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
2
Q
What are the characteristic of Dentinogenesis imperfecta?
A
- color: opalescent
- short roots
- constricted CEJ (tulip/bell shaped crowns)
- obliterated pulps (type I & II) only
- large pulp (type 3 only, aka brandywine) with multiple exposures and apical lesions
3
Q
Dens in dente is ……..
A
invagination of the enamel organ during formation
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
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
6
Q
Most commonly ankylosed tooth is …….
A
primary second molar and its successor
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)
8
Q
Porphyria in teeth appears ……..
A
red or brown
* defect in heme synthesis
9
Q
Dentin dysplasia is two types?
A
- Radicular
- Coronal
* Review Deck 12 (very important)
10
Q
Substitution of valine for glutamate causes ……
A
sickle anemia
- Characterized by enlarged marrow spaces
- RBC life is 20 days instead of 120
11
Q
Werlhof disease is ……..
A
Thrombocytopenic purpura
12
Q
Lymph nodes are usually ….. size in chronic leukemia
A
normal (enlarged in acute form)
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
14
Q
Oral manifestation of thalassemia is ….
A
flaring of anterior teeth
* there’s low level of RBC & hemeglobin
15
Q
Rhogam is a tx for ……
A
Rh incompatibility (given to mother during and after birth)
16
Q
Philadelphia chromosome is .
A
translocation from chromosome 22 to 9 in CML
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
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
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
20
Q
What are MEN types?
A
- MEN I: pituitary, parathyroid, pancreas, adrenal cortex
- MEN II (Sipple syndrome): parathyroid, pheochromocytoma, medullary thyroid
- Men III: any of the two, plus “mucocutaneous neuroma”
* Thyroid medullary carcinoma is a risk with MEN III
21
Q
Von recklinghausen disease is characterized by ….
A
- Cafe au lait and arm pit freckles
- Lisch nodules (iris freckles)
- multiple mucocutaneous neurofibroma
* Note: 6 or more cafe au lait is indicative
* High risk of malignancy
22
Q
Scleroderma is ……
A
autoimmune inflammation, followed by deposition of type I & III collagen.
* Oral signs: uniform widening of PDL (Note: similar osteosarcoma)
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)
24
Q
Most common tumor of nerve fibers is …….
A
neurofibroma
25
Focal sclerosing osteomyelitis (condensing osteitis) is similar to ......... with the difference being .....
benign cementoblastoma
* in osteomyelitis, the entire root form is visible
* It is a radiopaque mass
* Focal S O: Tx is exo or endo
26
Garre osteomyelitis is a form of chronic osteomyelitis, except .....
there is periosteal bone formation with Garre, and onion skin appearance
* Acute & chronic osteomyelitis are caused by strep & staph
27
Cleft lip occurs in ...., while cleft palate ...... (timing)
Define Vander Woude syndrome
6-7 weeks
8-10 weeks
* Vander: AD, lip pits with cleft lip/palate
28
Achondroplasia is accompanied by mandibular ......
prognathism
* teeth are normal size, but there is crowding
* patients are prone to ear infection
* Note: pituitary dwarfs have underdeveloped mandible (unlike achondroplasia)
29
Hypophosphatasia is caused by .......
deficiency of alkaline phosphtase
| * There is premature prims loss, with enlarged pulp chambers
30
Pierre robin syndrome is .......
micrognathia, high arched cleft palate, and glossoptosis (retruded tongue)
31
Cherubism is characterized by ......
multiple giant cell granulomas and "perivascular cuffing"
* more in males
* Radio: soap bubble like bone lesions
* resembles central giant cell granulloma
32
Hypothyroidism is treated with ........
Vit D
| * Note: Vit D deficiency may lead to hyperparathyroidism
33
Microscopically, brown tumors of hyperpara resembles .........
central giant cell granuloma
34
Osteomalacia may occur as a complication of pancreatitis due to ......
steatorrhea and subsequent vit D deficiency
35
Most common reason for liver transplant is ......
hepatitis C
36
Biopsy specimen is stored in .......
10% formalin
| * Note: lesions up to 1 cm are removed by excisional biopsy
37
EBV infects ......
| It is diagnosed by .......
```
B lymphocytes
heterophile test (mononucleosis spot test), which gives high level of IgM antibodies
```
38
Epithelioid cells are characteristic of ........
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
39
The most serious complication of Ludwig's angina is .....
edema of glottis
40
Ingestion of fluoride up to the level of ...... daily is safe
4-5 mg
| * In this low conc. , little is retained in the body
41
Causes of xerostomia are .......
| Tx is .........
radiation (main side effect), antihistamine, antidepressant, anticholinergics, anti hypertensives, antipsychotics etc,...
