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Part II > Oral patho > Flashcards

Oral patho Flashcards

1
Q

What is the difference between oligodontia and hypodontia?

A

oligodontia is absence of more than 6 teeth.. hypodontia is absence of few teeth

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2
Q

What are the characteristic of Dentinogenesis imperfecta?

A
  1. color: opalescent
  2. short roots
  3. constricted CEJ (tulip/bell shaped crowns)
  4. obliterated pulps (type I & II) only
  5. large pulp (type 3 only, aka brandywine) with multiple exposures and apical lesions
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3
Q

Dens in dente is ……..

A

invagination of the enamel organ during formation

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4
Q

In hypercementosis, teeth are ……..

A

vital

  • usually in premolars
  • associated with Paget’s, toxic goiter, gigantism, chronic tooth inflammation
  • PDL space is continuous
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5
Q

Odontodysplasia affects ……

A

epithelium (enamel) & mesenchyme (dentin, cementum)

  • Max. anterior are more affected
  • Teeth are short, large pulps (aka. ghost teeth)
  • Tx: exo
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6
Q

Most commonly ankylosed tooth is …….

A

primary second molar and its successor

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7
Q

Amelogenesis imperfecta will show normal pulp except …..

A

in case of abrasion, there’s obliteration of pulp due to secondary dentin

  • Tx is cosmetic for AI
  • open bite is common in AI. Caries rate is normal
  • pulp and cementum are normal
  • hereditary (could be AD, AR, X-linked)
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8
Q

Porphyria in teeth appears ……..

A

red or brown

* defect in heme synthesis

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9
Q

Dentin dysplasia is two types?

A
  1. Radicular
  2. Coronal
    * Review Deck 12 (very important)
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10
Q

Substitution of valine for glutamate causes ……

A

sickle anemia

  • Characterized by enlarged marrow spaces
  • RBC life is 20 days instead of 120
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11
Q

Werlhof disease is ……..

A

Thrombocytopenic purpura

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12
Q

Lymph nodes are usually ….. size in chronic leukemia

A

normal (enlarged in acute form)

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13
Q

Methimazole causes …….

A

agranulocytosis

  • It’s an antithyroid drug (along with carbimazole)
  • Causes severe oral ulceration
  • Cyclic neutropenia is an unusual form of agranulocytosis, causes severe gingivitis
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14
Q

Oral manifestation of thalassemia is ….

A

flaring of anterior teeth

* there’s low level of RBC & hemeglobin

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15
Q

Rhogam is a tx for ……

A

Rh incompatibility (given to mother during and after birth)

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16
Q

Philadelphia chromosome is .

A

translocation from chromosome 22 to 9 in CML

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17
Q

Most oral manif. of leukemia is in ……. type

A

AML & CML

  • hemorrhage, gingivitis, hyperplasia, ulcerations
  • Note: EBV & HTLV-1 may be the cause for leukemia
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18
Q

Osler’s disease is ………

A

hypoxia due to high altitude. Causes secondary polycythemia

* Note: Erythromelalgia is paroxysmal vasodilation of B.V with congestion and pain. Usually in limbs

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19
Q

Epulis granulomatosum is ……..

A

caused by retained foreign body after exo.

  • Soft non painful, bleeds easily
  • Granulation tissue with bone/dentin/cementum or foreign body
  • Tx is curettage
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20
Q

What are MEN types?

A
  1. MEN I: pituitary, parathyroid, pancreas, adrenal cortex
  2. MEN II (Sipple syndrome): parathyroid, pheochromocytoma, medullary thyroid
  3. Men III: any of the two, plus “mucocutaneous neuroma”
    * Thyroid medullary carcinoma is a risk with MEN III
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21
Q

Von recklinghausen disease is characterized by ….

A
  1. Cafe au lait and arm pit freckles
  2. Lisch nodules (iris freckles)
  3. multiple mucocutaneous neurofibroma
    * Note: 6 or more cafe au lait is indicative
    * High risk of malignancy
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22
Q

Scleroderma is ……

A

autoimmune inflammation, followed by deposition of type I & III collagen.
* Oral signs: uniform widening of PDL (Note: similar osteosarcoma)

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23
Q

Epulis granuloma of newborn is similiar to …….. with one difference

A

granular cell myoblastoma (usually on the tongue)

* difference: granular cell myoblastoma is covered with pseudoepithelium hyperplasia)

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24
Q

Most common tumor of nerve fibers is …….

