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GI2 E1 > oral cavity > Flashcards

oral cavity Flashcards

robbins

1
Q

what is the etiology of dental caries

A

focal demineralization of enamel and dentin by acidic metabolites produced by bacteria

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2
Q

what is the most common cause of tooth loss before the age of 35

A

dental caries

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3
Q

name a protective factor against developing dental carie

A

fluoride in the water, incorporates into the enamel

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4
Q

inflammation of the oral mucosa= _____. this results from _______ and will lead to ________

A

gingivitis

poor oral hygiene

accumulation of dental plaque and calculus

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5
Q

what is a dental plaque

A

a biofilm that collects on and between teeth made of bacteria, salivary proteins, and desquamated epithelial cells

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6
Q

if a dental plaque is not removed, it will ____ to form a _____

A

mineralize, calculus

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7
Q

in what population is gingivitis most common

A

adolescence

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8
Q

describe trx and prognosis of gingivitis

A

its no big deal, just don’t eat that much sugar, floss and brush your teeth

it is reversible

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9
Q

what is the pathogenesis periodontitis

A

inflammation of periodontal ligaments, alveolar bone, and cementum

caused by poor oral hygiene, leading to change in oral flora

can eventually lead to the loss of teeth

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10
Q

describe the classes of organisms that cause periodontitis

A

in healthy gingival sites= G+ organisms

in active periodontitis, you start to get anaerobic and microaerophilic G- flora

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11
Q

what are the organisms primary associated with adult periodontitis

A

Actinobacillus actinomycetemcomitans
prophyromonas gingivalis
prevotella intermedia

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12
Q

what systemic conditions are associated with periodontitis

A

it can be a part of AIDS, leukemmia, Crohn’s, DM, Down Syndrome, sarcoidosis, chediak-higashi, neutropenia…

can cause infective endocarditis, pulmonary and brain abscesses

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13
Q

what is an aphthous ulcer

A

a canker sore=

recurrent, v painful, superficial, oral mucosal ulceration

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14
Q

what population is an aphthous ulcer associated with

A

very common, but most common in the first 2 decades of life

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15
Q

what systemic conditions are associated with aphthous ulcers

A

celiac
IBD
Behcet ds

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16
Q

‘single or multiple, shallow hyperemic ulcerations (of oral mucosa) covered by a thin exudeate and rimmed by a narrow zone of erythema’

A

aphthous ulcer

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17
Q

what is an irritation/traumatic fibroma

A

a submucosal nodular mass that primarily occurs on the buccal mucosa along the bite line or the gingiva

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18
Q

what is the treatment for an irritation/traumatic fibroma

A

complete surgical excision

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19
Q

what is a pyogenic granuloma

A

an inflammatory lesion typically found on the gingiva of children, YA, and pregnant women

=ulcerated, red-purple

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20
Q

“a highly vascular proliferation of organizing granulation tissue” “ulcerated, red to purple” in the oral mucosa

A

pyogenic granuloma

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21
Q

what is the prognosis and treatment of a pyogenic granuloma

A

can either regress, mature, or develop into an ossifying fibroma

definitive treatment is surgical repair

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22
Q

what is a peripheral ossifying fibroma

A

a common gingival growth that may arise from either

  • a long standing pyogenic granuloma
  • de novo from cells of the periodontal L
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23
Q

what population has the peak incidence for peripheral ossifying fibroma

A

young and teenage females

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24
Q

what is the treatment for peripheral ossifying fibroma

A

complete surgical excision down to the periosteum

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25
Q

in the gingiva an “aggregation of multinucleated, foreign body-like giant cells seperated by a fibroangiomatous stroma” “covered by intact gingival mucosa, may be ulcerated”

A

peripheral giant cell granuloma

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26
Q

what entity are most orofacial herpetic infections caused by

A

herpes simplex virus type 1 (HSV-1)

HSV-2 can occur but not as common

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27
Q

in what population do primary HSV-1 infections occur

A

children between 2 and 4 years of age

most adults harbor a latent infection

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28
Q

what is the prognosis of HSV-1 infections of the oral cavity

A

most are asymptomatic

but 10-20% can progress to acute herpetic gingivostomatitis with abrupt onset of vesicles and ulcerations of the mucosa, with lymphadenopathy, fever, anorexia..

