MD ORAL PATHOLOGY Flashcards
Define cleft lip
lack of fusion b/w medial nasal process and maxillary process
define cleft lip
lack of fusion b/w palatal shelves
patient walks in with clefts and pits in lip:
what disease does he have?
Van Der Woude
fordyce granules made of what?
extopic sebaceous glands
ptnt walks in with whit lesion on buccal mucosa. dissipitated when cheeck is stretched
LEUKODEMIA
patient complains about hurting and burning. what is this and what is TX?
Geo tongue / migratory glossitis / erythema migrans
TX: none
patient walks in with fissured tongue and bels palsy
what syndrome does ptnt have?
MELKERSSON ROSENTHAL SYNDROME
what makes up an angioma?
blood vessels or lmyph vessels
what is this?
cherry angioma (vessel tumor)
child walks in with this. what is it?
HEMANGIOMA
( congenital proleferation of capillaries )
angioma of meninges (arachnoid and pia matter) + skin along distribution of trigeminal nerve
LYMPHANGIOMA ( congenital prolif of lymph vessels)
patient walks in with big cyst on midline of floor of mouth. contains structures such as hair and sebaceous glands with a doughy consistency
DERMOID CYST
Patient walks in with a lateral neck swelling. what is this and what causes it ?
epithelial cyst inside lymph node of neck
ptnt seen with these cysts along palatine and lingual tonsils. what is it?
oral lymphoepithelial cyst
R/L in posterior mandible. seems like it is below mandibular canal. what is this ?
STAFNE BONE DEFECT
below mandibular canal
heart shaped r/l in the ant. what is this cyst?
tx?
nasopalatine duct cyst
excision
This r/l is found b/w maxillary canine and lateral incisor
globulomaxillary cyst
a teenager gets hit really bad in foorball. R/L shows scalloping around roots.
what is this?
what is in the cyst?
TRAUMATIC BONE CYST
dead space in mandible no epithelial lining
no epithelial lining
aspirate it to diagnose
linea alba is made of what? how does it develop?
hyperkeratosis
chronic friction on mucosa
define erosion and ulcer
erosion: incomplete break through epithelium
ulcer: compelte break
what could have caused this chemical burn?
ASPIRIN
hydro perox
silver nitrate
phenol
patient is a pack a day smoker. what is this called and what is happeneing ?
is it malignant ?
nicotone stomatitis
inflammed salivary duct openings
only pre malignant is related to reverese smoking
patient is a pack a day smoke for past 20 years. what is going on with their gingiva?
what is tmnt?
smoking associated melanosis
tobacco chemicals stimulate melanocytes
tx: reverisble is smoking discontinues
ptnt walks in with pigmentation on mucosa. also has intestinal polyps. what disease do they have ?
PEUTZ JEGHERS SYNDROME ( PJ syndome)
sick from stomach ache at home wearing PJs and got spots on face
what product usually causes this tissue sloughing ?
suggestion for tmnt?
SLS ( sodium laural sulface)
toms of maine or rembrandt tooth paste
patient walks in with vesicles on vermillion border what is this disease?
tx?
HERPES SIMPLEX VIRUS
on keratinized tissue
ACYCLOVIR
shingles is what type of diseaes?
Recurrent varizella zoster virus (herpes zoster)
a patiet walks in with ramsay hunt syndrome. what disase causes this and what CN are affected?
HERPES ZOSTER (shingles)
CN 7 , 8 ( facial paralysis, vertigo, deafness)
a patient walks in and has paralysis, vertigo, and deafness. what diseae do they have and tx?
RAMSAY HUNT SYNDROME (cn 7 and 8)
HERPES ZOSTER (shingles)
NOT SIMPLEX!!!
acyclovir
what are 2 types of herpes simplex virus?
what causes them?
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
what is treatment for this and what type of herpes is it?
Recurrent keratanized
- HERPES LABIALIS
TX: ACYCLOVIR in prodromal period
patient walks in with these vesicles in hard palate.
what is this?
tx?
HERPES SIMPLEX VIRUS
Recurrent intraoral herpes ( attched gingiva, hard palate)
dentist who was treating a herpes patient develops vesicles on his finger. what is this called and what type of virus is it?
herpetic whitlow
HSV!!
what are 2 types of Varicella Zoster Virus?
syndrome associated?
tx?
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
hand-foot-mouth disease also called what?
coxsackie virus
(hand foot mouth cock sack)
people with kopliks spots on their cheek have what disease?
MEASLES
patient walks in and has this sessile proliferation on their skin. what is this called and what causes it ?
Papilloma (Wart)
HPV !!
