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Oral Surgery > Oral Path Exam 1 sweep 1 > Flashcards

Oral Path Exam 1 sweep 1 Flashcards

1
Q
  1. Fluctuant –
A

wavelike on palpation due to fluid content

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2
Q

hardened

A
  1. Indurated –
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3
Q

lines forming a skin pattern

A

Dermatoglyphics –

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4
Q

scalloped

A
  1. Crenated –
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5
Q

flakes of retained surface keratin

A
  1. Scale –
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6
Q

dried blood, serum or purulent exudate on the skin surface

A
  1. Crust –
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7
Q

Amelogenesis Imperfecta 3 divisions

A

Hypoplastic
Hypomaturation
Hypocalcified

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8
Q

inadequate deposition of

enamel matrix

A

Hypoplastic AI

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9
Q

incomplete mineralization

A

Hypomaturation AI

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10
Q

no significant degree of mineralization

A

Hypocalcified AI

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11
Q

Dentin Dysplasia

—— inheritance, 2 types:

A

Autosomal dominant

Type I: Radicular Dentin Dysplasia
Type II: Coronal Dentin Dysplasia

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12
Q

Dentin Dysplasia

Type II:

A

Coronal Dentin Dysplasia
Thought to be related to dentinogenesis
imperfecta
Enlarged pulps with “thistle tube” appearance, pulp stones

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13
Q

Dentin Dysplasia

Type I:

A

Radicular Dentin Dysplasia
Radicular roots are very short “rootless teeth”, obliteration of pulp (crescent-shaped remnant in crown), periapical radiolucencies

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14
Q

Syphilis - Primary
 Relatively painless ulceration – “chancre”  Develops —- days after exposure
 Most affect genital region; ~4% are oral
 Lip, buccal mucosa, tongue
 Resolves spontaneously in —-weeks

A

3-90

3-8

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15
Q

Syphilis - Secondary
 Develops —- weeks after initial infection
 Generalized ——
 —– cutaneous eruption
 Mucous patches & —– of oral mucosa
 Split —- at angles of mouth

A

4-10

lymphadenopathy

Erythematous maculopapular

condylomata lata

papules

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16
Q

Syphilis - Tertiary
 Develops after a latency period of —- years
 Approximately 30% of patients affected
 May affect any tissue; vascular, CNS, skin, bones, soft tissues
 —- formation
 Oral involvement may produce palatal perforation

A

1-30

Gumma

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17
Q

 Hutchinson’s triad:

A 
Malformed incisors (“Hutchinson’s incisors”)
and molars (“mulberry molars”) 
 Ocular interstitial keratitis
 Eighth nerve deafness
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18
Q

Syphilis - Histopathology
 Primary and secondary lesions show intense ——- infiltrate
 Tertiary (gumma) is characterized by ——- inflammation
 Spirochetes can be identified using the ——- stain

A

plasmacytic

granulomatous

Warthin-Starry

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19
Q

 Often associated with local trauma

A

actinomycosis

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20
Q

May follow dental extraction or untreated dental disease
 Diffuse swelling and erythema
 Draining sinus tracts
 “Sulfur granules” – colonies of organisms in purulent exudate

A

cervicofacial actinomycosis

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21
Q

Histopathology
 Filamentous bacteria that form colonies
 Bacterial colonies surrounded by neutrophils
 Adjacent tissue may show granulomatous inflammation or granulation tissue

A

Actino

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22
Q

Actino - Treatment

A

 Removal of offending tooth
 High-dose antibiotics, usually IV PCN for 2
weeks, then oral PCN for 2 weeks
 Periapical actinomycosis usually responds to less aggressive treatment
 Good prognosis with appropriate therapy

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23
Q

Histopathology: fluid accumulation within the epithelial cells of the spinous layer

A

leukoedema

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24
Q

Upper lip, lateral to midline; along nasolabial groove; 10% bilateral

A

nasolabial cyst

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25
Q

aka- “follicular cyst of the skin

A

epidermoid cyst

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26
Q

(Milia are simply very

A

small epidermoid cysts)

