Oral Path 2 Flashcards

1
Q

True or false… biopsy is mandatory with any leukoplakia

A

True

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2
Q

Proliferative verrucous leukoplakia is recurrent and warty. It may be associated with HPV ___ and ___. It has a high risk of malignant transformation to ___ and ___

A

16 and 18

SCC or verrucous carcinoma

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3
Q

Which has a higher risk of malignancy, leukoplakia or erythroplakia?

A

Erythroplakia

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4
Q

What is actinic cheilitis?

A

Lip inflammation/crusties due to sun damage (UVB rays especially)

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5
Q

What are the two highest risk sites for cancer lesions?

A

FOM

Posterior lateral tongue

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6
Q

Malignant neoplasm is a term given to cancer as soon as it invades past the ____

A

Basement membrane

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7
Q

Verrucous carcinoma is a [slow/fast] growing malignancy. It can be caused by ___ or ___ and ___. What is the treatment of choice?

A

Tobacco

HPV 16 and 18

Excision

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8
Q

SCC (squamous cell carcinoma) is caused by ___ or inactivation of ____. There is increased incidence of oropharyngeal SCC associated with ___ and ___. The 5-year survival rate is about ___%.

A

Oncogenes

Tumor suppressor genes

HPV 16 and 18

50%

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9
Q

____ is mucosal atrophy + dysphagia + iron deficiency anemia + increased risk of oral cancer

A

Plummer-Vinson Syndrome

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10
Q

What is the treatment of choice for SCC?

A

Excision or radiation

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11
Q

True or false… basal cell carcinoma frequently metastasizes

A

False, very rarely

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12
Q

Oral melanoma is a malignancy of ___. High-risk sites are the ___ and the ___. 5 year survival rate for skin lesions is greater than ___%, but less than ___% for oral lesions.

A

Melanocytes

Palate and gingiva

65%

20%

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13
Q

Name three medications that can cause gingival hyperplasia

A

Calcium channel blockers

Dilantin

Cyclosporine (immunosuppressant)

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14
Q

What is the treatment of choice for gingival hyperplasia?

A

Gingivectomy

Discontinue drug if possible

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15
Q

Denture-induced fibrous hyperplasia is called ___ if found in the vestibule and called ___ if found on the palate

A

Epulis fissuratum

Papillary hyperplasia

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16
Q

____ is an entangled submucosal mass of neural tissue and scar. Caused by injury to nerve.

A

Traumatic neuroma

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17
Q

Where is the most common location of a traumatic neuroma?

A

Mental foramen

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18
Q

____ = multiple neuromas + medullary thyroid cancer + pheochromocytoma of adrenal gland

A

Multiple endocrine neoplasia (MEN 2B)

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19
Q

Pyogenic granuloma is a hyperplasia of ____

A

Capillaries, causing it to be red

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20
Q

Nodular fasciitis is a neoplasm of ____. It is easy to eradicate and rarely recurs

A

Fibroblasts

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21
Q

____ is a neoplasm of fibroblasts, however it is difficult to eradicate and often recurs

A

Fibromatosis

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22
Q

A granular cell tumor is a neoplasm of ___. It is named such because these tumor cells have a ___.

A

Schwann cells

Granular cytoplasm

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23
Q

A granular cell tumor has _____ in the tumor which mimics SCC. Where is it most commonly found?