Ptnt comes in with this very common skin wart. what is this and what causes it?
Verruca Vulgaris
HPV
this type of wart develops from genitals or sexual contact from someone who has genital warts. what is it?
condyloma acuminatum
patient has multiple small dome shaped warts on oral mucosa. what is this disease ?
tx?
focal epithelial hyperplasia (Hecks disease)
warts: HPV
excision w/ excellent prognosis
whole mouth goes to heck
white patch on lateral tongue does not wipe off.
virus that causes it ?
disease associated with?
Oral hairy leukoplakia
EBV
oppurtunistic infection associated with HIV
associated with burkitts lymphoma
a person with oral hairy leukoplakia also has an association with what other ailment?
BRUKITTS LYMPHOMA ( B-cell NHL)
patient has a chancre ulcer on their genital. what type of disease and stage is this associated with?
syphilius
Primary Lesion
what type of bacteria is syphilis associated with?
TREPONEMA PALLIDUM ( spirochete bacteria)
what are 3 characterestics with congenital syphilis
hutchinsons and mulberry molars
deafness
ocular keratitis
*** what are the stages of syphilis and what do they affect?
Primary: chancre (painless lesion)
Seocndary: oral mucous patch / rash
Tertiary: systemic, gumma CNS involvement CV involvement
how does one get TB and what bacteria causes it ?
- inhalation
- mycobacterium tuberculosis
3 stages of TB?
primary
- ghon complex undergoes caseating necrosis
Secondary
- lung infection with cavitation
Miliary
- systemic spread
Tx for TB?
multidrug therapy
- Isoniazid
- rifampin
- ethambutol
IRE
gohnorrhea caused by what bacteria?
Neisseria gonnorhea
actinomycosis is caused by what bacteria?
what is it made of ?
tx?
actinomyces israeilii ( filamentous not fungal)
sulfur granules in purulent exudate
PENICILLIN
ptnt walks into clinic with a tongue that looks like below:
what bacteria causes this?
what disease does this come from?
tx?
SCARLET FEVER
Group A strep coccus pyogens
throat becomes systemc infection
PENCICILLIN
what happens to tongue papilla of strawberry tongue>
inflammed fungiform papillae
patient has white patch on tongue that rubs off. what is this ?
tx?
CANDIDIASIS:
pseudomembranous (white rubs off)
median rhomboid glossitis ( loss of lingual papillae
when on corner of mouth: angular cheilitis
TX:
antifungal (azole or statin)
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
Behcets syndrome (autoimmune disease)
TX: corticosteroids
apthous ulcers vs herpes
apthous: non keratin
herpes: keratin
patient walks in with mulitple red lesions all over lips. what is this called?
what are the 2 types?
erythema multiforme
Minor: herpes simplex hypersensitivty
major (also called steven johnson syndrome) : drug sensitivty
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
ANGIOEDEMA (blood - swelling)
mast cell release IgE and histamines
TX: antihistamines
patient walks into clinic. what is the name of the gingivitis he has.? what causes it? what is tx?
STRAWBERRY GINGIVITIS
wegeners granulomatosis
allergic to inhaled antigen (angioedema allergix rxn to touching or eating)
TX: corticosteroid (prednisone) and cyclophosphoamide
patient has white striations on the cheek. Histologically it has these “saw tooth” rete ridges.
what is this ?
how to tx?
LICHEN PLANUS (wickham striae)
T lymphocytes target and destroy BASAL keratinocytes
tx: corticosteroids
patient walks in with discoid shaped lesions across his face,
what does this patient have?
how is it tested?
tx?
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
hardening of skin and CT nand unifrom widerning of PDL space is called what?
scleroderma
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?
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)
difference between PEMPHIGUS VULGARIS and MUCOUS MEMBRANE PEMPHIGOID
- what are autoantibodies attacking?
- where is it taking place histologically ?
tx?
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
patient has white patch on their tongue that is not wiping off.
what does patient have?
what must be done to know forsure?
LEUKOPLAKIA
candidiasis = (wipes off)
tx: BIOPSY
What is this?
what causes this?
what can this lead to?
PROLIFERATIVE VERRUCOUS LEUKOPLAKIA
HPV 16 and 18
MALIGNANT TRANSOFORMATION TO SSC or verrucous carcinoma
abnormal red lesion of the mouth was found. usually by leukoplakias.
what is this
what is tx?
ERYTHROPLAKIA (red patch)
its a clinical description not diagnosis
HIGHER RISK than leukoplakia
TX: biopsy !!
blisters on lip
what is this ?
what causes this?
ACTINIC CHEILITIS
actinic = solar
UVB rays