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27
Q

Uncommon
Lined by epidermis-like epithelium
Cyst wall contains adnexal skin structures hair follicles, sebaceous glands, sweat glands
May be classified as “benign cystic form of teratoma” (composed of tissue derived from multiple germ layers)

A

dermoid cyst

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28
Q

Sistrunk procedure for

A

thyroglossal duct cyst

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29
Q

Cervical variant of lymphoepithelial cyst
Presumably arises from remnants of the
branchial arches; usually 2nd arch
Fluctuant swelling of upper lateral neck
Usually anterior to the sternocleidomastoid
May develop fistula tract (1/3 of cases)

A

branchail cleft cyst

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30
Q

Lined by stratified squamous epithelium with lymphoid tissue in cyst wall.

A

branchial cleft cyst

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31
Q

Oral counterpart to branchial cleft cyst
Arises from epithelial rests trapped in oral
lymphoid tissue (Waldeyer’s ring or accessory lymphoid aggregates)

A

Oral Lymphoepithelial Cyst

32
Q

Soft to firm, yellowish-white nodule
Usually <1 cm and asymptomatic
Treatment: Surgical excision is curative
Histopathology: Lined by stratified squamous epithelium with lymphoid tissue in cyst wall.

A

oral lymphoepithelial cyst

33
Q

Patient management: Incisional biopsy is necessary for definitive diagnosis. with

A

desquamative gingivitis

34
Q

Slowly progressive collagenous overgrowth

of the gingiva

A

gingival fibromatosis

35
Q

Can Brutus Describe the Easy Lesion?

A

Color – Borders – Diameter (size) – Elevation (character) - Location

36
Q

vareigated

A

(uneven color

37
Q

An area of color change with NO elevation or
depression of the surface
 May be any shape or color

A

macule

38
Q

 A macule over 2 cm in diameter

A

PATCH

39
Q

Solid, elevated lesion

 0.5 cm or less in diameter

A

papule

40
Q

Solid, elevated lesion

 Larger than 0.5 cm in diameter  Sessile or pedunculated

A

nodule

41
Q

 A slightly-elevated lesion  Can be of any surface area

A

Plaque

42
Q

 A fluid-filled elevation

 0.5 cm or less in diameter

A

Vesicle

43
Q

 A fluid-filled elevation

 Larger than 0.5 cm in diameter

A

Bulla

44
Q

 A slightly-raised lesion

 Caused by increased production and retention of keratin

A

Keratosis

45
Q
  • Flat, pinpoint areas of hemorrhage
A

Petechiae

46
Q

area of hemorrhage that is larger than

petechiae but not larger than 1 cm in diameter

A

Purpura

47
Q

– area of hemorrhage that is larger than 1 cm in diameter

A

Ecchymosis

48
Q

diffuse atrophy of dorsal tongue papillae, particularly after broad-spectrum antibiotics
acute onset
typically associated with “burning” sensation

A

acute atrophic candida

49
Q

Probably referred to as “median rhomboid glossitis” in the past
Most are due to chronic candidiasis
Well-defined area of redness, mid-posterior
dorsal tongue
Usually asymptomatic

A

central papillary atrophy

50
Q

Often associated with lip-licking or chronic use of petrolatum-based materials
Usually related to candidiasis, but may have other cutaneous bacterial microflora admixed
Redness, cracking of cutaneous surface
Typically responds well to topical antifungal therapy

A

perioral candida

51
Q

Patient will have angular cheilitis, central papillary atrophy and a “kissing lesion” of the posterior hard palate

A

chronic multifocal candida

52
Q

Also known as “candidal leukoplakia”
White patch that cannot be rubbed off
Uncommon; generally anterior buccal mucosa
May be problematic because a true leukoplakia may have candidiasis superimposed on it
Should resolve with antifungal therapy

A

hyperplastic candida

53
Q

associated with specific immunologic defects related to how the body interacts with Candida albicans

A

Chronic Mucocutaneous Candidiasis –

54
Q

– seen in situations of severe uncontrolled diabetes mellitus or immune suppression

A

Invasive Candidiasis

55
Q

Imidazole antifungal agent
No significant systemic absorption or side
effects
Pleasant-tasting lozenges (troches)
Disadvantage – dosing schedule (should be dissolved in mouth 5 times per day)

