Path Flashcards
What causes endocarditis and glomerulonephritis?
Lupus
2 tooth infections that can kill you
Cavernous Sinus Thrombosis & Ludwigs angina
What causes changes in the ear and eye and ENAMEL HYPOPLASIA
Treacher Collins Syndrome
Scarlet Fever is strawberry TONGUE and affects ____ papillae.
fungiform
Are fordyce granules uni or bilateral?
Bilateral
Turner Tooth is known as ___plastic. Most commonly involved site:
Hypo
Mandibular PM
Tx for recurrent aphthous stomatitis
Corticosteriod
What affects the skin and eye and causes a subepithelial split.
Pemhigoid
What causes positive Nikolsky sign
Pemphigus
What is classic for HPV
Condyloma Acuminatum (venereal wart)
Which candidiasis is accute?
Pseudomembranous
Median rhomboid glossitis causes atrophy of ____ papillae
filiform
Ulcer in NON-MOVABLE area (palate and gingiva) is
Herpes Simplex Virus (HSV)
Most common area for Traumatic Neuroma
Mental Nerve
Is Pyogenic Granuloma painful?
NO
What are the 3 P’s that cause lesions on gingiva
Pyogenic Granuloma
Peripheral Giant Cell Granuloma
Peripheral Ossifying Fibroma
What causes liver colored (brownish purple) mass on gingiva?
Peripheral Giant Cell Granuloma
What has cauliflower appearance on epithelium (most common benign neoplasm of epithelium origin). Can be induced by HPV 6 + 11
Squamous Papilloma
Fibroma is ___plasia
HYPER
#1 site for Granular Cell Tumor? Exhibits: psuedoepitheliomatous \_\_\_\_plasia
Dorsum of tongue
-HYPER
If you have a whit plaque after 2 weeks that doesn’t wipe off, it’s:
-Premalignant?
Leukoplakia
-Yes!
Does cytology smear work for leukoplakia?
NO! need biopsy
Erthroplakia is likely to transform into:
Carcinoma. BAD!
Most common oral site of SCC:
Worst area to see it:
Mid-lateral border of tongue
-floor of mouth
Most common site of Metastatic Disease of the jaws?
- Does it cause tooth shift?
- Does radiograph show [sclerotic] border?
Posterior mandible
- NO
- NO
Monomorphic Adenoma most common site
Upper lip
Pt has red, swollen (hyperplastic), bleeding gingiva (interdental papilla) with ulcers…
Leukemia
Verrucous Carcinoma most common site?
-Biggest difference from SCC?
Buccal vestibule
-Doesn’t metastasize
Most common gene of SCC
p53
Most common benign salivary gland tumor:
Most common Malignant salivary gland tumor:
Pleomorphic Adenoma
-Mucoepidermoid Carcinoma
Lateral Periodontal Cyst is a TRUE cyst. Is it between vital teeth?
Yes
Most common odontogenic tumor
Ameloblastoma
Ameloblastoma is most common:
Does it cross midline?
-Often associated with:
-Histology***
Odontogenic tumor
- Yes
- impacted tooth
- Reverse polarization of nuclei of the tall COLUMNAR cells of the periphery
What causes more pain – ameloblastoma or ameloblastic fibroma
Ameloblastic fibroma
Odontoma is what age range?
-Radiographically looks like:
First 2 decades of life
-Toothlets (a bunch of little white stones)
Teenage girls has impacted upper canine with snowflake calcifications
AOT (Adenomatoid Odontogenic Tumor)
What’s it called when enamel is missing?
Amelogenesis Imperfecta
What causes opalescent (blue grey) sclera, lack of pulp chambers and bell shaped crown
Dentinogensis Imperfecta
Young kid has unilateral expansion of maxilla or mandible onset before puberty. Pt also has Cafe au Lait pigmentation and ground glass appearance on x-ray
Fibrous Dysplasia
Difference of Cherubism and Fibrous Dysplasia?
Fibrous is unilateral
Pt has non-vital tooth with radioopacity at apex (that does NOT connect with root)
Condensing Osteitis (NOT cementoblastoma which connects to root)
Tooth is VITAL and has radioopacity at apex
Idiopathic Osteosclerosis
Tramatic Bone Cyst is radio____ with ____ margins
lucent
scalloped
Increased alkaline phophatase causes
Pagets
Bilateral maxilla affected with cotton wool appearance and histology shows mosaic pattern. 50% show hypercementosis
Pagets
How is pagets different than cherubism
Pagets is older people. Cherubism stops after puberty
What causes tooth “floating”
Langerhans Cells Disease (Histiocytosis X)
Does nasolabial cyst affect bone?
