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Tim's Cards > Oral Path Marathon II > Flashcards

Oral Path Marathon II Flashcards

1
Q

Tumefaction is another name for…

A

Swelling

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2
Q

Hyperplasia that can grow quite large but doesn’t have unlimited growth potential:

A

Reactive Tumors

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3
Q

Reactive Tumors are not…

A

Neoplasms

*unlimited growth potential

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4
Q

Reactive Lesions make up ____% of Biopsied lesions in the dental office

A

20%

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5
Q

The most common tumor of the Oral Mucosa:

A

Fibroma

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6
Q

Hyperplasia of fibrous connective tissue:

A

Fibroma

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7
Q

Fibroma incidence is higher in the _____ but occurs almost anywhere

Usually ______, smooth surfaced, normal color, asymptomatic

A

Cheek

Sessile (fixed)

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8
Q

2 Fibroma Variants:

A

Giant cell fibroma

Peripheral odontogenic (ossifying) fibroma

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9
Q

Increases incidence in Gingiva, also on the Tongue but to a lesser extent, and children, often confused with Papillomas

A

Giant Cell Fibroma

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10
Q

Giant Cell Fibroma is a fibrous CT tumor containing plump ________ Fibroblasts that are ______ nucleated

A

stellate

bi/tri

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11
Q

Giant Cell Fibroma contains what cells?

Peripheral Giant Cell Granuloma contains what cells?

A

stellate, multinucleated Fibroblasts

multinucleated Giant Cells

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12
Q

Reactive folds of hyperplastic fibrous CT along Border of ill-fitting Denture:

Hyperplastic response of Palatal Mucosa to ill-fitting Denture:

*2 names for each

A

Inflammatory Fibrous Hyperplasie (Epulis Fissuratum)

Inflammatory Papillary Hyperplasia (Papillomatosis)

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13
Q

Papillary hyperplasia + inflammation +/- psudoepitheliomatous hyperplasia =

A

Inflammatory Papillary Hyperplasia (Papillomatosis)

*ill-fitting denture to Palate

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14
Q

Only on Gingiva (more in Anterior), any age, asymptomatic, red/brown/purple

pedunculated or sessile

2:1 female to male

A

Peripheral Giant Cell Granuloma

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15
Q

Peripheral Giant Cell Granuloma is a tumor of well vascularized fibrous CT w/ numerous _______ cells

A

multinucleated Giant cells

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16
Q

The body’s basic reparative tissue:

A

Granulation tissue

Giant Cells?

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17
Q 
red/ulcerated  pedunculated/sessile 
2-4 decades 
Mostly in Gingiva but can occur anywhere (including skin) 
"pregnancy tumor" 
reactive lesion of granulation tissue
A

Pyogenic Granuloma

*misnomer

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18
Q

Pyogenic Granuloma is a reactive lesion of _______ tissue and often occurs during _______

A

Granulation

Pregnancy

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19
Q

If a Pyogenic Granuloma occurs in extraction sockets it is called…

A

Epulis Granulomatosa

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20
Q

Hyperplastic granulation tissue, Fibroblasts w/ Delicate Collagen

vascularized

A

Pyogenic Granuloma

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21
Q

Occurs anywhere, but if on Gingiva
Odontogenic and Pus

*pulpal/periodontal in origin

A

Parulis

“Gum Boil”

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22
Q

Exclusively 1-2 decades
Female 2:1
Mx 5:1
Papillary w/ edema

A

Localized juvenile spongiotic gingival hyperplasia

*red/papillary/gingival

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23
Q

Localilzed Juvenile Spongiotic Gingival Hyperplasia is red, ______, and gingival

A

Papillary

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24
Q

Overgrowth of Blood Vessels:

A

Hemangioma

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25
Q

Hemangioma is often ________

____% in the Head and Neck

Females __:__

A

developmental

60%

3:1

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26
Q

Rapid proliferation of Endothelial Cells at birth/short after

Most common tumor in infancy (5-10%)

A

Hemangioma

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27
Q

Hemangioma Tx: most of it naturally _______

Laser pulse, excision, sclerosing agents, and what 2 drugs?

