Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NERB > Oral Path > Flashcards

Oral Path Flashcards

1
Q

Cavernous Sinus Thrombosis

A
  • subcutaneous abscess of the upper lip or intrabony abscess of the anterior mx tooth
  • valveless facial veins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Systemic Lupus Erythematosus

A
  • autoimmmune disease
  • young adult females
  • butterfly rash on face
  • heart - endocarditis
  • kidney - glomerulonephritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Ludwig’s angina

A
  • submandibular space infection
  • can cause blockage of breathing.
  • can kill you b/c the infection goes down retropharyngeal space.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Scarlet Fever

A
  • white coating of tongue that sloughs off and leaves deep red surface with swollen hyperplastic fungiform papillae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Fordyce Granules

A
  • ectopic sebaceous glands
  • yellow papules
  • bilateral
  • lips and buccal mucosa
  • 80-90% of caucasians in America have them.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Turner Tooth

A
  • Something causes this succadenous tooth to come out malformed.
  • It may be b/c of carious primary tooth or infected.
  • Mandibular PM is the most common involved tooth b/c mandibular primary 1 M tooth has most common caries.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Recurrent Aphthous Stomatitis

A
  • found on moveable mucosa
  • recurrent with NOT VESICLE PRECEDING
  • associated with Human Lymphocyte Antigens (HLA) types
  • Tx corticosteroids
  • Three types: herpetiform (many small), minor and major (>1cm)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Intrinsic Tooth Stain

A
  • down in dentinal tubules.
  • Can only do crowns or veneers to cover these up.
  • Common analogue of tetracycline that can cause this kind of staining
  • MINOCYCLINE taken for acne.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Benign Mucous Membrane Pemphigoid

A
  • Autoimmune
  • Antibodies react to basement membrane zone
  • middle age women
  • Skin, eyes, and oral
  • SUBEPITHELIAL SPLIT
  • Corticosteroid PILLS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Condyloma Acuminatum

A
  • HPV of the mouth

- Genital wart can go systemically and can show up in mouth up under upper lip or ventral tongue.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Candidiasis pseudomembranous

A
  • Opportunistic infection: deficient immune system, antibiotic usage or corticosteroid usage
  • diagnosed by cytology smear
  • White, wipeable patch with red underling base
  • palate or buccal mucosa
  • found very young (Thrush) or very old
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Median Rhomboid Glossitis

A
  • Red atrophy of filiform papillae
  • Midline of tongue
  • nystatin or clotrimazole
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Denture Sore Mouth

A
  • Pt does not remove or clean denture
  • hyperplastic CT like
  • Rinse mouth and soak denture in antifungal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Recurrent Herpes Simplex

A
  • Reactivation from trigeminal ganglion
  • skin or vermilion
    Vesicles preceeds ulcers
  • HSV type 1
  • Hard palate and gingival if intraoral - overlays bone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Traumatic Neuroma

A
  • wandering transected nerve with scar tissue
  • painful or tender, firm “lump”
  • occurs at sites of chronic trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Pyogenic Granuloma

A
  • occurs at any age, pregnancy
  • Just granulomatous tissue
  • Could be from trauma.
  • bleeds readily, exophytic (grows outwards), non-painful, grows quickly
  • No nerves in there
  • Interdental papillae are most common site b/c things get stuck there, overhangs, etc.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Peripheral Giant Cell Granuloma

A
  • often “Liver colored” (brownish purple)
  • histology - multinucleated giant cells
  • limited to alveolar ridge/gingiva
  • usually anterior to first molar region
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Central Giant Cell Granuloma

A
  • intrabony
  • may cross midline
  • histology - multinucleated giant cells
  • SAME HISTOLOGY AS: Brown tumor of hyperpapathyoidism and Peripheral Giant Cell Granuloma
  • classically a multi-locular RL
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Squamous Papilloma

A
  • benign proliferating lesion induced by HPV
  • white to pink
  • rough surface (cauliflower)
  • elevated lesion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Fibroma

A
  • most common CT tumor
  • Reactive not true tumor
  • Firm, smooth, pink elevated papule/nodule
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Granular Cell Tumor

A
  • Dorsum of tongue #1 site
  • nodule with smooth or papillated surface
  • granular cells - cytoplasm
  • psuedoepitheliomatous hyperplasia - aka looks like cancer
  • LYSOSOMES
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Leukoplakia

