Oral Pathology

Question 1

ABCDE criteria of Melanoma

What type of melanoma does this criterion apply to

Answer 1

Asymmetry
Borders are irregular
Color variation
Diameter is greater than or equal to 6mm
Evolution

Superficial spreading melanoma

Question 2

The facial paralysis scale is also known as the …

Answer 2

House Brackmann Scale

Question 3

The House Brackmann Scale observes facial paralysis deformities in which three regions of the face

Answer 3

Eye closure, Forehead, and Angle of Mouth

Question 4

The House Brackmann Scale has how many categories and what does each indicate?

Answer 4

VI

1 - Normal function
2 - Mild deficit with slight weakness
3 - Moderate deformity - eyes can close with max effort
4 - Symmetric at rest - Moderately severe with incomplete eye closure
5 - Asymmetric at rest - Severe dysfunction
6 - Total paralysis

Question 5

Histology of a nasopalatine duct cyst

Answer 5

Pseudostratified columnar epithelium

Question 6

Which vessels and nerves are sacrificed when enucleating a nasopalatine duct cyst?

Answer 6

The nasopalatine vessels and nerves

Question 7

Typical diameter of a nasopalatine duct cyst

Answer 7

10mm - 25mm.
If there is a well-defined radiolucency in the midline of the anterior palate that is >6mm, a nasopalatine duct cyst should be suspected.

Question 8

Initial pharmacological management of trigeminal neuralgia

Answer 8

Carbamazepine (tegretol).
The dose should be slowly increased until the pain disappears or the patient experiences side effects.
After 6-8 weeks of pain control, the dosage should be titrated
Need to obtain Hepatic Panel and CBC as tegretol is metabolized by the ctyo P450 enzyme in the liver
MOA: Na+ channel blocked/anticonvulsant

Question 9

How many units of botox are injected into tigeminal neuralgia trigger zones?

Answer 9

50units of botox are injected into TN trigger zones

Question 10

What is the initial dose of carbamazepine that should be started for TN?

Answer 10

200mg BID.

Obtain CBC and hepatic panel when using carbazempine

Question 11

Most common vessel that causes classic (idiopathic) TN

Answer 11

Anterior inferior cerebellar or superior cerebellar artery is the most common vessel that is compressed and causes TN.

Question 12

To establish a diagnosis of MRONJ, what are the three criteria needed?

Answer 12

At least 8 weeks of exposed jaw bone; no history of radiation therapy to the jaws; prior or current history of bisphosphonate therapy

Question 13

Name the three radiographic presentations of the dentigerous cyst.

Answer 13

1. Circumferential
2. Central - crown in lumen
3. Lateral - portion of crown and portion of root surrounded

Question 14

Any pericoronal radiolucency that is larger than __mm is considered suggestive of cyst formation and should be submitted for path

Answer 14

4-5mm

Question 15

What is the histology of a dentigerous cyst?

Answer 15

Atrophic stratified squamous epithelium without significant inflammation

Question 16

What are the two variants of the OKC?

Answer 16

The syndromic variant associated with nevoid nasal cell carcinoma syndrome and the sporadic variant

Question 17

What is the histology of an OKC

Answer 17

A uniform layer of stratified squamous epithelium that is 6-8 cells in thickness.
Described as parakeratotic that is corrugated.
Prominent palisading basal layer

Question 18

Fluid accumulation between this layer and the crown will lead to a dentigerous cyst

Answer 18

Reduced enamel organ epithelium - covers the enamel surface until tooth eruption

Question 19

Origin of ameloblastoma

Answer 19

Rest of serres

Question 20

Reverse polarity of nuclei is pathognomonic for what odontogenic tumor

Answer 20

Ameloblastoma

Question 21

A peripheral ameloblastoma is most likely to be where in the mouth?

Answer 21

The anterior maxilla

Question 22

Ameloblastoma subtype mostly found in posterior mandible

Answer 22

Desmoplastic

Question 23

Treatment for solid or multicystic ameloblastoma

Answer 23

Resection with 1cm margin

Question 24

Treatment for peripheral ameloblastoma

Answer 24

Excision - no recurrence - 6th decade

Question 25

3 subtypes of unicystic ameloblastomas

Which requires 1cm margin resection

Answer 25

Luminal, intraluminal, mural
Mural requires 1cm of resection

3rd decade of life - no recurrence

Question 26

The 2/3 tumor

Answer 26

Adenomatoid odontogenic tumor

2/3 canine: 2/3 female: 2nd/3rd decade of life

Question 27

Tumor with pear shaped radiolucency that expands asymptotically

Answer 27

Adenomatoid odontogenic tumor

Question 28

Origin of odontogenic myxoma

Answer 28

The dental papilla (a mesenchymal tumor)

Question 29

Treatment of odontogenic myxoma

Answer 29

Resection with 1 cm margin

Question 30

Ameloblastic fibroma age range and type of odontogenic tumor

Answer 30

1st and 2nd decades: mixed

Question 31

Histology: suprabasilar epithelium shows stellate reticulum with ghost cell formation
This is the only cyst associated with a radio-opacity

Answer 31

Calcifying cystic odontogenic tumor (Gorlin Cyst)

Question 32

Primary affects of glycerol on nerves when used for glycerol this irony

Answer 32

Neurolytic, hyperosmolar, May down regulate central hyper excitability

Question 33

Ehlers-Danlos Syndrome is caused by a defect in what

a. keratin
b. collagen
c. elastin
d. laminin

Answer 33

Collagen

Question 34

Most appropriate management for an adenomatoid odontogenic tumor

a. En-bloc resection
b. Decompression followed by enucleation
c. Enucleation and curettage

Answer 34

Enucleation and curettage