A

PEH (pseduoepitheliomatous hyperplasia)

Dorsal tongue

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24
Q

A variant of granular cell tumor is found on the gingiva of newborns. It is called ___ and it has no ___

A

Congenital epulis

No PEH (pseudoepitheliomatous hyperplasia)

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25
Q

____ is a neoplasm of Schwann cells and has acellular verocay bodies in antoni A tissue

A

Schwannoma (neurilemmoma)

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26
Q

A neurofibroma is a neoplasm of ___ and ___

A

Schwann cells and fibroblasts

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27
Q

Neurofibromatosis type 1 (von recklinghausen’s disease) = ___+ ___ + ___ + ___

A

Multiple neurofibromas

Multiple skin freckles (cafe au lait spots)

Axillary freckles (Crowe’s sign)

Iris freckles (lisch spots)

Note that neurofibromas can transform to neurofibrosarcomas in this syndrome

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28
Q

____ is a neoplasm of smooth muscle cells

A

Leiomyoma

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29
Q

___ is a neoplasm of skeletal muscle cells

A

Rhabdomyoma

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30
Q

____ is a neoplasm of fat cells. Intraorally, it is found most commonly ___

A

Lipoma

Buccal mucosa

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31
Q

_____ is a malignant proliferation of fibroblasts

A

Fibrosarcoma

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32
Q

____ is also known as a malignant peripheral nerve sheath tumor. It is a malignant proliferation of Schwann cells

A

Neurofibrosarcoma

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33
Q

Kaposi’s sarcoma is a malignant proliferation of ____. It is caused by HHV___ and most commonly seen as a complication of ___. The lesions are ___ in color.

A

Endothelial cells

8

AIDS

Purple

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34
Q

____ is a malignant proliferation of smooth muscle cells

A

Leiomyosarcoma

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35
Q

Mucous extravasation phenomenon is caused by trauma to ___

A

Salivary duct

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36
Q

What is the difference between a mucous retention cyst and a mucous extravasation phenomenon?

A

Mucous retention cysts histologically are true cysts as they are lined with epithelium.

Caused by blockage of a salivary duct by a sialolith

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37
Q

Necrotizing sialometaplasia is a [slowly/rapidly] expanding ulcerative lesion. It is usually due to ___ necrosis of minor salivary glands in response to trauma or local anesthesia. What is the treatment of choice?

A

Rapidly

Ischemic

It will heal on its own in 6-10 weeks

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38
Q

A sinus retention cyst is also called ____. It is caused by….

What is the treatment of choice?

A

Antral pseudocyst

Blockage of glands in sinus mucosa

None

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39
Q

Which expands faster, sinus retention cyst or a sinus mucocele?

A

Sinus retention cyst

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40
Q

Sarcoidosis is due to a [hyper/hypo] immune response resulting in granulomas. It may be triggered by ___. It is primarily a pulmonary disease but also affects ___ and ___

A

Hyperimmune

Mycobacteria

Salivary glands (resulting in xerostomia) and mucosa

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41
Q

___ syndrome = erythema nodosum + bilateral hilar lymphadenopathy + arthritis

A

Lofgren’s

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42
Q

____ syndrome = anterior uveitis + parotid gland enlargement + facial nerve palsy + fever; also called uveoparotid fever

A

Heerfordt

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43
Q

What is the treatment of choice for sarcoidosis?

A

Corticosteroids

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44
Q

Sjögren’s syndrome is autoimmune and is ___ mediated. It affects salivary and tear glands. What is the treatment of choice?

A

Lymphocyte

Treat the symptoms

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45
Q

What is the difference between primary and secondary Sjögren’s syndrome?

A

Primary = keratoconjunctivitis sicca (dry eyes) and xerostomia

Secondary = above plus another autoimmune disease (usually RA)

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46
Q

_____ is the most common benign salivary gland tumor. It is a firm, rubbery swelling. It is composed of what cell type?

A

Pleomorphic adenoma

Mixture of cell types (epithelial and CT), why it is also called mixed tumor

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47
Q

Where are the most common locations for a pleomorphic adenoma?

A

Palate for minor salivary glands

Ear for parotid gland

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48
Q

A pleomorphic adenoma is described as a ___ ___ swelling

A

Firm, rubbery

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49
Q

Monomorphic adenomas are composed of a single cell type. Name 4 different monomorphic adenomas

A

Basal cell adenoma

Canalicular adenoma

Myoepithelioma

Oncocytic tumor

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50
Q

Warthin’s tumor is composed of ___ (which are ___) and ___. It is usually found in the ___ gland of older men.