A
  • white patch that does not wipe off
  • cytology smear doesnt help determine
  • incisional biopsy
  • tongue and FOM more dangerous sites
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Erythroplakia

A
  • red plaque that does not wipe off
  • likely to have severe dysplasia and become malignant
  • incisional biopsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Squamous cell carcinoma

A
  • Most common malignancy in oral cavity
  • Lower lip can be preceded by actinic cheilitis
  • REDor WHITE, firm, irregular, indurated ulcer, painless
  • submental node most common lymph node
  • mid-lateral border of tongue and FOM
  • staging (spread), grade (differentiation)
  • alveolar ridge appears poorly defined lucencies without reactive sclerotic border
  • p53 tumor gene
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Metastatic Disease of the Jaw

A
  • most common site - posterior mandible
  • does not cause a shift in occlusion
  • usually a poorly defined lucency without sclerotic border
  • prostate cancer most common
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Monomorphic adenoma

A
  • Canalicular adenoma another name
  • upper lip most common
  • old adult females
  • Firm and asymptomatic
  • maybe multinodular
  • rare on the lower lip.
  • NEVER answer MUCOCELE for upper lip bump.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Leukoedema

A
  • intracellular edema of cells
  • AA most common
  • bilateral on buccal mucosa most common
  • pull on buccall mucosa -> disappears or dissipates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Leukemia

A
  • red, swollen, boggy, bleeding gingiva with ulcers
  • get lab tests: CBC, WBC; see decrease in neutrophils and platalets
  • Red macules on skin
  • Tired feeling (malaise)
  • anemia (decrease RBCs)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Verrucous Carcinoma

A
  • large, elevated, papillary
  • often associated with smokeless tobacco habit
    buccal vestibule most common site
  • No tendency to metastasize
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Pleomorphic adenoma

A
  • benign neoplastic proliferation of parenchymatous glandular cells
  • most common tumor of salivary gland origin
  • palate most common site, next is parotid
  • slow growing, painless mass firm nodular mass, mobile
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Adenoid cystic carcinoma

A
  • tumor of the salivary gland
  • painless, slow growing masses of the mouth or face
  • perineural invasion
  • parotid - facial nerve involvement but no upper lip paresthesia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Lateral periodontal Cyst

A
  • true cyst (epithelial lining)
  • well circumscribed radioluceny between roots, erupted and vital teeth
  • most common seen at mandibular premolars
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

ameloblastic fibroma

A
  • more common in the first and second decades of life
  • most often in posterior mandible
  • In 50% of cases an unerupted tooth is involved
  • slight to no pain, swelling; not aggressive
  • unilocular lesions, occasionally multilocular when larger, with smooth well-demarcated borders.
  • Surgical excision with affected tooth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Adenomatoid odontogenic tumor

A
  • child or teenager - more common in females
  • more often located in anterior maxilla #1 and anterior mandible #2
  • Lucent and calcifications that show speckles of RO.
  • associated with unerupted tooth
  • YOUNG PERSON- unerupted tooth, don’t say it’s DENTIGEROUS CYST even if though it’s around the impacted crown!!!
  • simple enucleation treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

ameloblastoma

A
  • average age 34
  • most common in the posterior mandible
  • most common true odontogenic tumor
  • multilocular radiolucency “soap bubble”
  • superimposed over impacted tooth
  • histology - reverse polarization of the nuclei, columnar cells of the periphery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

odontoma

A
  • under 20 yrs of age
  • radiopacity with radiolucent rim
  • compound - anterior identifiable toothlets
  • complex - posterior unidentifiable mass
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Amelogenesis imperfecta

A
  • teeth lack enamel
  • dentin and cementum unaffected
  • shaped of root and crown normal
  • pulp chambers and RC normal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Cherubism

A
  • autosomal dominate
  • young person
  • loss of bone in the mandible replaced with fibrous tissue
  • multilocular bilateral lucencies
  • premature loss of the primary teeth and uneruption of the permanent teeth.
  • Normal bone remodeling activity may resume after puberty
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Condensing Osteitis

A
  • associated with pulpitis
  • nonvital tooth
  • periapical opacity
  • not connected with root
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Dentinogenesis imperfecta

A
  • opalescent dentin - blue/gray
  • often associated with OSTEOGENESIS IMPERFECTA
  • -blue sclera
    • multiple bone fractures
  • lack of pulp chambers and root canals
  • bell-shaped crown with constricted cervical region
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Fibrous Dysplasia