A

neurofibroma

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25
Q

Focal sclerosing osteomyelitis (condensing osteitis) is similar to ……… with the difference being …..

A

benign cementoblastoma

  • in osteomyelitis, the entire root form is visible
  • It is a radiopaque mass
  • Focal S O: Tx is exo or endo
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26
Q

Garre osteomyelitis is a form of chronic osteomyelitis, except …..

A

there is periosteal bone formation with Garre, and onion skin appearance
* Acute & chronic osteomyelitis are caused by strep & staph

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27
Q

Cleft lip occurs in …., while cleft palate …… (timing)

Define Vander Woude syndrome

A

6-7 weeks
8-10 weeks
* Vander: AD, lip pits with cleft lip/palate

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28
Q

Achondroplasia is accompanied by mandibular ……

A

prognathism

  • teeth are normal size, but there is crowding
  • patients are prone to ear infection
  • Note: pituitary dwarfs have underdeveloped mandible (unlike achondroplasia)
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29
Q

Hypophosphatasia is caused by …….

A

deficiency of alkaline phosphtase

* There is premature prims loss, with enlarged pulp chambers

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30
Q

Pierre robin syndrome is …….

A

micrognathia, high arched cleft palate, and glossoptosis (retruded tongue)

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31
Q

Cherubism is characterized by ……

A

multiple giant cell granulomas and “perivascular cuffing”

  • more in males
  • Radio: soap bubble like bone lesions
  • resembles central giant cell granulloma
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32
Q

Hypothyroidism is treated with ……..

A

Vit D

* Note: Vit D deficiency may lead to hyperparathyroidism

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33
Q

Microscopically, brown tumors of hyperpara resembles ………

A

central giant cell granuloma

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34
Q

Osteomalacia may occur as a complication of pancreatitis due to ……

A

steatorrhea and subsequent vit D deficiency

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35
Q

Most common reason for liver transplant is ……

A

hepatitis C

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36
Q

Biopsy specimen is stored in …….

A

10% formalin

* Note: lesions up to 1 cm are removed by excisional biopsy

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37
Q

EBV infects ……

It is diagnosed by …….

A 
B lymphocytes 
heterophile test (mononucleosis spot test),  which gives high level of IgM antibodies
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38
Q

Epithelioid cells are characteristic of ……..

A

granuloma

  • They’re specialized macrophages
  • Multinucleated giant cells are Langerhan’s cells with foreign bodies
  • Sarcoidosis: non necrotizing granuloma.
  • Crohn’s disease: non casseating granulomas
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39
Q

The most serious complication of Ludwig’s angina is …..

A

edema of glottis

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40
Q

Ingestion of fluoride up to the level of …… daily is safe

A

4-5 mg

* In this low conc. , little is retained in the body

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41
Q

Causes of xerostomia are …….

Tx is ………

A

radiation (main side effect), antihistamine, antidepressant, anticholinergics, anti hypertensives, antipsychotics etc,…
Tx is carboxy & hydroxymethylcellulose

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42
Q

ABCD’s of melanoma is ….

A

asymmetry, border irregular, color variance, diameter is over 1/4 inch

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43
Q

Plasmacytoma is …….

A

collection of abnormal monoclonal plasma cells

  • two types, primary (localized in bone marrow), seconday (extramedullary)
  • Importance: may develop into multiple myeloma
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44
Q

Hutchinson’s freckle (lentigo maligna) may develop into ……

A

lentigo maligna melanoma

  • Acral lentiginous melanoma is least common type. More common in africo-americans
  • Both are superficial type of melanoma
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45
Q

Burkitt’s lymphoma oral lesion is …….

A

expanding hemorrhagic masses on the palate and the gingiva

Radio: moth eaten, poorly marginated osteolytic lesion

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46
Q

Ewing’s sarcoma:

  1. Site?
  2. Radio?
  3. Histo?
A
  1. pelvis, thigh, ramus
  2. Medullary expansive lesion, with cortical erosion
  3. cells containing glycogen (characteristic)
    * Histo may be similar to neuroblastoma & reticulum cell sarcoma
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47
Q

Lymphoepithelial cyst is ……

A

pink-yellow moveable, submucosal nodule. Usually in the floor of the mouth
* Its extraoral counterpart is Branchial cyst

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48
Q

Reed sternberg cell is needed for Dx of ?

A

Hodgkin lymphoma

* Ann arbor system is used for staging and determining the extent of Tx for hodgkin’s

49
Q

Dx of metastatic carcinoma can be verified with ……

A

staining for cytokeratin, which is found in all carcinoma cells
* Cancer spread to the jaws is through blood

50
Q

Cauliflower lesion is …….

A

verrucous carcinoma

  • Site: mand. mucobuccal fold, alveolar mucosa
  • Cause: HPV (16 & 18), tobbaco
  • Note: non metastatic
51
Q

Melkersson rosenthal syndrome (triad) is …….

A

chelitis, bell’s palsy, plicated tongue

52
Q

Multiple sclerosis is characterized by ……..

A

demyelination of CNS nerves

  • autoimmune
  • bell’s palsy and trigeminal neuralgia occurs more frequently with MS
53
Q

Nasolabial (nasoalveolar) cyst is not a true cyst. T/F?

A

true

54
Q

Branchial cyst is located ….., the origin is ….

A

anterior to SCM

  • It’s filled with milky mucoid fluid. Lined with ciliated stratified squamous epi
  • Origin is second branchial POUCH
55
Q

“Teeth that are floating in space” is a characteristic of ……….

A

Langerhans cell disease (histiocytosis X)

  • Sharply circumscribed lesion with punched out appearance
  • Histo: eosinophiles mixed with langerhans multinucleated cells
56
Q

Fibrous dysplasia histology is ……

A

medullary bone replaced by fibrous tissue, with varying amount of osteoid
* Craniofacial FD: affect the Max., zygoma, sinus floor of orbit

57
Q

Jaffe Lichtenstein syndrome is …….

A

skin pigmentation and multiple fibrous dysplasia

58
Q

Ossifying fibroma: Origin? location? Tx?

A 
PDL undifferentiated cells
Mand. premolar-molar region
enucleation/curettage
* Note: it is asymptomatic and slowly growing, but the Juvenile type, is more aggressive
* It is a non-odontogenic tumor
59
Q

Radiographically, describe the fibrous dysplasia lesion?

A

“ground glass”, with irregular borders (NOTE: this is different from ossifying fibroma, which has well circumscribed borders)

60
Q

What is the difference between dentigerous and primordial cysts?

A

Primordial has no calcified tissue within

* Primordial is lined by stratified squamous epi

61
Q

Focal osteoporotic bone marrow defect is …….

A

hemopoietic bone marrow found in the extraction site

62
Q

Bohn nodules are…….

A

cysts of dental lamina, along the alveolar ridge of neonates (aka gingival cysts of newborn. They’re odontogenic)
* Epestein pearls are the same, but they’re found along the midline of palate (also developmental, but non odontogenic)

63
Q

Histo of KOC is ……

A

para or ortho keratinized lining, with palisaded basal layer. Keratin filled lumen

  • Orthokeratinized variant is less aggressive
  • High recurrence rate
64
Q

Lateral periodontal cyst is ……..

A

non keratinized, non inflammatory developmental cyst

65
Q

Histo of pindborg tumor (CEOT) is …..

A

sheets of large polyhedral cells with areas of amyloid and concentric calcified deposits (Liesegang rings)

66
Q

Cemento-osseous dysplasia goes into 3 stages:

A
  1. osteolytic
  2. osteoblastic
  3. sclerotic
    * AKA cementoma
67
Q

Bismuth line is found on ……

A

marginal gingiva as a blue dark line

* bismuth is used as tx for dermatologic disorders

68
Q

The most common lesion of the skin is …….

A

intradermal nevus (common mole)

  • Acquired nevi (intra and extra orally) are much more common than congenital nevi (birth mark)
  • Most common on hard palate
69
Q

B-K mole syndrome and dysplastic nevus syndrome are both characterized by …….

