MD ORAL PATHOLOGY Flashcards
1
Q
Define cleft lip
A
lack of fusion b/w medial nasal process and maxillary process
2
Q
define cleft lip
A
lack of fusion b/w palatal shelves
3
Q
patient walks in with clefts and pits in lip:
what disease does he have?
A
Van Der Woude
4
Q
fordyce granules made of what?
A
extopic sebaceous glands
5
Q
ptnt walks in with whit lesion on buccal mucosa. dissipitated when cheeck is stretched
A
LEUKODEMIA
6
Q
patient complains about hurting and burning. what is this and what is TX?
A
Geo tongue / migratory glossitis / erythema migrans
TX: none
7
Q
patient walks in with fissured tongue and bels palsy
what syndrome does ptnt have?
A
MELKERSSON ROSENTHAL SYNDROME
8
Q
what makes up an angioma?
A
blood vessels or lmyph vessels
9
Q
what is this?
A
cherry angioma (vessel tumor)
10
Q
child walks in with this. what is it?
A
HEMANGIOMA
( congenital proleferation of capillaries )
11
Q
angioma of meninges (arachnoid and pia matter) + skin along distribution of trigeminal nerve
A
LYMPHANGIOMA ( congenital prolif of lymph vessels)
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
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
14
Q
ptnt seen with these cysts along palatine and lingual tonsils. what is it?
A
oral lymphoepithelial cyst
15
Q
R/L in posterior mandible. seems like it is below mandibular canal. what is this ?
A
STAFNE BONE DEFECT
below mandibular canal
16
Q
heart shaped r/l in the ant. what is this cyst?
tx?
A
nasopalatine duct cyst
excision
17
Q
This r/l is found b/w maxillary canine and lateral incisor
A
globulomaxillary cyst
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
19
Q
linea alba is made of what? how does it develop?
A
hyperkeratosis
chronic friction on mucosa
20
Q
define erosion and ulcer
A
erosion: incomplete break through epithelium
ulcer: compelte break
21
Q
what could have caused this chemical burn?
A
ASPIRIN
hydro perox
silver nitrate
phenol
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
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
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
25
what product usually causes this tissue sloughing ?
suggestion for tmnt?
SLS ( sodium laural sulface)
toms of maine or rembrandt tooth paste
26
patient walks in with vesicles on vermillion border what is this disease?
tx?
HERPES SIMPLEX VIRUS
on keratinized tissue
ACYCLOVIR
27
shingles is what type of diseaes?
Recurrent varizella zoster virus (herpes zoster)
28
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)
29
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
30
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
31
what is treatment for this and what type of herpes is it?
Recurrent keratanized
- HERPES LABIALIS
TX: ACYCLOVIR in **prodromal** period
32
patient walks in with these vesicles in hard palate.
what is this?
tx?
HERPES SIMPLEX VIRUS
Recurrent intraoral herpes ( attched gingiva, hard palate)
33
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!!
34
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
35
hand-foot-mouth disease also called what?
coxsackie virus
(hand foot mouth cock sack)
36
people with kopliks spots on their cheek have what disease?
MEASLES
37
patient walks in and has this sessile proliferation on their skin. what is this called and what causes it ?
Papilloma (Wart)
HPV !!
38
Ptnt comes in with this very common skin wart. what is this and what causes it?
Verruca Vulgaris
HPV
39
this type of wart develops from genitals or sexual contact from someone who has genital warts. what is it?
condyloma acuminatum
40
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
41
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_**
42
a person with oral hairy leukoplakia also has an association with what other ailment?
BRUKITTS LYMPHOMA ( B-cell NHL)
43
patient has a chancre ulcer on their genital. what type of disease and stage is this associated with?
syphilius
Primary Lesion
44
what type of bacteria is syphilis associated with?
TREPONEMA PALLIDUM ( spirochete bacteria)
45
what are 3 characterestics with congenital syphilis
hutchinsons and mulberry molars
deafness
ocular keratitis
46
\*\*\* 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
47
how does one get TB and what bacteria causes it ?
