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Oral Path > Mucosal Immunologic Diseases > Flashcards

Mucosal Immunologic Diseases Flashcards

1
Q

an allergic reaction in response to contact to food or drugs causing diffuse swelling on face, neck, and/or lips

A

angioedema

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2
Q

In general, allergic reactions are mediated by the mast cell release of ______ and ______. This also occurs due to side effects of ______.

A

IgE and histamines / angiotensin-converting enzyme (ACE) inhibitors

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3
Q

tx of angioedema

A

antihistamines

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4
Q

the most common immunologic mucosal condition

A

aphthous ulcer (commonly known as a “canker sore”)

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5
Q

Which tissue does aphthous ulcer affect?

A

non-keratinized tissues, which includes lining mucosa such as alveolar, buccal, and labial mucosa, the soft palate, and ventral surface of the tongue

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6
Q

HSV vs aphthous ulcer

A

HSV- only impacts keratinized tissues
Aphthous ulcer- only impacts non-keratinized tissues

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7
Q

two different types of aphthous ulcers

A

Minor- heal without scarring
Major- heal with scarring, aka Sutton disease

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8
Q

Sutton disease

A

major aphthous ulcer

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9
Q

a multi-system vasculitis condition that causes aphthous ulcers in the oral cavity and genitals, as well as inflammation of the eyes

A

Behcet’s syndrome

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10
Q

tx for aphthous ulcers

A

only necessary for serious cases, corticosteroids are perfect due to their anti-inflammatory properties

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11
Q

an acute self-limiting condition causing oral and skin lesions that present as flat, round, bulls-eye target lesions, as well as hemorrhagic crusting of the lips

A

erythema multiforme

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12
Q

minor vs major erythema multiforme

A

Minor- related to herpes simplex hypersensitivity
Major- related to drug sensitivity, also known as Stevens Johnson syndrome

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13
Q

a skin or oral mucosa inflammatory condition in which T lymphocytes target and destroy basal keratinocytes resulting in a burning or itching rash

A

lichen planus

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14
Q

secondary to the destruction of basal keratinocytes are basal zone vaculization and sawtooth rete pegs, both of which are observed histologically

A

lichen planus

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15
Q

Two forms of lichen planus:

A

Reticular- characterized by Wickham striae, lacy ribbon-like stripes on affected area
Erosive- also has Wickham striae, as well as red ulceration

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16
Q

an autoimmune disease that causes widespread inflammation and tissue damage in affected organs

A

lupus erythematosus

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17
Q

Two main forms of lupus:

A

Systemic acute- a type III hypersensitivity reaction with involvement of multiple organs, presence of butterfly rash along the bridge of nose, detected via presence of autoantibodies using the ANA test

Discoid chronic- disc-shaped lesions on face, oral lesions look similar to erosive lichen planus

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18
Q

tx for lupus erythematosus

A

corticosteroids

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19
Q

an autoimmune disease characterized by blistering lesions on mucous membranes, a sub-basilar condition in which the body creates autoantibodies against the basement membrane

A

mucous membrane pemphigoid

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20
Q

an autoimmune disorder involving blistering and erosion of skin and mucosal membranes, a suprabasilar condition in which the body creates autoantibodies against desmosomes, adhesive proteins that maintain the structural integrity of tissues

A

pemphigus vulgaris

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21
Q

Mucous membrane pemphigoid vs pemphigus vulgaris

A

Mucous membrane pemphigoid: sub-basilar condition in which the body creates autoantibodies against the basement membrane

Pemphigus vulgaris: suprabasilar condition in which the body creates autoantibodies against desmosomes, adhesive proteins that maintain structural integrity of tissues

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22
Q

The primary lesion of this condition is a soft blister filled with clear fluid “bullae” followed by multiple painful ulcers.

A

pemphigus vulgaris

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23
Q

How is pemphigus vulgaris detected?