A

multiple large, pigmented nevi, with high risk of developing malignant melanoma

70
Q

Albright synd, Addison disease and Peutz jeghers all cause ……..

A

intra oral pigmentation

* Note: Cushing syndrome doesn’t cause pigmentation

71
Q

Addison disease is characterized by ……..

A

muscle weakness, weight loss, bronzing of skin and mucous membrane, low B.P, low Na, high K, hypoglycemia

72
Q

Tx for focal melanosis is …….

A

no Tx, observe

  • may be caused by addison’s
  • Most common site: gingiva, lower lip
73
Q

Intra oral nevus is most commonly a …….

A

an intra-mucosal nevus

74
Q

The lining of traumatic bone cyst is ………

A

C.T (it is a pseudocyst)

* Other pseudocysts include: aneurysmal bone cyst

75
Q

Rendu osler weber is characterized by ………

A

epistaxis, arteriovenous fistula (lungs and liver), multiple hemangioma (intra & extra orally)
* aka hereditary hemorrhagic telangiectasia, most commonly on the lip

76
Q

Encephalotrigeminal angiomatosis is …….

A

hemangioma of the face (port wine stain), meninges and cerebral cortex
* aka sturge weber syndrome

77
Q

Wegener granulomatosis is a triad of ……

A

vasculitis, granulomas, and necrosis

  • affects lungs and kidney
  • Dx: biopsy to show the triad, ANCA (antineutrophil cytoplasmic antibodies, highly specific)
78
Q

Most common sites of erythroplakia are ……

A

mand. mucobuccal fold, floor of the mouth, oropharynx

79
Q

Pyogenic granuloma is not pus producting, it is …..

A

tumor of granulation tissue

80
Q

Histo of peripheral giant cell granuloma is …..

A

spindled fibroblasts with multinucleated giant cells through the C.T stroma

81
Q

Most ccommon salivery gland tumoe is …….

A

pleomorphic adenome

  • a mixture of epithelial and mesenchymal tissue
  • parotid is main site
82
Q

Miculikz disease is …….

Dx?

A

enlargement of parotid from a secondary disease (TB, sjogren…). (aka benign lymphoepithelial lesion)

  • Dx: replacement of gland parenchyma by lymphocytic infiltrate within “epimyoepithelial islands”
  • There is risk of malignant transformation
83
Q

Mucocele is a term to describe …….

A

mucus extravasation phenomena (not a cyst, trauma caused) or mucus retention cyst (a true cyst).

84
Q

Sebaceous adenoma is usually found in ……

A

parotid

Tx is parotidectomy

85
Q

Lab abnormalities with sarcoidosis are …..

A

hyperglobulinemia, high serum ace level, hypercalcemia

86
Q

Most common parotid malignancy is ……

A

mucoepidermoid carcinoma, followed by acinic cell carcinoma

  • Adenocarcinoma is more aggressive than these two, also it’s non cystic. Causes facial weakness
  • Adenoid cystic carcinoma: Microscopically, have Swiss cheese pattern (cribriform)
87
Q

Sjogren is two types?

A

Primary: xerostomia, xerophthalmia, salivary gland enlargement

secondary: same, plus SLE/RA
* Note: lymphomas may occur in in sjogren patients

88
Q

Lupus is two types, …..

A

Discoid: skin and oral lesion (resembles erosive lichen planus).
Systemic: similar lesions, but with systemic organs involved

89
Q

Sialoscintigraphy is ……

A

a procedure to differentiate between benign (warthin’s, oncocytoma) tumors and malignant

90
Q

Warthin’s tumor cystic epithelium is two layers?

A

inner columnar and outer basal

  • bilateral in lower parotid, benign
  • Second most common after pleomorphic adenoma
  • aka papillary cystadenoma lymphamatossum
91
Q

Dysplasia that involves the entire thickness of epithelium is

A

carcinoma in situ

92
Q

Herpetic lesions are likely found on …..

A

keratinized tissue

* Preceded by vesicles

93
Q

Describe the lesion of actinomycosis?

A

red to purple lump, often on the jaw “lumpy jaw”

94
Q

Histoplasmosis is caused by ……., lesion is …….., Tx is …….