A

Clotrimazole (Mycelex)

56
Q

Triazole antifungal agent
Readily absorbed systemically- no significant
degree of side effects (potential drug interactions) Daily dosing is convenient
Relatively expensive

A

Fluconazole (Diflucan)

57
Q
  • combination of nystatin and triamcinolone
A

Mycolog II Cream

58
Q
  • combination of iodoquinol and hydrocortisone
A

Vytone Cream

59
Q

Most cases are asymptomatic – calcified hilar lymph nodes seen coincidentally
Acute – may have flu-like illness
Chronic – cavitary pulmonary lesions
Disseminated – elderly, debilitated, or immunocompromised

A

histo

60
Q

Granulomatous inflammation, with or without necrosis

1-2 micron yeasts, usually within macrophages Best visualized by silver stain (GMS) or PAS

A

histo

61
Q

Acute – no treatment is usually necessary
Chronic or disseminated histoplasmosis – may
require amphotericin B
Ketoconazole or itraconazole for mild cases or as maintenance therapy

A

histo

62
Q

Endemic to desert Southwest U.S.
100,000 people infected annually in U.S.
“Valley fever” represents a hypersensitivity reaction

A

coccidiomycosis

63
Q

Inhalation of spores
Flu-like illness in 40% of infected patients Dissemination in <1%
Skin of central face may be affected; oral lesions are rarely described

A

coccidiomycosis

64
Q

Histopathologically shows large (20-60 micron) spherules that contain endospores
Variable host response, ranging from acute to granulomatous inflammation
Diagnosis can be made by culture or biopsy

A

coccidiomycosis

65
Q

Amphotericin B for disseminated cases
Fluconazole or itraconazole for milder cases May be more aggressive in persons of color
Generally good prognosis if patient is not immunocompromised

A

tx coccidiomycosis

66
Q

Organism lives in pigeon droppings Transmitted by air-borne spores
Affects immunosuppressed patients almost exclusively

A

cryptococcosis

67
Q

Histopathologically, 4-6 micron yeasts with a clear halo (representing a mucopolysaccharide capsule)
Organisms may be visualized with mucicarmine, PAS, or silver stain (GMS)
Diagnosis based on culture or identification of organisms in tissue sections

A

cryptococcosis

68
Q

Severe cases treated with amphotericin B and flucytosine
Fluconazole for less severe cases and for maintenance
Poor prognosis because most patients are immunocompromised

A

tx crypto

69
Q

Diagnosis is usually based on histopathologic findings because culture is too slow
Large, branching, nonseptate hyphae with extensive tissue necrosis
Hyphae are often seen plugging small blood vessels

A

Zygomycosis

70
Q

Common; second in frequency to Candidiasis

Spectrum of disease that includes allergy, localized infection or invasive ———-
Spores in soil, water, decaying organic debris
May be “nosocomial” infection

A

Aspergillus

71
Q

Features vary, depending on immune status and extent of tissue invasion
Allergy- Allergic fungal sinusitis (may trigger asthma)
“——-” – maxillary sinus fungus ball
Tissue damage - locally invasive
Immunocompromised patient - disseminated

A

aspergillus

Aspergilloma

72
Q

Non-invasive disease: debridement
Invasive disease:
Voriconazole or itraconazole, with or without
debridement
Good prognosis if normal immune status
Poor prognosis if patient is immunocompromised

A

tx aspergillus

73
Q

First oral antifungal agent that could be absorbed systemically- imidazole
Requires acidic stomach environment
Single daily dose is convenient
Problems with drug interactions and idiosyncratic hepatotoxicity (1 in 12,000)

A

ketoconazole

74
Q

)
Approved for treating histoplasmosis Well-absorbed; daily dosing
Minimal side effects
Quite expensive

A

Itraconazole (Sporanox

75
Q

Triazole compound; IV or oral
Approved for treating Candida, Aspergillus and
several other species
Side effects include photosensitivity
1st line therapy - invasive aspergillosis
Quite expensive ($460)

A

Voriconazole

Oral Surgery (6 decks)

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