- inhalation
- mycobacterium tuberculosis
48
3 stages of TB?
**primary**
- ghon complex undergoes caseating necrosis
**Secondary**
- lung infection with cavitation
**Miliary**
- systemic spread
49
Tx for TB?
multidrug therapy
- Isoniazid
- rifampin
- ethambutol
IRE
50
gohnorrhea caused by what bacteria?
**Neisseria** gonnorhea
51
**actinomycosis** is caused by what bacteria?
what is it made of ?
tx?
actinomyces israeilii ( **filamentous** not fungal)
***sulfur granules** in purulent exudate*
PENICILLIN
52
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
53
what happens to tongue papilla of strawberry tongue\>
inflammed fungiform papillae
54
55
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)**
56
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
57
apthous ulcers vs herpes
apthous: non keratin
herpes: keratin
58
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_**
59
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
60
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
61
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
62
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
63
hardening of skin and CT nand unifrom widerning of PDL space is called what?
scleroderma
64
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)
65
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
66
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
67
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**
68
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 !!
69
blisters on lip
what is this ?
what causes this?
ACTINIC CHEILITIS
actinic = solar
UVB rays
70
patient who uses tobacco products walks in with this whitish looking lesion. what is this and what type of tobacco ?
smokeless tobacco associated lesion
white mucosal changes in vestibule = SMOKELESS TOBACCO (dip)
71
cancer types:
carcinoma : ET
Sarcoma : CT
Leukemia: blood
lymphoma: lymphatic
72
what are the stages of cancer?
when is something considered **malignant**??
hyperplasia -\> dysplasia -\> cancer in situe -\> invasice cancer
invades past BASEMENT MEMBRANE
local invasion : CT
metastasis: blood, lymph etc
73
WHAT IS THIS?
what are the causes ? 2 factors
what develops into this disease ?
tx?
**Verrucous Carcinoma**
cause : _**TOBACCO \*\***_ and HPV **16** and **18** (wart)
comes from verrucous ***LEUKOPLAKIA***!!!
tx: **excision**
74
what is the cause of squamous cell carcinoma ? \*\*
HPV accosiated with it ?? \*\*
5 - year survival ? \*\*
TX? \*\*
**_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
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 ?
PLUMMER VINSON SYNDROME (**SSC**)
76
BASAL CELL CARCINOMA:
cause?
danger?
tx?
SUN DAMAGE
rarely metastisizes
surgery
77
patient walks in with this lesion:
what is it?
what is going on histologically?
survival rate after 5 years?
ORAL MELANOMA
malignancy of MELANOCYTES
high risk on palate and gingiva
5year:
\>65% for skin
\<20% for oral lesions
78
what is this?
cause?
FIBROMA (benign)
chronic trauma or irritation
fibrous hyperplasia of oral mucosa
79
what 3 meds caused gingival hyperplasia ?
tx?
Ca+ Channel blockers
Dilantin (anticonvulsant)
cyclosporine (immunosuppressant)
TX: gingivectomy and discontinue drug
80
what is this called and what causes it ?
EPULIS FISSURATUM
over extended flange
81
What is this and what is this called?
papillary hyperplasia ( palate)
poorly cleaned or fitted denture
82
this neuroma is most common by mental forament. what is this and what causes it ?
traumatic neuroma
neurofibroma
mortons neuroma
TRAUMATIC NEUROMA
caused by injury to nerve
83
what is this called?
what structures make up this lesion?
pyogenic granuloma
nodular fasciitis
fibromatosis
granular cell tumor
PYOGENIC GRANULOMA
**hyperplasia of capillaries**: red
trauma induced
84
nodular fasciitis is neoplasm of what cells?
tx?
neoplasm of FIBROBLASTS
surgical excision ( easy to eradicate)
85
fibromatosis is neoplasm of what?
Fibroblasts
difficult to eradicate and ofter recurs
86
**granular cell tumor:**
neoplasm of what cells?
what does it mimic?
most ocmmon location ?