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29
Q

describe the clinical presentation of recurrent herpetic stomatitis

A

-sx occur at the site of primary inoculation or adjacent mucosa associated with the same ganglion, groups of small vesicles on the lips, nasal orifice, buccal mucosa, gingiva, and hard palate

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30
Q

what is the common causative agent for mononucleosis, nasopharyngeal carcinoma, lymphoma

A

EBV

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31
Q

what is the common causative agent with herpangina, hand-foot-and-mouth disease, acute lymphonodular pharyngiti

A

enterovirus

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32
Q

what is the common causative agent of measles

A

rubeola

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33
Q

what is the most common fungal infection of the oral cavity

A

candida albicans

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34
Q

what factors influence the likelihood of someone being infected with candida

A
  • immune status
  • the strain of candida
  • the individual’s normal oral flora
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35
Q

what is the most common clinical form of oral candidiasis

A

pseudomembranous aka thrush

as opposed to erythematous and hyperplastic

36
Q

in oral cavity ‘superficial, gray to white inflammatory membrane made of organisms enmeshed in a fibrinosuppurative exudate that can be readily scraped off to reveal an underlying erythematous inflammatory base’

A

candida albicans

37
Q

what are the oral changes associated with scarlet fever

A

raspberry tongue= fiery red with prominent papillae

strawberry tongue= white coated tongue through which hyperemic papillae project

38
Q

what are the oral changes associated with measles

A

spotty enanthema in the oral cavity, preceding a skin rash

ulcerations on the buccal mucosa

koplik spots

39
Q

what are the oral changes associated with infectious mono

A

acute pharyngitis and tonsillitis that can case a gray-white exudative membrane
enlargement of the LN in the neck
palatal petechiae

(EBV, associated with nasopharyngeal carcinoma)

40
Q

what are the oral changes associated with diphteria

A

dirty white, fibrinosuppurative, tough, inflammatory membrane over the tonsils

41
Q

what are the oral changes associated with HIV

A

changes with herpes, candida, kaposi sarcoma and hairy leukoplakia

42
Q

what are the oral changes associated with lichen planus

A

reticulate, lacelike, white keratotic lesions that sometimes ulcerate and sometimes form bullae

43
Q

what is a risk of abx that eliminate or alter the normal bacterial flora of the mouth

A

can result in candidiasis

44
Q

what deep fungal infections have a predilection for the oral cavity

A 
histoplasmosis
blastomycosis
coccidioidomycosis
cryptococcosis
zygomycosis (aka mucormycosis)
aspergillosis
45
Q

what is hairy leukoplakia

A

an oral lesion on the lateral border of the tongue caused by EBV usually seen in the immunocompromised

46
Q

in what populations will you see hairy leukoplakia

A

the immunocompromised

AIDS and older people

47
Q

“white, confluent patches of fluffy, hyperkeratotic thickenings” “balloon cells” in the upper spinous layer

A

hairy leukoplakia

48
Q

how do you differentiate between candida and hairy leukoplakia

A

candida you can scrape off, hairy leukoplakia you can’t

both are white

49
Q

a white patch or plaque that cannot be scraped off and cannot be characterized as any other disease

white patches/plaques that have sharply demarcated borders

A

leukoplakia

50
Q

until proven otherwise, all leukoplakias must be considered _______

A

precancerous

51
Q

“a red, velvety, possible eroded area.. remains level or slightly depressed” “almost always have severe dysplasia, CIS, or minimally invasive carcinoma” “subepithelial inflammation with vascular dilation”

A

erythroplakia

52
Q

what is a speckled leukoerythroplakia

A

an intermediate form between leukoplakia and erythroplakia

53
Q

in what population would you find leukoplakia and erythroplakia

A

male adults, mostly 40-70 y.o

54
Q

what is the most common CA of the head and neck

A

squamous cell carcinoma (95% of them)

55
Q

vascular neoplasms caused by _____ occur in AIDS patients

A

HHV8

56
Q

in what population will you find oral cavity squamous cell carcinoma

A

middle aged people who’ve been chronic abusers of smoked tobacco and alcohol

growing in individuals younger than 40 (HPV subtype)

57
Q

what are common risk factors for squamous cell carcinoma

A

tobacco and alcohol

eat paan or betel quid

actinic radiation (sun)

pipe smoking

58
Q

as many as 70% of squamous cell carcinomas harbor oncogenic variants of ____, particularly ________

A

HPV:HPV 16

59
Q

describe the prognosis of squamous cell carcinoma

A

classic early stage= 80% 5 year survival

late stage=20% 5 year survival

greater survival in HPV POSITIVE than HPV -

NOT DEPENDENT ON LEVEL OF DIFFERENTIATION IN CELLS

60
Q

describe the significance of field cancerization in respect to squamous cell carcinoma

A

rate of second primary tumor in patients with squamous cell carcinoma is higher than any other malignancy

field cancerization postulates that multiple individual primary tumors develop independently in the upper aerodigestive tract as a result of chronic exposure to carcinogens

61
Q

_____ ______ ______ are the most common cause of death in squamous cell carcinoma

A

second primary tumors

62
Q

what are the frequent genetic mutations in squamous cell carcinoma

A

p63+ NOTCH1

overexpression of p16

inactivation of p53 and RB

63
Q

describe the stages of squamous cell carcinoma

A

not a linear progresion

generally preceded by leuko/erythroplakia

early stages= raised, firm, pearly plaques or irregular, roughened or verrucous areas of mucosal thickening

can enlarge, and create ulcerated and protruding massess

may or may not progress to full thickness before invading the underlying connective tissue stroma

64
Q

what are the most common sites of distant metastasis of squamous cell carcinoma

A

mediastinal LNs, lungs, liver, and bones

65
Q

what are odontogenic cysts and where are they

A

=derived from remnants of odontogenic epithelim

present within the jaws

66
Q

cyst in the teeth area = ‘thin layer of keratinzed stratified squamous epithelium with a prominent basal cell layer and a corrugated epithelial surface”

A

OKC/ keratocystic odontogenic tumor

67
Q

in what population will you most likely see an OKC/keratocystic odontogenic tumor

A

between 10-40 y.o., most often a male with a posterior mandible

68
Q

treatment for an OKC/keratocystic odontogenic tumor requires _________________ because they are _____ and ______ can reach up to 60%

A

complete removal of the lesion

locally aggressive

recurrence rates

69
Q

patients with multiple OKCs/keratocystic odontogenic tumors should be evaluated for ____, which is associated with ______ located on _____

A

nevoid basal cell carcinoma syndrome (Gorlin syndrome)

mutations of the PTCH tumor suppressor gene

located on chromosome 9q22

70
Q

an inflammatory cyst found at the apex of teeth

A

periapical cyst

71
Q

what causes a periapical cyst and what can it result in

A

caused by advanced carious lesions/trauma

may result in necrosis of the pulpal tissue—> the cyst can exit into the surrounding alveolar base, causing the formation of a radicular cyst

72
Q

what is the treatment of a periapical cyst

A

because they persist a long time with the presence of bacteria, trx requires the complete removal of the offending agent and appropriate restoration of the tooth or extraction

73
Q

________ are derived from odontogenic epithelium, ectomesenchyme, or both

A

odontogenic tumors

74
Q

the two most common and clinically significant odontogenic tumors

and whats the differnece between them

A

ameloblastoma= no ectomesenchymal differentiation

odontoma= most common= extensive depositions of enamel and dentin

75
Q

what is the physical description of a mucocele

A

bluish in color, fluctuant and non tender mass

76
Q

pseudocyst vs real cyst

A

real cyst as epithelium, pseudocyst no have it

77
Q

inflammatory granulation tissue devoid of an epithelial lining

A

mucocele

78
Q

where is the HSV virus stored in latent infection

A

trigeminal ganglion/ semilunar ganglion

79
Q

“intra and intercellular edema with giant cells” Zank smear for cytopathic effect

A

HSV-1

80
Q

highly vascular fungal infections, how do you differentiate between them

A

aspergillosis and mucorymycoses

1st is 90 degrees and septated

mucormycoses is not septated, can erode bone –> rhinocerebralmucormucoses (nose septum/cribiform up to the brain)

81
Q

what fungus is shown by the india ink stain

A

cryptococcus

82
Q

mononucleosis and blueberry muffin baby is caused by what?

A

CMV

purpura over the baby is blueberry muffin baby

83
Q

what pathogen causes scarlet fever

A

strep pyogenes

84
Q

dilantin/ phenytoin usage can lead to what

A

gingival hyperplasia

85
Q

monocytic leukemia can result in

A

gingival hyperplasia

86
Q

describe the presentation of HPV related SCC

A

ear ache, sore throat, odynophagia

because is farther back in the pharynx, uncommon in the oropharynx itself

GI2 E1 (19 decks)

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