A

Oncocytes (whic are epithelial cells with excessive number of mitochondria)

Lymphoid cells

Parotid

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51
Q

Salivary gland diseases that are malignant are most common in which location?

A

Palate

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52
Q

What is the most common salivary gland malignancy? What cells is it composed of?

A

Mucoepidermoid carcinoma

Mucous and epithelial cells

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53
Q

What is the second most common salivary gland malignancy for minor glands?

A

Polymorphous low-grade adenocarcinoma

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54
Q

Adenoid cystic carcinoma has a ___ or ___ microscopic pattern. 5-year survival rate is __%, whereas the 15 year survival rate it ___%

A

Cribriform or Swiss cheese

70%

10%

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55
Q

True or false… all lymphoid neoplasms are malignant by nature

A

True

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56
Q

____ lymphoma has reed sternberg cells, which are malginant ___ cells.

A

Hodgkin’s

B

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57
Q

Non-hodgkin’s lymphoma is a neoplasm of __ or __ cells.

A

B or T

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58
Q

____ is a type of B cell non-hodgkins lymphoma (NHL) with bone marrow involvement, swelling, pain, tooth mobility, lip paresthesia, and halts root development

A

Burkitt’s lymphoma

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59
Q

_____ involves neoplasm of antibody-secreting B cells (AKA ___ cells). Multiple _____ are usually found radiographically in the skull. ____ is found due to accumulation of complex ___ proteins that develop from antibody light chains. This disease has a poor prognosis

A

Multiple myeloma

Plasma

Punched-out radiolucencies

Amyloidosis

Amyloid

60
Q

____ is a neoplasm of bone marrow cells (lymphocytes, NK cells, granulocytes, and megakaryocytes). Classification is based on….

A

Leukemia

Cell lineage (myeloid or lymphoid) and whether the disease is acute or chronic.

61
Q

List the types of leukemia in which is most common form youngest to oldest.

A

ALL > CML > AML > CLL

62
Q

What are the three main clinical signs of leukemia?

A

Bleeding (platelets)

Fatigue (RBCs)

Infection (WBCs)

63
Q

What is the most common odontogenic cyst?

A

Periapical cyst (radicular cyst)

64
Q

A periapical cyst is always associated with a ___ tooth at the ___

A

Nonvital

Apex

65
Q

Necrotic pulp causes periapical inflammation. Acute leads to ___. Chronic leads to ___

A

Abscess

Granuloma

66
Q

The ____ from ___ within pocket of inflammation encapsulate the lesion resulting in the formation of a periapical cyst

A

Epithelial rests of malassez

Hertwig’s epithelial root sheath

67
Q

What is the treatment for a periapical cyst?

A

RCT

Apicoectomy

Extraction with curettage

68
Q

A dentigerous cyst is called an eruption cyst if…

A

The lesion occurs over an erupting tooth in children

69
Q

A dentigerous cyst is a radiolucency attached to the ___ of an impacted tooth. They are found most commonly with which teeth?

A

CEJ

Canines and third molars

70
Q

In a dentigerous cyst there is an accumulation of fluid between the crown and the ___

A

Reduced enamel epithelium

71
Q

Where are lateral periodontal cysts found most commonly?

A

Mandibular premolar region

72
Q

True or false… lateral periodontal cysts are always associated with a vital tooth

A

True

73
Q

What is the soft tissue counterpart of the lateral periodontal cyst? Does it have a radiolucency?

A

Gingival cyst of the adult

No radiolucency because no bone is involved

74
Q

Gingival cysts of the newborn found on the lateral palate are called ___ is they are found on the midline of the palate they are called ___

A

Bohn’s nodules

Epstein’s pearls

75
Q

Gingival cysts of the newborn are derived from…

A

Rests of dental lamina

76
Q

What is the treatment of choice for gingival cysts of newborn?