NO, just soft tissue
Pale, yellowish, well circumscribed sweeling on ventral tongue/floor of mouth
Lymphoepithelial cyst
What infrabony cyst in posterior mandible has a parakertain surface and HIGH recurrence
Odontogenic Keratocyst (OKC)
Gorlin Syndrome includes what 3 things:
Nevoid Basal Cell Carcinomas, OKCs, bifid RIB
What causes bifid rib, and calcification of falx cerebri?
Nevoid Basal Cell Carcinoma Syndrom (Gorlin Syndrome)
What syndrome causes multiple skin nodules, HYPERdontia (unerupted teeth), and GI polyps
Gardner Syndrome
Bell’s Palsy causes __ nerve paralysis. How long does it last?
7th
-less than a month
Erythema Multiforme causes bullseyes in what age/sex?
- Triggered by?
- Which part of mouth does it NOT affect
Young males
- Drug or viral infection
- Gingiva
Stevens Johnson syndrome is a severe version of:
Erythema Multiforme
Which affects basement membrane (deep) – pemphigoid or pemphigus.
pemphigoiD (D for DEEP)
Most common Immunoglobulin for Pemphigus?
IgG
What causes wideining of PDL space and Trismus
Progressive Systemic Sclerosis (Sclerodema)
Benign Migratory Glossitis (geographic tongue) causes atrophy to ____ papillae.
-Tx?
filliform
-Corticosteroid rinse (dexamethasone)
Painless ulcer of UPPER lip with raised margins. Does NOT occur intraorally.
Basal Cell Carcinoma
Does basal cell carcinoma usually metastasize?
NO
Where is an Antral (mucous retention) Pseudocyst located?
Maxillary sinus
Proliferation of the Reduced Enamel Epithelium cause:
Dentigerous Cyst
Can dentigerous cyst become malignant?
YES (unicystic ameloblastoma)
What are blue dilated veins seen in the elderly called?
Varices
What can tuberculosis cause orally?
Ulcers that mimic cancer
Eagle Syndrom is elongation or calcification of the ____ ligament.
-So it causes pain when:
stylohyoid
-chewing, yawning, opening mouth
What has a striking unilateral distribution?
Herpes ZOSTER
What causes sore throat, lymphadenopathy, malaise, low grade fever?
Primary Herpes Gingivostomatitis
How does Crohns appear in the mouth?
Granulomatous gingivitis, aphthous-like ulcers
Which cyst on the MIDLINE has a DOUGHY consistency?
Dermoid Cyst — Dermoid Doughy
Multiple Endocrine Neoplasia Syndrome causes what orally?
multiple neuromas on tongue
What is the most common developmental NON-odontogenic cyst?
-What shape is it radiographically?
Incisive Canal Cyst
-heart
What causes White Sponge Nevus?
-Does it affect the eyes?
Genetics – autosomal dominant
-NO!
Best x-ray for cleft palate?
Maxillary occlusal
What causes intense pain for one week on ONE side at forehead and around eye?
Neuritis
What is Cheilitis Grandularis?
-Premaligannt?
inflamed minor salivary glands on lips causing mucous secretions
-yes! (SCC)
White, rough plaque on lateral border of tongue that shows HIV patient progressing to AIDS ?
-What virus is it caused by?
Oral Hairy Leukoplakia
-Epstein-Barr Virus
Middle aged black woman has multifocal periaplical radiolucencies on vital lower anterior teeth
Periapical Cemento-osseous dysplasia
What age and sex is most common for Lichen Planus?
Middle aged women
Wickham’s striae that does NOT wipe off
Lichen Planus
Is Peripheral Ossifying Fibroma in bone?
NO! In soft tissue, but makes bone. It’s one of the 3 P’s on the gingiva
Cleidocranial Dysplasia has what affect on number of teeth and eruption timing?
-Retention of:
Multiple unerupted supernumerary teeth. Delayed eruption of permanent teeth.
-primary teeth
Neurofibromatosis causes neurofibromas where?