A
  • unilateral mandibular or maxillary expansion
  • onset before puberty
  • painless swelling, stops at age 20
  • ground glass appearance on Radiograph
  • cosmetic bone shaving
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

idiopathic osteosclerosis

A
  • no apparent reason including no pulpitis in adjacent tooth
  • no expansion, pain
  • radiopacity without peripheral lucent rim
  • not connected to tooth’s root
  • no treatment necessary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Traumatic Bone Cyst

A
  • spontaneous healing without treatment
  • pseudocyst
  • radiolucent with scalloped margins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Langerhans Cell Disease

A
  • also called Histiocytosis X
  • composed of Langerhans cells
  • eosinophilic granuloma
  • tooth “floating in air or space”
  • Advanced periodontal mimicker!!!
  • younger people
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Central Neural Lesion

A
  • neurofibroma and Schwannoma

- enlargement of canals and foramina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Paget’s Disease

A
  • older age
  • bilateral maxilla
  • involved bone can become malignant
  • CN deficits b/c closing of foremen
  • does NOT have hyperglolinemia
  • Onset at Puberty
  • No premature exfoliation of primary teeth
  • Cotton wool appearance
  • 50% hypercementosis
47
Q

Malignant Bone Involvement

A
  • spontaneous paresthesia of lip

- can see radiographicly

48
Q

Nasolabial Cyst

A
  • mucolabial, smooth swelling adjacent to maxillary lateral incisor
  • Lots of respiratory epithelium lining this true cyst.
  • External naris.
  • soft tissue involvement, not bone
  • histology: pseudostratified squamous epithelium
49
Q

Odontgenic Keratocyst

A
  • high recurrence
  • most often intrabony, posterior mandible but can happen anywhere
  • radiolucent, usually multilocular
  • histology: palisaded basal cell layer and parakeratinized surface
50
Q

Gardner Syndrome

A
  • multiple facial osteomas and skin nodules
  • hyperdontia, unerupted teeth
  • Multiple GI polyps
  • can happen young
51
Q

Morsicatio Buccarum

A
  • check and lip chewing
  • buccal mucosa
  • white, rough, tissue tags above and below the occlusal plane
52
Q

Nevoid Basal Cell Carcinoma Syndrome

A
  • onset in childhood
  • cysts of the jaw - odontotogenic keratocysts with high recurrence rate
  • basal cell carcinoma common
  • RG - unilocular or multilocular lucencies
  • calcification of the falx cerebri
53
Q

Lymphoepithelial cyst

A
  • common on ventral tongue/FOM
  • circumscribed swelling
  • pale, yellowish at times
54
Q

Bell’s Palsy

A
  • 7th nerve paralysis
  • unilateral
    inability to close of wink eyelid
  • last usually less than one month
55
Q

Erythema Multiforme

A
  • young adult males
  • sudden onset and explosive
  • triggered by drug or viral infection
  • Crusted, bleeding vesicles, ulcers of vermilion
  • if intraorl none on gingiva
  • bulls-eye lesions on hands and feet
56
Q

Pemphigus Vulgaris

A
  • rare autoimmune disease that caused painful blisters
  • basal cell later intact
  • demonstrates immunoglobulin fluorescence
  • IgG immunoglobulin
  • positive Nikolsky sign
  • Lips, palate and gingiva
57
Q

Progressive Systemic Sclerosis

A
  • widening of PDL
  • no facial expressions
  • fingers frozen in position
  • notch at angle of mandible
  • average opening 45mm
58
Q

aspirin Burn

A
  • white = coagulative necrosis of surface

- rubs off with difficulty

59
Q

mucocele

A
  • children and young adults
  • trauma
  • lower lip most common
  • vesicle/bulla
  • bluish in color
60
Q

basal cell carcinoma

A
  • painless ulcer with raised margins
  • NOT INTRAORALLY
  • papule with telangiectasia
  • does not metastasize
61
Q

Benign Migratory Glossitis

A
  • Red, flat depapillated area of tongue
  • white, keratin, cell debris
  • comes and goes
  • soreness of burning of mouth
  • corticosteroid rinse
62
Q

Ranula

A
  • FOM swelling
  • bluish
  • mucin if aspirated
63
Q

dentigerous cyst

A
  • posterior mandible most common (3rd molars)
  • can be ameloblastoma, SCC
  • pericoronal radiolucency attached to CEJ of unerupted tooth
64
Q