A

involutes

steroids, Systemic Propanolol

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28
Q

Sturge-Weber Angiomatosis, aka…

A

Encephalotrigeminal angiomatosis

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29
Q

Nonheriditary developmental, congenital
Vascular proliferation brain/face
Large purplish lesions identical to port-wine stains
Ipsilateral Common

A

Sturge-Weber Angiomatosis

encephalotrigeminal angiomatosis

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30
Q

Sturge-Weber and port wine stains are due to somatic activation mutations in _______- which encodes _______

This is a member of the ____ class of ____ protein alpha that mediates G-protein to downstream receptors

(difference is when mutation occurs)

A

GNAQ, G-alpha-q

q class, G protein

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31
Q

Leptomingeal angioma of cerebral cortex

A

Sturge-Weber

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32
Q

Developmental overgrowth of Lymphatic Vessels:

A

Lymphangioma

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33
Q

Tx for Lymphangioma

b/c the don’t ______

A

Excision

Involute

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34
Q

Head and Neck
0-5 yrs
Tongue
pebbly if superficial, more diffuse deeper
called a Cystic Hygroma if large/deep/neck

A

Lymphangioma

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35
Q

Pathologic new growth of tissue - Uncontrolled - no regression if caused by stimulus and the stimulus was removed

A

Neoplasm

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36
Q

T/F

You can usually differentiate if a Neoplasm is epithelial/mesenchymal or benign/malignant

A

True

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37
Q

2 kinds of Epithelial Neoplasms (etiologies):

A

HPV etiology

Keratoacanthoma

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38
Q

3 Types of HPV derived Epithelial Neoplasms:

A

Papilloma (soft palate)

Verruca vulgaris (common wart - HPV 2)

Condyloma Acuminatum (veneral - HPV 6/11)

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39
Q

Exophytic, pedunculated, pink/white Epithelial Neoplasm w/ HPV etiology on the Palate:

A

Papilloma

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40
Q

Sun Exposed areas will create Reactive (not Neoplastic) tumor

increased in older patients with ___% on the lips

Natural History is involution/healing

A

Keratocanthoma

10%

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41
Q

Neoplasms can be ______ or ________

A

Epithelial

Mesenchymal

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42
Q

3 types of Mesenchymal Neoplasms:

A

CT

Muscle

Nerve

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43
Q

Most _____ Neoplasms look identical clinically and present as asymptomatic, slowly growing Submucosal Masses

A

Mesenchymal

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44
Q

3 CT derived Mesenchymal Neoplasms:

A

Fibroma

Lipoma

Verruciform xanthoma

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45
Q

A benign neoplasm of fat

yellowish, very common in skin, less Orally

A

Lipoma

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46
Q

Reactive lesion, often in Hard Palate or Gingiva

Oral, but can be in skin/genitals

Irregular

Pink to White

A

Verruciform Xanthoma

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47
Q

Papillary hyperplasia in which CT papiiae contain phagocytic cells that have engulfed Lipid

A

Verruciform Xanthoma

xanthoma = engulfed lipid cells

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48
Q

Benign neoplasm of Smooth Muscle, common in the Uterus

*rare orally, red to purple

A

Leiomyoma

angioleiomyoma, vascular leiomyoma

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49
Q

Benign neoplasm of Skeletal Muscle, often in the Heart, rare orally (but in tongue)

A

Rhabdomyoma

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50
Q

Once thought to originate from Muscle, but now Nerve (possibly sheath)

Tongue

Fixed

A

Granular Cell Tumor

*Myoblastoma

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51
Q

Granular Cell Tumors have large ____ cells with granular cytoplasm

1/2 cause overlying epithelium to react, stimulating Carcinoma, this is called?

A

polygonal

pseudoepitheliomatous hyperplasia (PEH)

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52
Q

Congenital Tumor of the Anterior Alveolar Ridge

A

Congenital Epulis of the newborn

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53
Q

Congenital Epulis of the Newborn occurs 2:1 in the _______ and F:M :

A

Mx

10:1

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54
Q

Identical Cells to Granular Cell Tumor but no Nerve markers

No PEH (pseudoepitheliomatous hyperplasia)

May regress if incompletely excised

A

Congenital Epullis of the Newborn

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55
Q

Aberration of healing following Trauma to Nerve (not real Neoplasm)

Lateral/Anterior ______, lower lip, mental foramen,

Palpation produced ______

A

Traumatic Neuroma

Tongue

Pain

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56
Q

Benign Neoplasm in Nerve composed of Schwann Cells, Axons, and Fibrous Tissue

Most are _____ but can occur anywhere

A

Neurofibroma

asymptomatic

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57
Q

Developmental form of Neurofibromatosis, can affect Pigmentation, central/peripheral NS….

A

Von Recklinghausens Disease of the Skin

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58
Q

Von Recklinghausen’s Disease of the Skin can cause what skin pigmentation?