A

a positive Nikolsky’s sign in which slight rubbing of affected skin or mucosa results in exfoliation of the outermost layer

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24
Q

detected via a positive Nikolsky’s sign

A

pemphigus vulgaris

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25
Q

tx for pemphigus vulgaris

A

corticosteroids

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26
Q

a condition involving the hardening of skin and CT, can make it more difficult to open the mouth

A

scleroderma

27
Q

dental consequences of scleroderma (2)

A
  • more difficult to open the mouth
  • uniform widening of the PDL space
28
Q

an allergic reaction to inhaled antigens (NOT direct contact like angioedema)

A

Wegener’s granulomatosis (new name: granulamatosis polyangiitis, GPA)

29
Q

characteristic oral manifestation of this condition is strawberry gingivitis

A

Wegener’s granulomatosis (new name: granulamatosis polyangiitis, GPA)

30
Q

tx of granulamatosis polyangiitis

A

corticosteroids (prednisone) and cyclophosphamide

31
Q

high risk areas for premalignant mucosal lesions

A

floor of mouth, lateral and ventral tongue, and palate

32
Q

inflammation of lip due to prolonged sun exposure

A

actinic cheilitis

33
Q

meaning of actinic cheilitis

A

“actinic” = solar
“cheilitis” = reaction to long term sun damage caused primarily by UVB rays

34
Q

tx for actinic cheilitis

A

surgical excision or laser ablation for severe cases

35
Q

red patch on inside surface of mouth, this is a clinical description (NOT a dx)

A

erythroplakia

36
Q

Almost all true erythroplakias are histologically diagnosed as…?

A

significant epithelial dysplasia or carcinomas

37
Q

tx of erythroplakia

A

mandatory biopsy for histology

38
Q

white patch inside mouth that does not wipe off, clinical description (NOT a dx)

A

leukoplakia

Once diagnosis is determined, we no longer refer to this as leukoplakia.

39
Q

tx of leukoplakia

A

mandatory biopsy for histology

40
Q

white patch that does not rub off, is spreading, and has a warty appearance

A

proliferative verrucous leukoplakia (PVL)

41
Q

PVL is believed to be associated with…?

A

HPV 16 and 18 (the same strains that are highest risk for development of cervical cancer)

42
Q

PVL has a high risk of malignant transformation into ________ or ________.

A

verrucous carcinoma or SCC

43
Q

tx of PVL

A

surgical resection

44
Q

lesions from prolonged smokeless tobacco use, smokeless tobacco and its additives drive white mucosal change in vestibule

A

smokeless tobacco associated lesions

45
Q

tx of smokeless tobacco associated lesions

A

ranges from basic biopsy to surgical excision depending on severity, early and late stage lifestyle interventions

46
Q

Progression of cancer development:

A

hyperplasia –> dysplasia –> in situ cancer –> invasive cancer

47
Q

initial stage in the development of cancer, characterized by increased cell reproduction rate

A

hyperplasia

48
Q

abnormal development of cells, can lead to a variety of conditions and pre-cancerous cells

A

dysplasia

49
Q

refers to cancer cells that have not spread beyond their formation site

A

in situ (original place)

50
Q

marks when cancer has officially grown past the original tissue and has entered blood or lymph to travel

A

invasive cancer

51
Q

T or F: True basal cell carcinoma of the oral cavity is extremely rare.

A

T

52
Q

caused by sun damage, has an ulcerated erythroplakia appearance, metastasis is extremely rare

A

oral basal cell carcinoma

53
Q

tx for oral BCC

A

simple surgery to remove lesion

54
Q

melanoma frequently impacting the hard palate and maxillary alveolar mucosa

A

oral melanoma

55
Q

a malignancy of melanocytes, the dark purple/black lesions metastasize more rapidly than other malignant lesions

A

oral melanoma

56
Q

tx of oral melanoma

A

wide excision, continued follow-ups

57
Q

exophytic or ulcerated erythroplakia or leukoplakia growth between vermillion border and junction of hard and soft palate or posterior 1/3 of tongue

A

oral SCC

58
Q

What causes SCC?

A

oncogene or tumor suppressor gene inactivation, which is driven by use of tobacco and/or alcohol

59
Q

viral risk factor for oral SCC

A

HPV 16 and 18

60
Q

syndrome that has been identified as a risk factor for oral SCC, includes mucosal atrophy, dysphasia, and iron deficiency anemia

A

Plummer Vinson syndrome

61
Q

tx for oral SCC

A

excision or cancer radiation therapy

62
Q

a variant of oral SCC, accounts for 2-12% of all oral carcinomas, has slow exophytic growth and appears warty and pebbly

A

oral verrucous carcinoma (OVC)

63
Q

5-year survival rate for OVC, OSCC, OBCC, and oral melanoma

A

OVC = 50%
OSCC = 50%
OBCC = 100% (in cases that have not spread)
Oral melanoma = 10-25%

Oral Path (13 decks)

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