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Dentistry Module 4 > Oral Medicine And Pathology > Flashcards

Oral Medicine And Pathology Flashcards

1
Q

What is the meaning of “aplasia”?

A

Failure to develop normally

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2
Q

What does “atresia” mean?

A

A condition in which an orifice or passage in the body is closed or absent

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3
Q

What duct is most often affected if atresia of the head and neck occurs?

A

Submandibular duct

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4
Q

What is heterotrophic salivary gland tissue?

A

The presence of normal salivary tissue occurring outside of the normal distribution of the major and minor salivary glands

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5
Q

What is a mucocoele?

A

A cystic filled cavity filled with mucus

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6
Q

what are the two types of mucocoele?

A
  1. Extravasation mucocoele (or mucous extravasation cyst)
  2. Retention mucocoele (or mucous retention cyst)
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7
Q

How does an extravasation mucoceole present clinically?

A

As a bluish or transparent swelling most commonly affecting minor salivary glands, especially in the lower lip

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8
Q

Trauma is associated with which type of mucocoele?

A

Extravasation mucoceole

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9
Q

Why does an Extravasation mucocoele form?

A

Due to a ruptured duct with leakage of saliva into surrounding connective tissue

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10
Q

What protein fills a mucous Extravasation cyst?

A

Mucin

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11
Q

Why is a mucous Extravasation cyst not classed as a true cyst?

A

It has no epithelial lining

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12
Q

How would you treat an Extravasation mucocoele?

A

Initially, treatment is not needed, these lesions can resolve themselves. However, in the case of more troublesome lesions, excision of all of the mucocoele with the associated ruptured duct and gland so to prevent recurrence

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13
Q

How does a mucous retention cyst differ from an Extravasation mucocoele?

A

The mucin pooling is confined within a dilated excretory duct or cyst, typically due to obstruction. Doesn’t escape into surrounding connective tissue

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14
Q

Which is more common, a mucous extravasation cyst or a mucous retention cyst?

A

Mucous extravasation cyst

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15
Q

Why is mucous retention cyst likely to present with less inflammation than an Extravasation cyst?

A

Because the saliva is retained within the duct and doesn’t escape into the surrounding connective tissue

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16
Q

What is the treatment for mucous retention cyst?

A

Excision

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17
Q

What is a Ranula?

A

A painlesss soft bluish swelling in the FOM

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18
Q

What is an uncommon form of mucous Extravasation cyst arising from the sublingual gland?

A

Ranula

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19
Q

What is a “plunging Ranula”?

A

Arises when the mucin passes through and develops below the mylohyoid muscle as a welling in the neck

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20
Q

How would you treat a Ranula?

A

Drainage of the cystic cavity and removal of sublingual gland

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21
Q

What is Sialadenitis?

A

Infection and inflammation of the salivary glands

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22
Q

What are the two most common cause of Sialadenitis?

A

Bacterial or viral infection

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23
Q

What salivary gland is most often affected by bacterial Sialadenitis?

A

Parotid gland

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24
Q

What is a major predisposing factor of acute bacterial Sialadenitis?

A

Decreased salivary flow

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25
Q

What are the frequently associated bacteria of acute bacterial Sialadenitis?

A
  • staphylococcus aureus
  • streptococci
  • oral anaerobes
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26
Q

What would be the appropriate treatment for acute bacterial Sialadenitis?

A

Antibiotics after culture/sensitivity testing

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27
Q

What may chronic bacterial sialadenitis be a result of?

A

Duct obstruction most frequently caused by stones/salivary calculus/mucous plugs

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28
Q

what salivary gland is most likely to be affected by chronic bacterial Sialadenitis?

A

Submandibular gland

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29
Q

What causes salivary calculi?

A

Mineralisation of phosphates from supersaturated saliva being deposited around a central nidus of cell debris

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30
Q

What gland is most commonly affected by salivary calculi?

A

Submandibular

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31
Q

How do salivary calculi elicit an inflammatory response?

A

Bacteria often grow on the stone surface, causing an inflammatory response

32
Q

What is the treatment for salivary calculi?

A

Depends on size and location of stone:
- may be possible to remove or breakdown some stones
- may be necessary to remove the gland, especially if it has become very damaged by longstanding infection

33
Q

If not treated, what May progressive chronic bacterial Sialadenitis inflammation result in?

A

Almost complete replacement of salivary parenchyma by fibrous tissue, resulting in a firm mass within the gland.

34
Q

How would you treat chronic bacterial Sialadenitis?

A

Aim to remove obstruction, and if not the obstruction and gland should be excised

35
Q

What is a commonly known viral Sialadenitis infection?

A

Mumps

36
Q

what virus causes mumps?

A

Paramyxovirus

37
Q

What are the three significant complications that can arise due to mumps?

A

Orchitis: inflammation of testicles
Oophoritis: inflammation of ovaries
Nephritis: inflammation of kidneys

38
Q

What are the main characteristics of HIV associated Salivary gland disease?

A
  • causes swelling of major salivary glands
  • swelling can be painful and soft to palpate
  • multiple cysts can be seen on imaging of glands
39
Q

What is necrotising Sialometapalsia?

A

A benign, self-limiting inflammatory reaction that mainly affects the minor salivary glands of the hard palate. It usually presents as a large, deep ulcer.