1/2 inherited as ______ trait, the other 1/2 _____ mutations

Most on Chromosome _____

A

cafe-au-lait spots

autosomal dominant, somatic

17

*Remember, this is a neurofibroma

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59
Q

Von Recklinghausen’s Disease of the Skin causes freckling, cafe au lait spots, or defects in the iris called…

___% of pts develop malignancy in their neurofibromas

A

Lisch spots

1-5%

60
Q

Benign encapsulated neural neoplasm arising withing the sheath of a peripheral nerve

Painless, often Freely Moveable

A

Neurilemmoma (Schwannoma)

61
Q

Antoni A Neurilemmoma, _____ areas of replicated basement membrane material surrounded by ______ nuclei

Antoni B Neurilemmoma, haphazardly arranged _____ Schwann cells in loose _____

A

Acellular, Schwann cell

spindled, stroma

62
Q

Neural Crest Tumor in Jaws (rarely extragnathic)

A

Melanotic Neuroectodermal tumor of Infancy

63
Q

Melanotic Neuroectodermal Tumor of Infancy is mostly Congenital and occurs where?

Rapidly growing, pigmented, Radiolucent, produces _____ in serum/urine

Tx is aggressive _______

___% recur

A

Anterior Jaws, Mx

VMA - vanilymandelic acid

curettage

10-20%

64
Q

MEN3:

A

Multiple Endocrine Neoplasia Type 3

65
Q

Multiple Endocrine Neoplasia Type 3, 95% of pts have mutation on the _____ gene

This is a ProtoOncogene on chromosome _____

50/50 autosomal dominant/_____

A

RET

10

somatic

66
Q

3 Examples of MEN3 neoplasms:

*remember, this is a Mesenchymal neoplasm of the Nerve

A

Mucosal neuromas

Medullary carcinoma of thyroid

Pheochromocytoma of adrenal medulla

67
Q

Pigmented lesions we focus on are _____ lesions

A

melanocytic

68
Q

Common mole, aka…

A

Nevi (nevus)

69
Q

Nevus cells are pigmented lesions that migrate from _____ to skin and occasionally mucous membranes

A

Neural Crest Cells

70
Q

Nevi can be congenital: _% of newborns

Acquired: genetic influence, avg person has about ____

A

1%

15

71
Q

4 types of Nevi:

A

Junctional

Intradermal

Compound

Blue

72
Q

Junctional Nevus: flat macule, in the ____ epithelium at junction btwn epithelium/CT

Intradermal Nevus: Nodule (+/- hair) in the dermis or ______

Compound Nevus: nodule, combo of…

Blue Nevus: ____ nevus in deep _____

A

Basal Epithelium

Lamina Propria

Junctional/Intradermal

Dentritic, CT

73
Q

Reactive proliferation of intraepithelial dentritic melanocytes

  • increased in blacks, cheeks
  • resolves if irritant removed
A

Melanocanthoma

74
Q

Freckle:

A

Ephelis

75
Q

Localized overproduction of Melanin of flat macules, increased in Head and Neck

A

Ephelis

76
Q

T/F

Freckles (Ephelis) are an increase number of cells

A

False

*increased overproduction of Melanin

77
Q

From Chronic UV damage, not seen intraorally
increases after 40, 90% of elderly have them
Flat, evenly discolored, multiple

A

Actinic/Senile Lentigo

*aka Age Spots, Liver Spots

78
Q

A big freckle that isn’t sun related:

female:male = :

avg size:

A

Melanotic Macule

2: 1
6. 8 mm

79
Q

Melanotic Macule occurs ___% in the Lower Lip

also common in palate and ______

___% multiple

A

33%

gingiva

15%

80
Q

A malignancy of melanin-producing cells

A

Malignant Melanoma

81
Q

Malignant Melanomi is the ____ most common skin cancer

but incidence in increasing

A

3rd

82
Q

The likelihood of a White person developing Malignant Melanoma is less than 1 in 100 throughout life

A

True

83
Q

Malignant Melanoma happens ___% in the Head and Neck

___% in the extremities

__% Intraorally

A

25%

40%

less than 1%

84
Q

Risk factor for Malignant Melanoma:

A

Sun exposure

85
Q

Clinical Features of Malignant Melanoma A:

B:

C:

D:

A

Asymmetry

Borders

Color - red/tan/brown/black

Diameter (growth, greater than 6mm)

86
Q

2 Biologic Growth phases Malignant Melanoma:

A

Radial

Vertical

87
Q

% of Radial Malignant Melanoma:

A

75-85%

88
Q

5 types of Melanoma:

A

Superficial spreading

Nodular

Lentigo maligna

Acral lentiginous

Oral

89
Q

70% of Cutaneous melanomas

more in trunk (28% in head and neck)

A

Superficial Spreading Melanoma

90
Q

Superficial spreading malanoma has a short ____ phase, develops nodules, goes _____

A

radial

vertical

91
Q

15% of cutaneous melanoma

30% head/neck

A

Nodular Melanoma

92
Q

Nodular Melanom has almost no _____ growth

it is rarely ______

A

Radial

amelanotic

93
Q

5-10% of cutaneous melanoma

A

Lentigo maligna melanoma

94
Q

Lentigo maligna melanoma increases with age (sun) and has an extremely long _____ growth phase

This is called _______ and may last for ____ years

*ultimately develops vertical growth

A

Radial

Hutchinson’s freckle, 15-20 years

95
Q

Small subset of Melanomas affecting palms, soles, sublingual and mucous membranes

A

Acral lentiginous melanoma

96
Q

Most Oral Melanom has _____ growth (more than 50%)

most often found in what 2 places?

A

radial

palate, Mx gingiva

97
Q

Excise Malignant Melanoma w/ a minimum of a ___ margin

+/- lymph nodes, chemo, radiation, etc

A

1 cm

98
Q

Most important factor influencing survival of Malignant Melanomas

survival is ___% over 10 years

Oral melanomas survival is ____ over 5 years

A

Depth of invasion

79%

less than 20%

*oral much much worse Prognosis

99
Q

T/F

Antimalarials, Antimicrobials, Psychotropics, and Chemotherapeutics can cause Pigmentation

A

True

100
Q

Multifocal pigmentation includes Addisons, Peutz-Jeghers, McCune Albright, and Smoker’s melanosis

A

True

101
Q

4 Drugs that can cause Multifocal Pigmentation:

A

Antimalarials

Antiarrythmics (quinidine)

Tranquilizers (thorazine)

cis-platinum

102
Q

Adrenocortical insufficiency that triggers hypothalamus to stimulate ant pit to over-produce ACTH and MSH (Melanin Stimulating Hormone)

A

Addison’s Disease

*multifocal pigmentation

103
Q

Peutz-Jeghers Syndrome is ______ (heritability)

Affects skin, intestine, oral and perioral freckles

A

autosomal dominant

*multifocal pigmentation

104
Q

Neurofibromatosis and McCune Albright syndroms (polyostotic fibrous dysplasia) cause _____

A

cafe au lait spots

*multifocal pigmentation

105
Q

Smoker’s melanosis is a type of _________

increased on palate/gingiva

A

multifocal pigmentation

106
Q

melanoma, kaposi’s sarcoma, petechiae, ecchymosis, purpura

A

multifocal pigmentation

107
Q

Odontogenesis starts with _________ growing into the _______ and producing tooth germ, a portion of which is the enamel organ

A

ectoderm (epithelilum)

dental lamina (jaw)

108
Q

Pathologic Cavity lined by Odontogenic Epithelium and filled with fluid or semisolid material

A

Odontogenic Cyst

109
Q

Odontogenic can by Inflammatory or not

A

True

110
Q

2 types of Inflammatory Odontogenic Cysts:

The rest are _______

A

Radicular cyst, buccal bifurcation cyst

Developmental

111
Q

A cyst arising from degeneration of enamel organ prior to tooth formation.

This aborts odontogenesis resulting in radiolucency in place of a missing tooth

A

Primordial Cyst

112
Q

Primordial Cysts most often occur in what tooth?

A

Mn 3M

113
Q

Cyst resulting from the separation of the follicle from around the crown of a developing tooth

A

Dentigerous Cyst

*aka follicular cyst

114
Q

Dentigerous Cyst happen at any age, most often in the Mandibular ______

and the Maxillary ______

A

3M

Canines

115
Q

Dentigerous cysts are expansive and symptomatic

A

False

*asymptomatic, usually no expansion

116
Q

Dentigerous cysts usually are lateral and unerupted crowns, creating a radiolucency where?