Antral Pseudocyst

A
  • asymptomatic
  • no treatment needed
  • slight radiopaque, dome shaped in maxillary sinus
65
Q

Parulis

A
  • tooth needs RCT
  • elevated reddish- yellow
  • bad taste in mouth common
66
Q

Eagle syndrome

A
  • calcification of stylohyoid ligament

- CN impingement

67
Q

Varices

A
  • dilated vein - blue
  • elderly
  • can feel hard as a rock
68
Q

Herpes Zoster

A
  • vesicle change to ulcers
  • unilateral distribution on skin and oral
  • comes from dorsal root ganglion
69
Q

dermoid cyst

A
  • doughy
  • anterior floor of mouth MIDLINE
  • bluish yellow color
70
Q

Primary Herpes Gingivostomatitis

A
  • inflamed, enlarged marginal gingiva, bleeding
  • vesicles to ulcers
  • malaise
  • low grade fever
  • sore throat
  • HSV
  • hangs out before reactivation
  • trigeminal ganglion
71
Q

Crohn’s disease

A
  • granulomatous gingivitis
  • aphthous-like ulcers
  • rectal bleeding
72
Q

incisive canal cyst

A
  • most common developmental non-odontogenic cyst
  • vital teeth
  • mx midline
  • true cyst
  • heart shaped radiolucency
73
Q

actinic cheilitis

A
  • vermilion board indistinct
  • great potential for dysplasia
  • Feels rough like sand paper.
  • Scaling, crusting.
  • High percentage turns into cancer.
74
Q

white sponge nevus

A
  • genodermatosis
  • autosomal dominant
  • moderately extensive thick, white folds of tissue
  • bilateral buccal mucosa
  • no eye involvement
75
Q

Periapical Cemento-osseous Dysplasia

A
  • middle aged black woman
  • mandibular anterior vital teeth
  • no pain or expansion
  • multifocal periapical lucencies
76
Q

Florid Cemento-Osseous Dysplasia

A
  • multiple fibro-osseous
  • in all 4 quads
  • RL and radiopaque
  • African american women
  • not in mandibular anterior
77
Q

Focal Cemento-osseous dysplasia

A
  • single site
  • 3rd-6th decade
  • 90% female
  • one round radiolucency to radiopaque
  • posterior mandible
  • no pain or expansion
  • white female
78
Q

Cheilitis Glandularis

A
  • mucous minor salivary gland of lips inflamed
  • mucus secretions
  • premalignant condition - SCC
  • Pt will talk about burning, tingling or weird sensation of lip
79
Q

Oral hairy leukoplakia

A
  • white, rough plaque on lateral border of tongue that doesn’t rub off
  • Hypertrophy of filiform papillae
  • HIV positive patient
  • caused by Epstein-Barr virus
80
Q

Lichen Planus

A
  • middle age women most often
  • purple, polgonal, pruritic papules
  • white papule or coalescing - wickam’s striae
  • Microscopic - hyperkeratosis, irregular epithelial proliferation in a “saw-tooth” pattern of rete pegs
  • does not wipe off - reticular form
  • erosive form wipes off
  • hyperplastic - plaque like and doesnt wipe off
81
Q

peripheral ossifying fibroma

A
  • soft tissue lesion
  • not in bone but makes osteoid/bone
  • occurs in gingiva especially interdental papilla area
  • scattered light opacities on radiograph
82
Q

Calcifying Odontogenic cyst

A
  • Not purely RL, b/c calcifying - salt and pepper appearence
  • most likely to affect the anterior areas of the jaws
  • most common in people in their second to third decades but can be seen at almost any age
  • Gorlin cyst- histo GHOST CELLS!!
  • lossed blue nucleus
83
Q

Nicotine Stomatitis

A
  • hard palate
  • red, inflamed minor salivary gland ducts
    tobacco use
84
Q

cleidocranial dyplasia

A
  • multiple unerupted supernumerary teeth
  • retention of primary teeth
  • missing clavical, frontal bossing, large head
85
Q