40
Q

What is necrotising Sialometaplasia most likely caused by?

A

Ischaemia or infarction secondary to trauma (e.g. dental injection or hot liquid burn)

41
Q

What is the treatment for necrotising Sialometaplasia?

A

None required, it slowly resolves itself.

42
Q

What is Sjögren’s syndrome?

A

An autoimmune disease of unknown cause characterised by lymphocytic infiltration and acinar destruction of lacrimal and salivary glands

43
Q

What are the two forms of Sjögren’s syndrome that exist?

A
  • primary Sjögren’s syndrome
  • secondary Sjögren’s syndrome
44
Q

What are the characteristics of primary Sjögren’s syndrome?

A

Patients have dry eyes and/or a dry mouth with no associated connective tissue disease

45
Q

What are the characteristics of secondary Sjögren’s syndrome?

A

Patients have dry eyes and/or, a dry mouth and a connective tissue disease, e.g. RA

46
Q

what are the common systemic symptoms of Sjögren’s syndrome?

A

Fatigue, joint pain and peripheral neuropathy

47
Q

What do patients with primary Sjögren’s syndrome have an increased risk of developing, in regards to affected glands?

A

Lymphoma in affected glands

48
Q

What is the labial gland biopsy test?

A

A diagnostic test for Sjögren’s syndrome, where a biopsy is taken from the lower lip. It examines focal periductal collections of lymphocytes and a score of one or more is suggestive of Sjogrens.

49
Q

What may be prescribed by specialists to patients with Sjögren’s syndrome, in order to stimulate saliva production?

A

Systemic acetylcholine esterase inhibitor pilocarpine

50
Q

What is Sialadenosis?

A

A non-inflammatory, non-neoplastic, bilateral, symmetrical swelling if salivary glands

51
Q

what salivary glands does Sialadenosis predominantly affect?

A

Parotid glands

52
Q

what conditions are associated with Sialadenosis?

A

-malnutrition
- anorexia
- bulimia
-alcoholism
-diabetes mellitus

53
Q

What does Sialadenosis result in?

A

Hypertrophy of serous acini

54
Q

Are tumours (including benign and malignant) more common in major or minor salivary glands?

A

Major glands

55
Q

In what salivary gland does 90% of major salivary gland tumours occur?

A

Parotid

56
Q

Where is the most common region for minor salivary gland tumours?

A

Palate (55%)

57
Q

Are carcinomas more common in major or minor salivary glands?

A

Minor salivary glands

58
Q

what are the 4 methods of obtaining tissue to confirm a definitive diagnosis of a salivary gland tumour?

A
  1. Fine needle aspiration (FNA)
  2. Core biopsy
  3. Open biopsy
  4. Excision
59
Q

What diagnostic test for salivary gland tumours is this:

“A needle is used to aspirate cells from the lesion and the cell features examined”

A

Fine needle aspiration (FNA)

60
Q

What diagnostic test for salivary gland tumours is this:

“ a larger hollow needle is used to remove a core of tissue”

A

Core biopsy

61
Q

What diagnostic test for salivary gland tumours is this:

“ a surgical incision is made then an incisional biopsy of the lesion taken”

A

Open biopsy

62
Q

What diagnostic test for salivary gland tumours is this:

“ all of the tumour is removed for diagnosis and treatment”

A

Excision

63
Q

Which two diagnostic techniques for salivary gland tumours are quickest and easiest to do but given the limited sampling, can be nondiagnostic?

A

Fine needle aspiration (FNA) and core biopsy

64
Q

what are the five current WHO classification categories of salivary gland tumours?

A
  1. Malignant tumours
  2. Benign tumours
  3. Non-neoplastic epithelial lesions
  4. Benign soft tissue lesions
  5. Haematolymphoid tumours
65
Q

What is a Mucoepidermoid carcinoma?

A

The most common of the 22 epithelial salivary gland malignant tumours, often affecting the parotids, it is locally invasive and can recur and metastasise.

66
Q

Fusion of what gene is found in up to 80% of Mucoepidermoid carcinoma cases?

A

MAML2

67
Q

What three types of tumour cells make up a Mucoepidermoid carcinoma?

A
  1. Mucous-secreting cells
  2. Epidermiod (squamous) cells
  3. Intermediate cells
68
Q

Tumours with high mucous cell numbers tend to be what?

A

Cystic

69
Q

Tumours with mainly epidermoid lesions tend to be what?

A

Solid and often aggressive

70
Q

How would you treat Mucoepidermoid carcinoma?

A

Complete excision of tumour

71
Q

What is the most common type of benign salivary gland tumour?

A

Pleomorphic adenoma

72
Q

What are the key features of pleomorphic adenoma?

A

1.benign
2.painless
3.slow-growing
4.”rubbery” lump

73
Q

Rearrangements of what two genes is mostly associated with pleomorphic adenoma?

A

PLAG1 and HMGA2

74
Q

How would you treat pleomorphic adenoma?

A

Complete excision

75
Q

What is the concern if pleomorphic adenoma is incompletely excised?

A

It has a high recurrence rate and malignant transformation can occur.

76
Q

what are malignant pleomorphic adenomas known as and what is their prognosis?

A

Carcinoma ex pleomorphic adenoma, are typically high grade malignancies with poor prognosis

Dentistry Module 4 (20 decks)

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