**SCHWANN CELLS**
most common on dorsal tongue
pseudoepitheliomatous hyperplasia (PEH)
mimics SCC
87
patient gets a biopsy for this tumor. this is what it looks histologically.
what type of tumo is this?
what cells is it affecting?
**_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
\*\*\* **NEUROFIBROMA**:
neoplasm of what cells?
what is disease asociated with it?
transforms into what if not treated?
**Schwann** cells AND **fibroblasts** (neuro cells and fibrin cells)
**Neuofibromatosis type 1 / Von recklinghausens disease**
( skin freckles, axillary freckles, iris freckles)
Neurofibrosarcoma
89
patient with neurofibromatosis type 1 / con recklinghausen has what clinical feature?
cafe au lait spots ( skin freckles)
also have axillary freckles (underarm) and iris freckles
90
BENIGN CT TUMORS:
Leimyoma: neoplasm SM cells
rhabdomyoma: neoplasms: skelatal muscle cells
lipoma: neoplasm of fat cells
91
fibrosarocma:
malignancy of what?
cells it affects?
**CT cancer**
**malignant** proliferation of **_fibroblasts_** (malignant ct disease)
92
what is neurofibrosarcoma?
**malignant** proliferation of **_schwann cells_** ( neuro = schwann cells)
also known as malignant peripheral nerve sheath tumor
93
Kaposis sarcoma:
affects what cells ?? \*\*\*
caused by what cell?
**malignant** proliferation of **_ENDOTHELIAL CELLS_** (lines organs and blood) (still malignant ct disease)
**HHV8 (human herpesvirus 8)**
**purple lesion**
94
mucocele vs ranula: \*\*\*\*\*
trauma to what??
how do you get them?
their location?
tx?
**salivary duct** (mucous cyst)
Mucocele **: LOWER LIP (** contains mucous**)**
Ranula **: FLOOR OF MOUTH**
tx: complete excision
95
\*\*\* MUCOUS RETENTION CYST:\*\*\*\*
what causes it?
how is it different than mucocele and ranula ?
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
\*\*\*\* **rapidly expanding** and **ulcerative lesion** due to ischemic necrosis of **salivary gland**:
what is it?
what causes necoris ?
tmnt?
**_NECROTIZING sialometaplasia_**
cause: TRAUMA or LA !!
heals on own in 6-10 weeks
97
this is a blockage of glands in **sinus** of mucosa:
what is it called?
tx?
sinus retention cyst
none
98
this is a type of pulmonary disease that also affects salivary glands and mucosa.
**what is an oral clinical feature ?**
tx?
SARCOIDOSIS
XEROSTOMIA
corticosteroids
99
patient with dry mouth, bilateral hilar lymphadenopathy and arthirits comes in. what do they have?
sarcoidosis
100
\*\*\*SJOGRENS SYNDROME:
cells associated with?
what glands does it affect?
Primary vs Secondary?
TX:
autoimmune: **_lymphocytes_** mediated
**salivary** and **tear** glands
**PRIMARY**: keratoconjunctivitits sicca (dry eyes) and xerostomia
**SECONDARY**: everything above + another autoimmune diseae (RA)
tx: symptomatic
101
MOST COMMON BENIGN SALIVARY GLAND TUMOR?
monomorphic adenemoa
pleomorphic adenoma
adenoid cystic carcinoma
polymorphous low grade adenocarcinoma
PLEOMORPHIC ADENOMA (most common parotid tumor)
102
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
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
this benign tumor is composed of single cell type
tx?
MONOMORPHIC ADENOMA (single cell type)
benign salivary gland
exccision
104
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?
**WARTHINS TUMOR**: (old age + parotid gland)
**Oncocytes** ( epithelial cell w/ excessive # of mitochondria) + **lymphoid** cells
105
MOST COMMON **MALIGNANT** SALIVARY GLAND?
monomorphic adenemoa
pleomorphic adenoma
Mucoepedermoid carcinoma
adenoid cystic carcinoma
polymorphous low grade adenocarcinoma
MUCOEPUDERMOID CARCINOMA
**Mucous** + **epithelial** cells
106
second most common salivary gland malignancy for minor salivary glands?
monomorphic adenemoa
pleomorphic adenoma
Mucoepedermoid carcinoma
adenoid cystic carcinoma
polymorphous low grade adenocarcinoma
PLGA ( polymorphous low-grade adenocarcinoma)
first is mucoepidermpod carcinoma
107
after taking biopsy it is show that histolgy has a swiss cheese pattern
what is this?
5 year and 15 year survival rate?
ADENOID CYSTIC carcinoma
5year: 70%
15 year: 10%
108
\*\*\* HODKINS LYMPHOMA:
affects what cells?
tx?
REED-STERNBERG CELLS = malignant B cells
chemo/radio
rmbr: **LYMPHOMA** = all lymphoids are **malignant b/c cancer spread to lymph**
109
NONHODGKINS LYMPHOMA:
cell type?
tx?
Neoplasm: B or T cells
chemo / radio
rmbr: LYMPHOMA = all lymphoids are malignant b/c cancer spread to lymph
110
\*\*\* what type of disease is **_BURKITTS_** lymohoma associated with?
what happens during it?
**NONHODKINGS LYMPHOMA _B CELL TYPE_**
**bone marrow**
B cell Bone marrow Burkitt
lip paresthesia, tooth mobility, halts root development
111
\*\*\* punched out R/L in the skull \*\*\*
what is this disease and what causes punched out lesions?
cells it effects?
tx?
**\*\*\*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
\*\*\*LEUKEMIA\*\*\*\*:
cells ?
classification is based on what 2 things?
3 clinical signs ?
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
least dangerous to most dangerous leukemia
CLL
CML
AML
ALL
**ALL** (acute lymphocytic lekemia) \> **CML** (chronic myeloid (bone marrow) lymphocytic leukemia \> **AML** \> **CLL** (chronic lymphocytic leukemia)
## Footnote
**ALL Children Are ChiLL**
114
what is the most common ODONTOGENIC cyst?
radicular cyst
115
what is this?
vital or non vital?
what happens in acute vs chronic stage?
tx?
RADIUCLAR CYST ( odontogenic cyst)
- **nonvital**
necrotic pulp causes inflammation
_acute_: **abscess**
_chronic_: **granuloma**
rct apicectomy or extraction with curettage
116
RADICULAR CYST does damge to what part of tooth?
EPITHELIAL RESTS OF MALASSEZ (ERM) from Hertwigs epithelial root sheath (HERS) in pockets of inflmation encapsulated resulting foramtion of a cysts
117
EPITHELIAL RESTS OF MALASSEZ FROM HERTWIGS EPITHELIAL FUNCTION and what happens when get inflammed?
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
what is this called?
area most common in?
what is this made of?
tx?
**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
Dentigerous cyst:
wehre is r/l?
CEJ of impacted tooth
120
what is this cyst found mostly in mand premolar region ?
vital or nonvital?
tx?
LATERIAL PERIODONTAL CYST
vital tooth
mandibular premolar region
121
ptnt walks in with this cyst but it is not showing on radiograph. what is it?
tx?
GINGIVAL CYST OF ADULT
same as lateral periodontal cyst except **_NO R/L_**
excision
122
NEW BORN GINGIVAL CYST:
what is one on midlien called?
one on lateral plate called?
what tissue causes this?
LATERAL PLATE: bohns nodule
epstein pearls: midline plate
**rests of dental lamina**
**BLEM**
tx: none
123
what is this?
most common location ?
**PRIMORDIAL CYST**
develops where tooth would have formed
mand 3rd molar region
complete removal
124
**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
**KCOT** (keratocystic odtongenic tumor)
**thin corrugated parakeratinized epithellim**
agressive enucleation !!
125
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
GORLIN SYNDROME
126
gorlin syndrome associated with what clinical features?