A

Pericoronal

*from CEJ around crown

117
Q

Stratified Squamous epithelium w/out Keratinization

*originally ameloblast, but now reduced enamel epithellium

A

Dentigerous Cyst

118
Q

Tx Dentigerous Cyst for Mn3M

for Canine:

A

Extraction

may be able to decompress and pull orthodontically

119
Q

2 Variants of Dentigerous Cysts:

A

Eruption

Lateral

120
Q

A Dentigerous Cyst has high Neoplastic Potential

A

False

*exceedingly rare

121
Q

3 types of the Exceedingly Rare Dentigerous Cyst Neoplasms:

A

Ameloblastoma

Squamous cell carcinoma

Mucoepidermoid carcinoma

122
Q

2 Types of Periodontal Cysts:

Which most common?

A

Apical Periodontal Cyst (most common)

Lateral Periodontal Cyst

123
Q

Cyst of Inflammatory Origin secondary to Devitalized Pulp:

A

Apical Periodontal Cyst

124
Q

Apical Periodontal Cyst is a _____ cyst

2 types:

A

Radicular

Lateral radicular cyst, Residual cyst

125
Q

Rest or Malassez cystic degeneration

Most often seen on what tooth?

A

Lateral Periodontal Cyst

Mn Canine/PM

126
Q

Apical Periodontal Cyst

Lateral Periodontal Cyst

Which one is Vital?

A

Lateral

*apical NOT vital

127
Q

Polycystic, multilocular, recurring variant on a Lateral Periodontal Cyst:

A

Botryoid Odontogenic Cyst

128
Q

2 Types of Gingival Cysts:

A

Newborn (dental lamina)

Adult

129
Q

Common, congenital, Gingival Cyst of Newborn are what color?

Tx?

A

Yellowish elevations

none - will self-marsupialize and heal

130
Q

Adult Gingival Cyst is attached gingiva, arises from a degeneration of glands of _______

Occurs in what tooth?

Similar to _____

A

Serres (dental lamina)

Mn Canine/PM

mucocele

131
Q

Developmental cyst from the dental lamina:

A

Odontogenic Keratocyst

132
Q

Odonotogenic Keratocyst are _____ parakeratinized

_____ orthokeratinized

A

90%

10%

133
Q

Parakeratinized Odontogenic Keratocyst occurs 2:1 in what arch?

They are clinically _______

A

Mn

aggressive

134
Q

Parakeratinized Odontogenic Keratocyst is unilocular/multilocular _______ and mimics other odontogenic cysts

A

radiolucency

135
Q

Parakeratinized Odontogenic Keratocyst histologic parakeratotic stratified squamous epithelium lining with well developed _____/______ basal cells

Often daughters of ______ in wall

Tx is conservative, about ____ recur

A

palisaded/hyperchromatic

microcysts

1/3

136
Q

5% of pts w/ keratocysts have what Autosomal Dominant disorder?

A

Basal Cell Nevus-Bifid Rib Syndrome

*nevoid basal cell carcinoma syndrome

137
Q

Basal Cell Nevus-Bifid Rib Syndrome is a mutation on the tumor suppressor gene _______

Creates a basal cell carcinoma not to be confused with?

calcification of ______, bone anomalies, multiple OKC’s

A

9q22

sun exposed/elderly

falx cerebri

138
Q

Keratocysts are known for what 3 things?

A

Clinical aggression

Recurrence

association w/ basal cell nevus-bifid rib syndrome

139
Q

The smaller, less aggressive, minimal recurrence, not associated w/ syndrome odontogenic cyst?

A

Orthokeratinized odontogenic cyst

140
Q

Asymptomatic Odontogenic cyst, occurs at any age, may be associated with unerupted teeth/odontoma

A

Calcifying odontogenic cyst

*Gorlin Cyst

141
Q

Calcyfying Odontogenic Cyst (Gorlin Cyst)_ is fully or partially cystic, contains ____ cells which tend to calcify

Tx is conservative and recurrence is ____

A

ghost

low

142
Q

Glandular Odontogenic Cyst occurs more often in what arch?

may be _____, unilocular or multilocular radiolucency,

Shows _____ differentiation (mucous, columnar w/ cilia, lumina)

Recurrence rate:

A

Mn

Large

Glandular

30-50%

143
Q

Buccal Bifurcation Cyst, aka…

A

Paradental Cyst

144
Q

An inflammatory cyst occurring on the buccal of an erupting tooth:

Happens most often in what demographic?

What tooth?

A

Buccal Bifurcation Cyst

children

Mn 1M

145
Q

Unilocular radiolucency involving furcation of the roots:

This is an inflamed cyst lined by ________

Tx enucleation of cyst, no ______

A

Buccal Bifurcation Cyst

stratified squamous epithelium

extraction

Tim's Cards (140 decks)

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