Tx is carboxy & hydroxymethylcellulose
42
ABCD's of melanoma is ....
asymmetry, border irregular, color variance, diameter is over 1/4 inch
43
Plasmacytoma is .......
collection of abnormal monoclonal plasma cells
* two types, primary (localized in bone marrow), seconday (extramedullary)
* Importance: may develop into multiple myeloma
44
Hutchinson's freckle (lentigo maligna) may develop into ......
lentigo maligna melanoma
* Acral lentiginous melanoma is least common type. More common in africo-americans
* Both are superficial type of melanoma
45
Burkitt's lymphoma oral lesion is .......
expanding hemorrhagic masses on the palate and the gingiva
| Radio: moth eaten, poorly marginated osteolytic lesion
46
Ewing's sarcoma:
1. Site?
2. Radio?
3. Histo?
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
47
Lymphoepithelial cyst is ......
pink-yellow moveable, submucosal nodule. Usually in the floor of the mouth
* Its extraoral counterpart is Branchial cyst
48
Reed sternberg cell is needed for Dx of ?
Hodgkin lymphoma
| * Ann arbor system is used for staging and determining the extent of Tx for hodgkin's
49
Dx of metastatic carcinoma can be verified with ......
staining for cytokeratin, which is found in all carcinoma cells
* Cancer spread to the jaws is through blood
50
Cauliflower lesion is .......
verrucous carcinoma
* Site: mand. mucobuccal fold, alveolar mucosa
* Cause: HPV (16 & 18), tobbaco
* Note: non metastatic
51
Melkersson rosenthal syndrome (triad) is .......
chelitis, bell's palsy, plicated tongue
52
Multiple sclerosis is characterized by ........
demyelination of CNS nerves
* autoimmune
* bell's palsy and trigeminal neuralgia occurs more frequently with MS
53
Nasolabial (nasoalveolar) cyst is not a true cyst. T/F?
true
54
Branchial cyst is located ....., the origin is ....
anterior to SCM
* It's filled with milky mucoid fluid. Lined with ciliated stratified squamous epi
* Origin is second branchial POUCH
55
"Teeth that are floating in space" is a characteristic of ..........
Langerhans cell disease (histiocytosis X)
* Sharply circumscribed lesion with punched out appearance
* Histo: eosinophiles mixed with langerhans multinucleated cells
56
Fibrous dysplasia histology is ......
medullary bone replaced by fibrous tissue, with varying amount of osteoid
* Craniofacial FD: affect the Max., zygoma, sinus floor of orbit
57
Jaffe Lichtenstein syndrome is .......
skin pigmentation and multiple fibrous dysplasia
58
Ossifying fibroma: Origin? location? Tx?
```
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
Radiographically, describe the fibrous dysplasia lesion?
"ground glass", with irregular borders (NOTE: this is different from ossifying fibroma, which has well circumscribed borders)
60
What is the difference between dentigerous and primordial cysts?
Primordial has no calcified tissue within
| * Primordial is lined by stratified squamous epi
61
Focal osteoporotic bone marrow defect is .......
hemopoietic bone marrow found in the extraction site
62
Bohn nodules are.......
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
Histo of KOC is ......
para or ortho keratinized lining, with palisaded basal layer. Keratin filled lumen
* Orthokeratinized variant is less aggressive
* High recurrence rate
64
Lateral periodontal cyst is ........
non keratinized, non inflammatory developmental cyst
65
Histo of pindborg tumor (CEOT) is .....
sheets of large polyhedral cells with areas of amyloid and concentric calcified deposits (Liesegang rings)
66
Cemento-osseous dysplasia goes into 3 stages:
1. osteolytic
2. osteoblastic
3. sclerotic
* AKA cementoma
67
Bismuth line is found on ......
marginal gingiva as a blue dark line
| * bismuth is used as tx for dermatologic disorders
68
The most common lesion of the skin is .......
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
B-K mole syndrome and dysplastic nevus syndrome are both characterized by .......
multiple large, pigmented nevi, with high risk of developing malignant melanoma
70
Albright synd, Addison disease and Peutz jeghers all cause ........
intra oral pigmentation
| * Note: Cushing syndrome doesn't cause pigmentation
71
Addison disease is characterized by ........
muscle weakness, weight loss, bronzing of skin and mucous membrane, low B.P, low Na, high K, hypoglycemia
72
Tx for focal melanosis is .......
no Tx, observe
* may be caused by addison's
* Most common site: gingiva, lower lip
73
Intra oral nevus is most commonly a .......
an intra-mucosal nevus
74
The lining of traumatic bone cyst is .........
C.T (it is a pseudocyst)
| * Other pseudocysts include: aneurysmal bone cyst
75
Rendu osler weber is characterized by .........
epistaxis, arteriovenous fistula (lungs and liver), multiple hemangioma (intra & extra orally)
* aka hereditary hemorrhagic telangiectasia, most commonly on the lip
76
Encephalotrigeminal angiomatosis is .......
hemangioma of the face (port wine stain), meninges and cerebral cortex
* aka sturge weber syndrome
77
Wegener granulomatosis is a triad of ......
vasculitis, granulomas, and necrosis
* affects lungs and kidney
* Dx: biopsy to show the triad, ANCA (antineutrophil cytoplasmic antibodies, highly specific)
78
Most common sites of erythroplakia are ......
mand. mucobuccal fold, floor of the mouth, oropharynx
79
Pyogenic granuloma is not pus producting, it is .....
tumor of granulation tissue
80
Histo of peripheral giant cell granuloma is .....
spindled fibroblasts with multinucleated giant cells through the C.T stroma
81
Most ccommon salivery gland tumoe is .......
pleomorphic adenome
* a mixture of epithelial and mesenchymal tissue
* parotid is main site
82
Miculikz disease is .......
| Dx?