A

None, they will involve as infant ages

77
Q

What is a primordial cyst?

A

Develops where a tooth would have formed

Most common at mandibular third molar region

Treatment is removal

78
Q

What is the other name for an OKC (odontogenic keratocyst)?

A

Keratocystic odontogenic tumor

79
Q

Keratocystic odontogenic tumors are aggressive and recurrent. They are found most commonly ____. They are lined with [thin/thick] corrugated ___ epithelium

A

In posterior ascending ramus of mandible

Thin

Parakeratinized

80
Q

____ = multiple OKC (KCOTs), multiple Basel cell carcinomas, calcified falx cerebri. It is often fatal. It is also called nevoid basal cell carcinoma

A

Gorlin syndrome

81
Q

What is the treatment of KCOT (OKCs)

A

Aggressive enucleation

82
Q

What is associated with Gorlin syndrome?

A

Multiple OKCs (odontogenic keratocyst/keratocystic odontogenic tumors)

Multiple Basel cell carcinomas

Calcified falx cerebri

Fatal

AKA nevoid basal cell carcinoma

83
Q

What is the other name for the Gorlin cyst?

A

Calcifying odontogenic cyst

84
Q

Which type of cyst/tumor involves Ghost cells? What are they?

A

Calcifying odontogenic cyst

Empty space where nucleus was and keratin fills it, can undergo calcification and little radiodensities detected radiographically

85
Q

The ameloblastoma is [malignant/benign] and [aggressive/docile]

A

Benign

Aggressive

86
Q

What is the classical differential diagnosis for multilocular radiolucency in posterior mandible?

A

Ameloblastoma

KCOT (OKC)

CGCG

COF

87
Q

What is the other name for the CEOT (calcifying epithelial odontogenic tumor)?

A

Pindborg tumor

88
Q

Which odontogenic tumor has a radiolucent appearance with “driven snow” calcifications?

A

CEOT

89
Q

The ___ tumor has an amorphous pink amyloid with concentric calcifications termed ____

A

CEOT

Liesegang rings

90
Q

True or false.. even after surgical excision the CEOT has a poor prognosis.

A

False. It has a good prognosis

91
Q

Which odontogenic tumor contains epithelial duct-like spaces and enameloid material. It is mostly in the anterior maxilla and over impacted canines. With surgical excision it has a good prognosis.

A

AOT (adenomatoid odontogenic tumor)

92
Q

The odontogenic myxoma is also called a ___. It is filled with a myxoma to us connective tissue with is pulp-like with little collagen, it is often referred to as ___

A

Myxofibroma

Slimy stroma

93
Q

____ has a messy radiolucency with unclear borders and a honey comb pattern. It is filled with slimy stroma

A

Odontogenic myxoma

94
Q

True or false… the odontogenic myxoma has a very poor prognosis and near 100% recurrence

A

False.. with surgical excision it only has a moderate recurrence

95
Q

The COF (central odontogenic fibroma) is dense collagen with strands of epithelium. It can be central (___) or peripheral (___)

A

Bone, well-defined multilocular radiolucency

In the gums

(Note that it is often located in posterior mandible)

96
Q

Ameloblastic fibroma mostly occurs in which population? Where is it most commonly located?

A

Children and teens

Posterior mandible

97
Q

What is the difference between compound and complex odontomas?

A

Compound = mostly in anterior, bunch of miniature teeth

Complex = mostly posterior, conglomerate mass

98
Q

____ = multiple odontomas + intestinal polyps

A

Gardner syndrome

99
Q

What is Gardner syndrome?

A

Multiple odontomas + intestinal polyps

100
Q

_____ is composed of fibroblastic stroma in which foci of mineralized products are formed

Central = bone, well-circumscribed radiolucency

Peripheral = gum

A

Central ossifying fibroma

101
Q

What is different about the juvenile form of central ossifying fibroma?