Auriculotemporal syndrome

A
  • Frey syndrome
  • Due to parotid surgery, sweat gland nerves are hooked up to your parotid gland,
  • so when you’re parotid salivates, it activates to make sweat instead.
86
Q

actinomycosis

A
  • soft tissue swelling with multiple draining fistulas
  • sulfur granules
  • woody consistency
87
Q

condylar hyperplasia

A
  • irregular elongated condyle

- chin deviates away from affected side upon closure

88
Q

dens-in-dente

A
  • dens invaginatus

- found most commonly in anterior mx lateral incisor

89
Q

Periapical cyst and granuloma

A
  • non-vital tooth at apex

- periapical lucency with radiopaque line

90
Q

Ectodermal dysplasia

A
  • exhibits missing teeth (hypodontia or anodontia)
  • heat intolerance
  • lack of hair and fingernails and eyebrows
91
Q

Dentin dysplasia

A
  • dentin abnormal with exposure
  • draining fistulas
  • misshapen teeth
  • type 1 “rootless” teeth
  • periapical lucencies
92
Q

Lymphangioma

A
  • lymph-filled superficial vessels

- most common cause of macroglossia (enlarged tongue)

93
Q

Infectious mononucleosis

A
  • lateral cervical swelling
  • sore throat
  • teenagers most common
  • positive monospot test
  • EBV associated
  • palatal petechiae
94
Q

Hemangioma

A
  • hamartoma
  • red to blue elevated lesions
  • blanches and compressible
  • collection of small or large vessles filled with RBC
95
Q

Hypercementosis

A
  • vital mandibular first molar
  • generalized acromegaly
  • radiopacity with intact PDL
  • attached to root surface
96
Q

Acquired Melanocytic nevus

A
  • pigmentation that is not an amalgam tattoo
  • biopsy taken
  • junctional type most common to undergo malignant transformation
97
Q

Keratoacanthoma

A
  • Difficult to differentiate from squamous cell carcinoma of the face and lip
  • sun-exposed skin
  • keratin plug in the center of ulceration
  • present for months and spontaneously resolves
98
Q

Warthin’s tumor

A
  • papillary cystadenoma lymphommatosum
  • benign cystic tumor of the salivary glands
  • most common in males and parotid gland
  • not inside mouth
99
Q

Vitamin C deficiency

A
  • scurvy

- does not cause xerostomia

100
Q

Sjogren’s syndrom

A
  • autoimmune disorder
  • elderly women
  • dry eyes, dry mouth
  • parotid swelling
101
Q

Stafne Defect

A
  • salivary gland depression defect
  • developmental
  • more in males
  • asymptomatic
  • vital teeth
  • well demarcated lucency found near the angle of mandible below mandibular canal
102
Q

Peutz-Jeghers Syndrome

A
  • oral and paraoral
  • pigments brown macules
  • found on lips, tongue, buccal mucosa, vermilion
  • intestinal polyposis
103
Q

Osteosarcoma

A
  • localized pain and swelling, tingling of lower lip
  • onset late 20s to early 30s
  • early radioluceny then opacity
  • trabeculae changes,
  • PDL symmetrical widening
  • sunburst appearance radiographicly
  • common in posterior mandible
104
Q

Osteopetrosis

A
  • massive overproduction of dense, nonvital bone of both jaws
  • young adults
105
Q

osteoma

A
  • found at angle of mandible

- well circumscribed radiopacity

106
Q

Necrotizing sialmetaplasia

A
  • rapidly expanding ulcerative lesion
  • deep ulcerations of palate
  • usually benign, often painless, self-limiting, and resolves in about six to ten weeks.
107
Q

multiple myeloma

A
  • elderly males
  • immunoglobulin spike
  • multiple bone sites
  • punched-out lucencies
108
Q

Odontogenic myxoma

A
  • young adult onset
  • multilocular lucency with soap bubble pattern
  • closely resemble ameloblastoma
109
Q

desquamative gingivitis would be what three diseases

A
  • pemphigoid
  • pemphigus
  • lichen planus
110
Q

what does causes gingival hyperplasia

A

cyclosporine
nifedipine (Procardia)
Phenytoin (Dilantin)

111
Q

How do you increase the intensity of an x-ray

A

milliamperage

double will double intensity of an x-ray beam

112
Q

what controls contrast and penetrating characteristics of an x-ray

A

kilovoltage

113
Q

Epulis Fissuratum

A
  • Hyperplastic connective tissue like fibroma
  • Associated with ill-fitting denture flange
  • Treatment does NOT include antibiotic treatment

NERB (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions