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DMD2 > ORAL PATHOLOGY > Flashcards

ORAL PATHOLOGY Flashcards

1
Q

Formation of an enamel pearl is due to the disruption of which dental structure?

A

Hertwigs epithelial root sheath during root formation

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2
Q

Cleidocranial Dysplasia usually presents with which of the following abnormalities

A. hyperdontia
B. hypodontia
C. Retention of primary dentition
D. both A and C
E. both B and C
A

D - cleidocranial dysplasia often presents with hyperdontia of 10+ teeth, retention of primary dentition, unerupted teeth and ectopic eruptions

Hypodontia is associated with ectodermal dysplasia, down’s syndrome, cleft lip/palate and traumatic injury

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3
Q

A young patient attends your surgery, they have joint hypermobility, skeletal deformity, dentinogenesis imperfecta and blue sclera.
What condition do they have?

A

Osteogenesis Imperfecta

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4
Q

Which form of amelogenesis imperfecta resembles fluorosis?

A

Hypomaturation type

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5
Q

Which of the following conditions presents with symmetrical horizontal bands of pitted enamel in the permanent dentition.

A. dentinogenesis imperfecta
B. chronological enamel hypoplasia
C. amelogenesis imperfecta
D. intrinsic staining due to tetracycline

A

B

A. presents with amber/translucent appearance
C. presents with deficiencies in entire enamel surface, whether it be in quality or quantity –> not in symmetrical horizontal bands
D. the intrinsic stain does not effect the enamel quality –> there is no pitting

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6
Q

A paitent has returned to your surgery after a complicated extraction of 46, 2 days prior.
Patient is in extreme pain around the extraction site, which is not resolving with panadol & neurofen.
SHx - smoker

What is the most likely pathosis?

A

Alveolar Osteitis

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7
Q

How would you differentiate a radicular cyst and chronic apical periodontitis?

A

Radiographically
A cyst is usually diagnosed when it reaches >10mm, a cyst will also present with well-defined cortication, where the apical periodontitis will not

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8
Q

A 6 year old patient attends your surgery, they present with blue fluctuant swellings on their anterior maxillary alveolar mucosa.
Which is the most likely cause

A. Trauma
B. Haemangioma
C.. Eruption Cysts
D.. Dentigerous Cysts

A

Eruption Cysts

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9
Q

Which of the following is a non-inflammatory cyst

A. Paradental Cyst
B. Radicular Cyst
C. Residual Cyst
D. Lateral Periodontal Cyst

A

Lateral Periodontal cyst is a non-inflammatory development cyst arising from the cell rests of Serres/reduced enamel epithelium

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10
Q

What is a clinical differentiating feature of a radicular cyst vs. lateral periodontal cyst

A

Radicular cyst will be associated with a non-vital tooth, lateral periodontal cyst is associated with vital teeth

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11
Q

Which pathology is responsible for “Bohn’s Nodules”

A

Gingival cysts in neonates

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12
Q

Which of the following is most correct?

A. nasopalatine duct cysts are benign lesions with a heart-shaped/ovoid radiolucency that are associated with non-vital teeth

B. Nasolabial cysts are slowly-enlarging lesions that appear in the soft tissues of the lower lip

C. The difference between an epidermoid and dermoid cyst is that the epidermoid cyst does not contain hair follices, sebaceous glands and sweat glands

D. Thyroglossal cysts most commonly appear intra-orally in the midline of the dorsal tongue

A

C

A - nasopalatine duct cysts are associated with vital teeth
B - nasolabial cysts arise in the soft tissue of the upper lip, below the alar of the nose
D. thyroglossal cysts rarely have I/O presentations

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13
Q 
Patient presents with productive cough, fever, malaise and weight loss. Oral examination indicates tongue ulcerations and mandibular swellings. Histology indicated fibrocalcific nodules with caseating granulomas. What is the most likely diagnosis? 
A) HSV
B) TB
C) EBV
D) Syphillis
A

B) Histology described is fairly characteristic of TB

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14
Q

Distinguish verruca vulgaris and condyloma acuminatum. What mucosal infection causes these lesions?

A

HPV

Verruca vulgaris = Common warts - keratinised pointy papillary surface
Condyloma acuminatum = Genital warts - non keratinised blunted epithelium with pink appearance

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15
Q 
Patient presents with bony expansion of the maxilla. On radiographic examination, a flocculent appearance is evident. Histology indicates larges osteoclasts with multiple nuclei. Which is the most likely diagnosis?
A) Fibrous dysplasia
B) Osteopetrosis 
C) Paget's disease
D) Cherubism
A

C)

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16
Q

Describe the four types of cementoosseous dysplasia - specifically noting where they commonly occur.

A
  • Focal: Single lesion → Posterior mandible teeth
  • Periapical: Multiple small (<1cm) lesions at the apex → Lower anterior
  • Florid: Extensive, larger lesions involving one or more quadrants → Mostly posterior mandible
  • Familial gigantiform cementoma: Extensive; Hereditary Condition → Rare
17
Q

What is osteopetrosis, where is the common site and what are the clinical features?