A

Aggressive variant

Rapid growth

Younger patients

102
Q

____ has a ground-glass apperance. Usually stops growing after puberty.

A

Fibrous dysplasia

103
Q

_____syndrome = polyostotic fibrous dysplasia + cutaneous cafe au lait spots + endocrine abnormalities like precocious puberty

A

McCune-Albright Syndrome

104
Q

What 3 things make up McCune Albright Syndrome?

A

Polyostotic fibrous dysplasia

Cutaneous cafe au lait spots

Endocrine abnormalities like precocious puberty

105
Q

What is the treatment of choice for fibrous dysplasia?

A

Surgical recontoruing for cosmetics

106
Q

____ is composed of fibroblasts and multinucleated giant cells. It is anterior mandible favored.

A

Central giant cell granuloma

107
Q

What is the difference between the central giant cell granuloma and peripheral giant cell granuloma?

A

Central = in bone. Radiolucency with thin wispy septations

Peripheral = gum, red-purple gingival mass

108
Q

The ___ is a pseudocyst composed of blood-filled spaces. It is a multilocular radiolucency and is expansile. Posterior mandible is favored.

A

Aneurysmal bone cyst

Treatment is excision

109
Q

____ causes multiple bone lesions that look like central giant cell granulomas resulting from excessive levels of parathyroid hormone

A

Hyperparathyroidism

110
Q

___ is assocaited with hyperparathyroidism due to excess osteoclast activity

A

Brown tumor

111
Q

In hyperparathyroidism there is elevated ____ due to too much breakdown of bone

A

Alkaline phosphatase

112
Q

Von recklinghausen’s disease of BONE is the result of ___

A

Hyperparathyroidism (not to be confused with von recklingausen’s disease aka neurofibromatosis)

113
Q

Cherubism is assocaited with multiple ___

A

Giant cell lesions symmetrically and bilaterally

Stops growing after puberty

114
Q

Langerhans cell disease, AKA ____, is a rare type of cancer. Here, there is a discrete punched out “ice cream scoop” radiolucencies that lead to floating teeth.

A

Idiopathic histiocytosis

115
Q

_____ is a progressive metabolic disturbance of many bones (spine, femur, skull, jaws) causing symmetrical enlargement. Usually in adults older than 50. There are elevated levels of alkaline phosphatase due to breakdown of bone. There is a “___” appearance. Pts may complain that dentures or hats become too tight

A

Paget’s disease

Cotton wool

116
Q

What is the treatment for Paget’s disease?

A

Bisphosphanates

Calcitonin

117
Q

What are the most common initiating causes of acute osteomyelitis?

Infection and inflammation usually begins in ___ space involving the __ bone and spreads to ___ bone, __, and ___

A

Odontogenic infection and trauma

Medullary

Cancellous

Cortical
Periosteum
Soft tissue

118
Q

Name four symptoms of acute osteomyelitis

A

Deep and intense pain

High or intermittent fever

Paresthesia or anesthesia of IAN

Tooth is NOT loose!

119
Q

True or false… acute osteomyelitis causes teeth to loosen

A

False. This is caused by periodontitis

120
Q

What is the radiographic appearance of chronic osteomyelitis?

A

Diffuse mottled radiolucency

121
Q

What is sequestra?

A

Piece of dead bone assocaited with chronic osteomyelitis

122
Q

what is Garre’s osteomyelitis?

A

Chronic osteomyelitis with proliferative periosteitis (onion skin)

123
Q

What is the treatment for chronic osteomyelitis?

A

Antibiotics and debridement

124
Q

What is focal sclerosing osteomyelitis (AKA condensing osteitis)?

