocystic odontogenic tumor

Aneurysmal bone cyst

Langerhans cell disease

Osteoblastoma

Ameloblastic fibroma

A

LANGERHANS CELL DISEASE aka iodpathic histiocytosis

rmbr: giant bone cell lesion
tx: excision , radiation, chemo

152
Q

50 y/o patient walks who who has many bone defects causing symmetrical enlargement. says dentures dont fit anymore

what is it?

elevated levels of?

TX?

A

PAGETS DISEASE (cooton wool)

elevated alkaline phosphatase due to breakdown of bone

tx: bisphosphonates, calcitonin

pagets = bad bone= bisphosphonates/calcitonin

153
Q

ptnt walks in clinic and has deep pain. high fever, and paresthesia.

what does patient have?

what is it caused by?

tx?

A

ACUTE OSTEOMYELTITIS

caused by periodontitis not the tooth

infection and inflammation begins in medullary space in cancelous bone -> cortical bone -> periosteum -> soft tissue

tx: antibiotics and drainage

154
Q

radiograph shows mottle r/l resembling onion skinning?

TREATMENT ??

A

chronic osteimyelitis

antibiotics and debridement

155
Q

tooth is severly decayed. low grade inflammation like chronic pulpitis is seen on aoex and theres a wall forming around apex.

what is this ?

tx?

cute osteomyelitis

Focal sclerosis osteomyelitis

Diffuse sclerosis osteomyelitis

big board ***

A

FOCAL SCLEROSING OSTEITIS

** ( CONDENSING OSTEITIS) **

bone slclerosis happens from infection causes apex to form a wall to block infection from spreading

tx: none just adress the issue !

156
Q

woman walks in who is taking bisphosphonates.

what is this called ?

is it worse in IV or oral ?

tx?

A

BRONJ (bisphoph related ostenec of jaws)

IV> oral

tx: CHX rinse, antibiotics, surgery ****

157
Q

what do nearly ever malignant bone lesions have an issue with clinically?

A

paresthesia or anesthesia

158
Q

pstients xray shows sunburst pattern

what is this?

5 year survival?

how does this happen?

tx?

A

OSTEOSARCOMA

new bone is produced by tumor cells

25-40 %

resection and chemotherapy ( b/c cancer type)

159
Q

Cancer patient showing new cartilage developing called what?

more common involving what structure ?

A

CHONDROSARCOMA

CONDLYE b/c cartilage

160
Q

this sarcoma effects children and histolgy has round cells

A

EWINGS SARCOMA

kids say EW to round belly

161
Q

a patient with breast cancer comes to dentist because her lip is numb

patient shows ill defined changes in radiograph

what is this>

A

METASTATIC CARCINOMA **

metastatic= originated from somwhere else

BREAST > LUNG > KIDNET > COLON> PROSTATE

162
Q

patient has white spongy stuff on buccal mucosa that they cant wipe off. what is it?

A

white sponge nevus

163
Q

a patient who has iron defincieny anemia has consisten nose bleeds and andormal capilary formation on skin,

what is this?

A

HHT ( hereditary hemorrhaig telangiectasia)

telangiectasia: red macules or papules, dilated or broken capillaries

164
Q

iron deficinecy anemia and epistaxis (nose bleeds) is associated with what disease ?

A

HEREDITARY HEMORRHAGIC TELANGIECTASIA

HHT

165
Q

**** this ailment has missing clavicles and supernumery teeth

A

CLEIDOCRANIAL DYSPLASIA

missing clavicles in xray

166
Q

missing teeth and hypoplastic hair and nails. what is this ?

A

ECTODERMAL DYSPLASIA

ectoderm = hair and nails

167
Q

bones abnormally dense and prone to breakage.

how does it happen?

A

OSTEOPETROSIS

lack of bone remodeling and resorption

168
Q

a person who has damaged enamel has this radiograph

tx?

A

AMELOGENESIS IMPERFECTA

enamel damage all teeth affected

tx: full coverage crowns

169
Q

blue sclera is a characteristic of what ?

A

dentinogenesis imperfect

170
Q

what is this?

tx?

A

demtinogenesis imperfect

short roots, bell shjaped crowns, obliterated pulps

all teeth affected

tx: full coverage crowns

171
Q

what is this?

A

dentin dysplasia

chevron pulps and short roots!!

172
Q

what is this?

Tx?

A

regional odontodysplasia

  • quadrant of teeth exhibit short roots, open apices, enlarged pulp chambers

GHOST TEETH (huge pulps)

173
Q

what is it called when tooth count is one less than normal?

A

FUSION

2 buds = 1 tooth

geminiation =

  • 1 root = 2 crowns
  • normal count
174
Q
A