KCOTS
BCC
**CALCIFIED FALX CEREBRI**
127
128
this type cyst is associated with ghost cells
Calcifying odontogenic cyst
Keratocystic odontogenic tumor
Ameloblastoma
Calcifying epithelial odontogenic tumor
COC (calcifying odontogenic cyst) aka GORLIN CYST
ghost cell : empty space where nucleus is filledw ith keratin
129
what is this agressive **multilocular** disease?
tx?
likely to come back ?
Calcifying odontogenic cyst
Keratocystic odontogenic tumor
Ameloblastoma
Calcifying epithelial odontogenic tumor
AMELOBLASTOMA \*\*\*
**benign** but agressive
**wide escision or resection,**
high recurrence if too conservative
130
MULTILOCULAR DIFFERENTIAL DIAGNOSIS?
**AMELOBLASTOMA**: benign but agressive and recurring/wide escision or resection
**KCOT**: agressive and recurring / aggressive enucleation.
**CGCG**
**COF**
131
this r/l has a driven snow calcification ( white flecks)
tc?
Calcifying odontogenic cyst
Keratocystic odontogenic tumor
Ameloblastoma
Calcifying epithelial odontogenic tumor
**CEOT** aka **pindborg** tumor
surgical excision, good prognosis
132
what lesion is accosiated with histological l**_iesegang rings_**? \*\*
Calcifying odontogenic cyst
Keratocystic odontogenic tumor
Adenomatoid odontogenic tumor
Ameloblastoma
Calcifying epithelial odontogenic tumor
CEOT aka PINDBERG TUMOR
133
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
ADENOMATOID ODONTOGENIC **_TUMOR (AOT)_**
mostly in ant **maxilla** and over **impacted canine**
TX: surgical excision good prognosis
134
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
ODONTOGENIC MYXOMA aka mycofibroma
myxomatous connective tissue: **_SLIMY STROMA_**
surgical excision
135
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
CENTRAL ODONTOGENIC FRIBROMA (COF)
dense collagen with strands of epithelim
**central**: bone, well definined multioculat r/l
**peripheral** = gums
136
here is a well circumscribed r/o mass
what is this called?
tx?
CEMENTOBLASTOMA !! \*\*
ball of cememntum and cementoblasts replacing TOOTH ROOT
tx: surgical excision (cutting out) and extraction
137
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
**AMELOBLASTIC FIBROMA** (mixed benign tumor)
children in teens
mostly post mandible
**MYXOMATOUS CT**
surgical excision
138
what is this called ?
COMPOUND odontoma
| (bunch of minature teeth)
139
what is this r/o mass called that is blocking eruption?
**COMPLEX** odontoma
mostly posterio (conglomerate mass of hard tissue)
140
Clinical features of **GARDNER SYNDROME**?\*\*
**multiple odontomas + intestinal polyps**
multiple **teeth bits** buried in a **garden** that causes **intestinal** problems if eaten
141
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
CENTRAL OSSIFYING FIBROMA
rmbr: central = middle of bone (very similar to odontogenic tumor )
surgical **excision**
142
this has a **ground-glass** appearance.
what is this ?
FIBROUS DYSPLASIA (fiber glass)
stops growing after puberty
143
what disease is associated with fibrous dysplasia\>
**mcCune Albright syndrome:**
polyostotic fibrous dysplasia + cafe au lait + endocrine abnormalities (precocius puberty)
144
40 year old black woman shows this on her radiograph in her mand anteriors.
what is it?
vital or non vital?
tx?
**PCOD ( periapical cemento osseous dysplasia) \*\*\***
apices mand ant/ middle aged black women
vital
rmmbr: odontogenic tumor
none
145
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
osteoBLASTOMA ( Oblasts)
surgical excision
146
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
_**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
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
**ANEURYSMAL bone cyst**
-**pseudo** cyst filled with **blood**
**rmbr: aneurysm: bulge filled with blood**
tx: excision
148
ptnt has multiple bone lesions
tests show elevated alkaline phophatase
what is this ?
what disease associated with?