A

Bone sclerosis resulting from low-grade inflammation like chronic pulpitis

The body forms sclerotic bone to wall off the infection

Treatment = addressing the cause (RCT)

125
Q

True or false… diffuse sclerosing osteomyelitis is the same as condensing osteitis but on a wider scale. It may lead to jaw fracture and osteomyelitis. What is the treatmet?

A

True

Antibiotics and address the cause

126
Q

BRONJ has a much higher risk of development with ___ administration rather than ___

A

IV

Oral

127
Q

What is the treatment for BRONJ?

A

Chlorhexidine rinse***

Antibiotics

Conservative surgery

128
Q

What is the most common symptom of oral malignancies?

A

Numb lip

129
Q

_____ is sarcoma of the jaws where new bone is produced by tumor cells. It exhibits a sunburst pattern. 5 year survival is 25-40%. What is the treatment?

A

Osteosarcoma

Resection and chemotherapy

130
Q

____ is sarcoma of the jaws where new cartilage is produced by tumor cells. It is most common in which location?

A

Chondrosarcoma

The condyle

131
Q

___ is sarcoma of long bones involving “round cells”. It seldom affects the jaws. Most common in children and involves swelling.

A

Ewing’s sarcoma

132
Q

Metastatic carcinoma involves pain, swelling, and especially paresthesia. I’ll-defined changes are noted. List the most common to least common areas in which the cancer originated.

A

Breast

Lung

Kidney

Colon

Prostate

133
Q

True or false.. white sponge nevus is hereditary

A

True

134
Q

____ is a hereditary condition that causes skin (and mucosa) to be fragile and blister easily

A

Epidermolysis Bullosa

135
Q

Hereditary Hemorrhagic Telangiectasia, (AKA ____) is associated with telangiactasias, which are ____. There is abnormal capillary formation on skin, mucosa, and viscera. It is associated with ____. ___ is a frequent presenting sign.

A

Older-Weber-rendu Syndrome

Red macule or papules, dilated or broken capillary

Iron-deficiency anemia

Epistaxis (nose bleeds)

136
Q

Cleidocranial dysplasia is inherited in ____. What are two key characteristics?

A

Autosomal dominant

Missing clavicles

Supernumerary teeth

137
Q

Ectodermal dysplasia is inherited by ___. What are two key characteristics?

A

X-linked recessive

Missing teeth

Hypoplastic hair or nails

138
Q

Osteopetrosis is autosomal dominant or recessive. It is also called ___ and ___. Describe this condition.

A

Albergs-Schoenberg disease

Marble bone disease

Lack of bone remodeling and resorption leads to “stone bone”

139
Q

Amelogenesis imperfecta is hereditary. It involves intrinsic alteration of ___ in which teeth? True or false… thin to no enamel yet dentin and pulp are normal

A

Enamel

All teeth in primary and permanent dentitions

True

140
Q

What is the treatment for amelogenesis imperfecta?

A

Full-coverage crowns for cosmetics

141
Q

Dentinogenesis imperfecta involves intrinsic alteration of ___ of which teeth? What do the teeth look like?

A

Denting

All teeth from both dentitions

Short roots, bell-shaped crowns, and obliterated pulps

Bulbous crowns in radiographs due to constricted DEJ

blue sclera

142
Q

Blue sclera is assocaited with…

A

Dentinogenesis imperfecta

And osteogenesis imperfecta

143
Q

Dentin dysplasia involves intrinsic alteration of dentin that affects all teeth from both dentitions. How does it look different from dentogenesis imperfecta?

A

Chevron pulps and short roots (or thistle pulps)

Note that teeth are not good for restoration

144
Q

Type 1 dentin dysplasia is associated with ___

Type 2 dentin dysplasia is assocaited with ___

A

Short roots

“Chevron pulps”

145
Q

_____ involves a quadrant of teeth with short roots, open apices, and enlarged pulp chambers. The teeth are called “ghost teeth”

A

Regional odontodysplasia

146
Q

What is the treatment for teeth with regional odontodysplasia?

A

Extract affected teeth