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
Mucocele is a term to describe .......
mucus extravasation phenomena (not a cyst, trauma caused) or mucus retention cyst (a true cyst).
84
Sebaceous adenoma is usually found in ......
parotid
| Tx is parotidectomy
85
Lab abnormalities with sarcoidosis are .....
hyperglobulinemia, high serum ace level, hypercalcemia
86
Most common parotid malignancy is ......
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
Sjogren is two types?
Primary: xerostomia, xerophthalmia, salivary gland enlargement
secondary: same, plus SLE/RA
* Note: lymphomas may occur in in sjogren patients
88
Lupus is two types, .....
Discoid: skin and oral lesion (resembles erosive lichen planus).
Systemic: similar lesions, but with systemic organs involved
89
Sialoscintigraphy is ......
a procedure to differentiate between benign (warthin's, oncocytoma) tumors and malignant
90
Warthin's tumor cystic epithelium is two layers?
inner columnar and outer basal
* bilateral in lower parotid, benign
* Second most common after pleomorphic adenoma
* aka papillary cystadenoma lymphamatossum
91
Dysplasia that involves the entire thickness of epithelium is
carcinoma in situ
92
Herpetic lesions are likely found on .....
keratinized tissue
| * Preceded by vesicles
93
Describe the lesion of actinomycosis?
red to purple lump, often on the jaw "lumpy jaw"
94
Histoplasmosis is caused by ......., lesion is ........, Tx is .......
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
The highly infectious stage of syphilis is .....
second stage (mucocutaneous lesions, condlyoma lata)
96
Hutchinson's triad include
huntchinson's incisors, deafness, interstitial keratosis
97
Most common fungal infection associated with DM is .........
mucormycosis
* the head and neck lesions appear as destructive ulceration is the paranasal sinuses or nasal cavity
* tx is amphotrecin B
98
Lipschutz bodies are .....
chromatin found in the nuclei of cells infected with HSV-1
| * The specimen is taken with Tzanck smear
99
Chicken pox is most contagious .....
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
Pemphigus cause is ......
antibodies against the desmosomal adhesions molecules, causing acantholysis
* The lesions are intra and extra orally
* Resembles erosive lichen planus
101
Pemphigoid is ......
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
Condyloma acuminatum is caused by .......
HPV 6 & 11
103
Asymptomatic, slightly raised, well circumscribed papillary lesion on the buccal gingiva is ........
verruciform xanthoma
| * the surface is keratinized, giving it a white color
104
Oral papilloma, a benign condition is analogous to skin .......
verruca vulgaris (skin wart)
105
Histo of leukoedema is ......
acanthotic cells with water within the spinous cells
106
The cause of snuff pouch lesions is ......
nitrosamine and hydrocarbons
| * May cause SCC
107
Loss of elasticity & vermilion border, dry, with gray plaque on the lips is a sign of ......
actinic chelitis
| * Precursor of SCC
108
Bilateral, folded, asymptomatic, spongy lesions on the buccal mucosa is most likely .....
Epidermolysis bullosa is .....
sponge nevus
* acquired or genetic disease, characterized by formation of blisters at sites of minor trauma (skin and oral lesions)
109
What are the forms of lichen planus?
1. regular, lacelike webbing (wickham striae)
2. erosive
3. bullous
* Caused by T cells attacking the basal keratinocytes. Usually in people under stress
110
What is the histo of lichen planus?
1. Hyperparakeratosis (thickening of granular layer)
2. Saw tooth rete pegs
3. Degeneration of basal layer, with inflammatory infiltrate
111
Epulis fissuratum is similar histologically to ......
irritation fibroma
112
Apical root resorption is caused by ..........
periapical cyst and periapical granuloma
113
Stevens Johnson's triad is ....
eye, genital and mouth lesions
| * Note: the cause in elderly is mostly drugs and malignancy, while in childeren usually infections
114
Hand-Foot-Mouth disease is caused by .....
coxackie A virus
| * unlike herpangina, the lesions are in the front of the mouth
115
What do we get from doubling the target film distance???
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
Healing of exo socket requires ....
fibroblasts, blood clot, and neutrophils
117
Verocay bodies is found in .......
Schwannoma neoplasms
118
Mucosal and dermal manifestation is most common in ....... leukemia
monocytic (a type of myloid leukemia)
119
Nodular fascitis can be removed with ........
simple conservative excision
| * Unlike fibromatosis, which has a high recurrence rate