A

Osteopetrosis: bone disease that makes bones abnormally dense and prone to breakage (fracture)
(uncommon hereditary bone condition)

Common: Mandible > Maxilla
S+S
- Development of secondary anaemia
- Bone pain
- Excessive formation of bone that is mechanically weak → Fractures are common
- Cranial nerve compression: Blindness, deafness, ageusia, facial paralysis.

Dental-related:

  • Delayed eruption of teeth
  • Osteomyelitis common complication of tooth extraction
  • Defective and abnormally thickened periodontal ligament
18
Q

Patient presents with persistent ulcers around the approximately 2cm in size that have reoccurred every several weeks. There is significant inflammation and the lesions heal with scarring. What is your most likely diagnosis?

A

Recurrent apthous ulceration - Major Type

19
Q

Briefly describe histology in Wegener’s Granulomatosis.

A
  • Necrosis in walls of blood vessels (Characteristic)
  • Granulomas
  • Dense inflammatory cell infiltration → Neutrophils, macrophages, lymphocytes, plasma cells.
  • Loss of lumen
  • Circulating anti-neutrophil cytoplasmic antibodies
20
Q

A patient presents to your clinical with widespread bullous eruptions extra and intraorally. The bullae are soft and fragile with Nikolsky’s sign. What is the most likely diagnosis?

A

Pemphigus vulgaris

21
Q

Histology - central erythematous necrosis surrounded by a halo, erythrocytes are present intraepithelial, infiltration of inflammatory cells. What is the most likely diagnosis?

A

Erythema multiforme

22
Q

Histology - Dense, well-defined band of t-cell under epithelium and liquefactive degeneration of basal cells. What is the most likely diagnosis?

A

Lichen planus

23
Q 
Patient presents to your clinical with restricted mouth opening and painful ulceration and blistering intraorally. Extraorally, the patient exhibits extreme skin fragility with multiple bullae and scarring. What is the most likely diagnosis? 
A) Pemphigus vulgaris 
B) Epidermolysis bullosa
C) Scleroderma
D) Erythema multiforme
A

B)

24
Q

Clinical feature - Painless, smooth swelling
Histology - Antoni A and B and fibrous capsule
Most likely diagnosis?

A

Neurilemmoma (Schwannoma)

25
Q

A patient presents with speckles of radiolucencies around the canine region. Histology shows sheets of epithelium that form duct-like structures. What is the most likely diagnosis?

A

Adenomatoid odontogenic tumour

26
Q

Distinguish histology of follicular and plexiform type for ameloblastoma

A

Follicular Type = Epithelium arranged in discrete round islands, each resembling an enamel organ
• Stellate area = Central mass of stellate reticulum-like cells
• Peripheral area = Surrounding layer of columnar cells that resemble ameloblasts
• Fibrous tissue separates follicles
• Cysts form via epithelial degeneration

Plexiform Type = Epithelium arranged in tangled network of strands and masses.
• Each layer has same cell layer structure as follicular type.
• Cyst forms via stromal degeneration

27
Q

What type of neoplasm is odontogenic fibroma? Explain radiographic and histological appearance.

A

Benign mesenchymal neoplasm.

Radiographic = Well-defined radiolucency, unilocular, cortical expansion. 
Histology = Fibrous tissue, cementum-like material, dentine-like matrix
28
Q

What type of neoplasm is an ameloblastic tumour? Distinguish from ameloblastoma based on:

  • Age group most commonly affected
  • Common site
  • Radiographic appearance
  • Histology
A

Ameloblastoma: Benign epithelial tumour
- Age group most commonly affected: 40s - 50s
- Common site: Angle of mandible
- Radiographic appearance: Multilocular, well-define radiolucency
- Histology:
> Plexiform = Epithelial degeneration - discrete round islands with ameloblast-like cells surrounded stellate reticulum-like cells. Fibrous tissue separates the follicles.
> Follicular = Stromal degeneration - tangled network of strands and masses - same cellular structures as above.

Ameloblastic tumour:
- Age group most commonly affected: < 21 years
- Common site: Premolar/molar region
- Radiographic appearance: Depends on type
> Fibroma = Radiolucent
> Fibrodentinoma/Fibroodontoma = Focal radiolucency
Both are well-circumscribed with sclerotic margin
- Histology: Epithelial and mesenchymal components
> Fibroma = No dental hard tissue
> Fibrodentinoma = Dentine
> Fibroodontoma = Dentine and enamel

29
Q

Which of the following is correct regarding pleomorphic adenoma?
A) Clinical presentation of painful swelling
B) Most commonly affects submandibular glands
C) Contains epithelial and mesenchymal components
D) Most commonly affects females < 40 years

A

C)

30
Q 
A patient presents with painful swelling of the parotid gland. Histological examination indicates large, granualted polyhedral cells. Which of the following is most likely diagnosis? 
A) Adenoid cystic carcinoma
B) Sialodenitis
C) Pleomorphic adenoma
D) Acinic cell adenocarcinoma
A

D)

DMD2 (13 decks)

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