HYPERPARATHYROIDISM
^ PTH = ^ alkaline phosphates (too much bone breakdown)
_**von recklinghausen disease *of bone***_ : hyperparathyoridsm
***von recklinghausen disease***: neurofromitosis 1
149
what is **brown tumor** associated with?
HYPERPARATHYROIDISM
^ osteoclast activity = ^ bone breakdown
150
child with radiograph shows multilocuilar r/l
bilateral swellings and expansile
stops growing after puberty
CHERUBISM
151
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
LANGERHANS CELL DISEASE aka iodpathic histiocytosis
rmbr: giant bone cell lesion
tx: excision , radiation, chemo
152
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?_**
PAGETS DISEASE (cooton wool)
elevated **alkaline phosphatase** due to breakdown of bone
tx: bisphosphonates, calcitonin
pagets = bad bone= bisphosphonates/calcitonin
153
ptnt walks in clinic and has deep pain. high fever, and paresthesia.
what does patient have?
what is it caused by?
tx?
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
radiograph shows mottle r/l resembling onion skinning?
## Footnote
**TREATMENT ??**
chronic osteimyelitis
**_antibiotics and debridement_**
155
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 \*\*\*
**_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
woman walks in who is taking bisphosphonates.
what is this called ?
is it worse in IV or oral ?
tx?
**_BRONJ_** (bisphoph related ostenec of jaws)
IV\> oral
tx: ***_CHX rinse_***, antibiotics, surgery \*\*\*\*
157
what do nearly ever malignant bone lesions have an issue with clinically?
paresthesia or anesthesia
158
pstients xray shows sunburst pattern
what is this?
5 year survival?
how does this happen?
tx?
OSTEOSARCOMA
**new bon**e is produced by tumor cells
25-40 %
resection and chemotherapy ( b/c cancer type)
159
Cancer patient showing new cartilage developing called what?
more common involving what structure ?
CHONDROSARCOMA
CONDLYE b/c cartilage
160
this sarcoma effects children and histolgy has round cells
EWINGS SARCOMA
**kids** say **EW** to round **belly**
161
a patient with breast cancer comes to dentist because her lip is numb
patient shows ill defined changes in radiograph
what is this\>
**METASTATIC CARCINOMA \*\***
metastatic= originated from somwhere else
BREAST \> LUNG \> KIDNET \> COLON\> PROSTATE
162
patient has white spongy stuff on buccal mucosa that they cant wipe off. what is it?
white sponge nevus
163
a patient who has _iron defincieny anemia_ has consisten _nose bleeds_ and andormal capilary formation on skin,
what is this?
HHT ( hereditary hemorrhaig telangiectasia)
telangiectasia: red macules or papules, dilated or broken capillaries
164
iron deficinecy anemia and epistaxis (nose bleeds) is associated with what disease ?
HEREDITARY HEMORRHAGIC TELANGIECTASIA
HHT
165
\*\*\*\* this ailment has missing clavicles and supernumery teeth
CLEIDOCRANIAL DYSPLASIA
missing clavicles in xray
166
missing teeth and hypoplastic hair and nails. what is this ?
ECTODERMAL DYSPLASIA
ectoderm = hair and nails
167
bones abnormally dense and prone to breakage.
how does it happen?
OSTEOPETROSIS
lack of bone remodeling and resorption
168
a person who has damaged enamel has this radiograph
tx?
AMELOGENESIS IMPERFECTA
enamel damage all teeth affected
tx: **full coverage crowns**
169
blue sclera is a characteristic of what ?
dentinogenesis imperfect
170
what is this?
tx?
**demtinogenesis imperfect**
short roots, bell shjaped crowns, obliterated pulps
all teeth affected
tx: full coverage crowns
171
what is this?
**_dentin dysplasia_**
**chevron pulps** and **short roots**!!
172
what is this?
Tx?
**_regional odontodysplasia_**
- quadrant of teeth exhibit short roots, open apices, enlarged pulp chambers
GHOST TEETH (huge pulps)
173
what is it called when tooth count is one less than normal?
**FUSION**
2 buds = 1 tooth
geminiation =
- 1 root = 2 crowns
- normal count
174