A

histoplasmosis capsulatum
oral non healing ulcer
long term (6-12 mo) amphtercin B, ketoconazole
* Same tx for coccidioidomycosis
* Note: scarlet fever is caused by streptococcus pyogenes (strawberry tongue & toxic shock syndrome)

95
Q

The highly infectious stage of syphilis is …..

A

second stage (mucocutaneous lesions, condlyoma lata)

96
Q

Hutchinson’s triad include

A

huntchinson’s incisors, deafness, interstitial keratosis

97
Q

Most common fungal infection associated with DM is ………

A

mucormycosis

  • the head and neck lesions appear as destructive ulceration is the paranasal sinuses or nasal cavity
  • tx is amphotrecin B
98
Q

Lipschutz bodies are …..

A

chromatin found in the nuclei of cells infected with HSV-1

* The specimen is taken with Tzanck smear

99
Q

Chicken pox is most contagious …..

A

1 day before the rash and until all the vesicles have crusted

  • Shingles is the VZV that resided in the sacral ganglia. Reactivation is unilateral
  • Both have same histology
100
Q

Pemphigus cause is ……

A

antibodies against the desmosomal adhesions molecules, causing acantholysis

  • The lesions are intra and extra orally
  • Resembles erosive lichen planus
101
Q

Pemphigoid is ……

A

antibodies against the attachment between the epithelium and the underlying C.T (no acantholysis)

  • Main oral lesion is desequamative gingivitis
  • less aggressive than pemphigus
  • usually, no skin lesions
102
Q

Condyloma acuminatum is caused by …….

A

HPV 6 & 11

103
Q

Asymptomatic, slightly raised, well circumscribed papillary lesion on the buccal gingiva is ……..

A

verruciform xanthoma

* the surface is keratinized, giving it a white color

104
Q

Oral papilloma, a benign condition is analogous to skin …….

A

verruca vulgaris (skin wart)

105
Q

Histo of leukoedema is ……

A

acanthotic cells with water within the spinous cells

106
Q

The cause of snuff pouch lesions is ……

A

nitrosamine and hydrocarbons

* May cause SCC

107
Q

Loss of elasticity & vermilion border, dry, with gray plaque on the lips is a sign of ……

A

actinic chelitis

* Precursor of SCC

108
Q

Bilateral, folded, asymptomatic, spongy lesions on the buccal mucosa is most likely …..

Epidermolysis bullosa is …..

A

sponge nevus

  • acquired or genetic disease, characterized by formation of blisters at sites of minor trauma (skin and oral lesions)
109
Q

What are the forms of lichen planus?

A
  1. regular, lacelike webbing (wickham striae)
  2. erosive
  3. bullous
    * Caused by T cells attacking the basal keratinocytes. Usually in people under stress
110
Q

What is the histo of lichen planus?

A
  1. Hyperparakeratosis (thickening of granular layer)
  2. Saw tooth rete pegs
  3. Degeneration of basal layer, with inflammatory infiltrate
111
Q

Epulis fissuratum is similar histologically to ……

A

irritation fibroma

112
Q

Apical root resorption is caused by ……….

A

periapical cyst and periapical granuloma

113
Q

Stevens Johnson’s triad is ….

A

eye, genital and mouth lesions

* Note: the cause in elderly is mostly drugs and malignancy, while in childeren usually infections

114
Q

Hand-Foot-Mouth disease is caused by …..

A

coxackie A virus

* unlike herpangina, the lesions are in the front of the mouth

115
Q

What do we get from doubling the target film distance???

A

1/4 the intensity of the beam (according to the law)

* We need to increase the exposure time 4 times, while keeping kvp and ma fixed

116
Q

Healing of exo socket requires ….

A

fibroblasts, blood clot, and neutrophils

117
Q

Verocay bodies is found in …….

A

Schwannoma neoplasms

118
Q

Mucosal and dermal manifestation is most common in ……. leukemia

A

monocytic (a type of myloid leukemia)

119
Q

Nodular fascitis can be removed with ……..

A

simple conservative excision

* Unlike fibromatosis, which has a high recurrence rate

Part II (6 decks)

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