-Causes what skin pigmentation?
Tongue
-Cafe au Lait
What causes ghost cells?
Calcifying Odontogenic Cyst
Melanotic Neuroectodermal Tumor of Infancy causes increase in:
vanillymandelic acid (VMA)
Auriculotemporal syndrome causes what before eating?
-Often after which surgery?
Sweating of one side of face
-parotid gland surgery
Starch Iodine test would be used to diagnose:
Auriculotemporal Syndrome
What causes soft tissue swelling with “woody” consistency and multiple draining fistulas with SULFUR granules?
Actinomycosis
Most common site for dens-in-dente
maxillary lateral incisor
Ectodermal Dysplasia has what affect on teeth?
Hypodontia (anodontia)
What is Epulis Fissuratum?
Hyperplastic CT from ill-fitting denture
Gingival cyst of the adult is most common where
mandibular anterior
Most common cause of macroglossia (large tongue)
lymphangioma
Hypercementosis is on a (vital/non-vital) mandibular 1st molar.
-Generalized if you have:
VITAL
-acromegaly
Infectious Mononucleosis causes swelling where?
-Associated with which virus
cervical/lateral swelling
-Epstein-Barr
Which type of nevus is most likely to undergo malignant transformation (melanoma)
Junctional type
Karposi’s Sarcome is caused by:
-Most common site
Herpes virus type 8
-hard palate
Keratoacanthoma is caused by:
- Does it resolve?
- What’s in thecenter of the ulceration?
Sun
- Spontaneously resolves
- Keratin plug
Where is Warthin’s tumor located?
Parotid (NOT in oral cavity)
Does Vit C deficiency cause xerostomia?
NO
Stafne Defect is caused by?
salivary gland in x ray (nothing to treat)
Sjogrens Syndrome is an ____ disease
autoimmune
Sarcoidoisis causes:
-tx:
Bilateral hilar lympadenopathy (chest x-ray)
-corticosterois
Proliferative Periostitis causes what pattern radiographically?
Onion skin
Peutz-Jeghers syndrome causes:
pigmented (brown) macules and intestinal polyps
Young person with tingling lower lip probably has:
Osteosarcoma
Most common malignancy in bone in people less than 25 yrs old
Osteosarcoma
What does decrease in serum estrogen and calcium cause?
Osteoporosis
What is OsteoPETROSIS?
-Frequent complication:
Massive OVERproduction of dense, non-vital bone.
-Osteomyelitis
Most common site for osteoma
Angle of mandible
Most common oral sites of malignant melanoma
hard palate and gingiva
What causes punched out lucencies of bone of the whole skull
Multiple Myeloma
Odontogenic Myxoma radiographic pattern:
Soap bubble
Oncocytoma is a tumor of:
parotid gland
What controls contrast/penetration of x-ray machine?
-What controls intensity?
kVP
-MA
Local Anesthetics we use now are which group?
Amide (NOT ester)
Amide LA’s (what we use) are metabolized by:
Liver
Prilocaine toxicity can cause:
methemoglobinemia
Local Anesthetics work by preventing generation of nerve impulses by PREVENTING the transport of _____ into the neuron – which prevents an action potential
Sodium (Na+)
What is the only form of LA that can penetrate tissue membranes?
NON-ionized (free base)
Which penicillin has best gram-NEGATIVE spectrum
ampicillin
Which one is NOT cross allergic with penicillin: cephalosporins, ampicillin, erythromycin
erythromycin
Which penicillin is useful against penicillinase-producing bugs such as STAPH?
dicloxacillin
Bacteriocidal agents (penicillin) MOA:
inhibit cell wall synthesis
Bacteriostatic agents (tetracycline) MOA:
interfere with protein synthesis
Antifungals (nystatin) MOA:
Bind to ergosterol in fungal cell walls to weaken wall
Which antibiotic produces GI upset and colitis (c. difficile)?
Clindamycin
Which antiobiotic causes liver damage (hepatotoxicity)
Tetracyclines
What effect do broad spectrum antibiotics have on coumadin anticoagulants?
ENHANCE! because of reduction of vit k sources
Why is penicillin Vk given for oral infections and NOT penicillin G
It’s less sensitive to acid degradation (more reliable oral absorption) – G has to given IM
Are cephaplosporins (Anything with CEPH… like cephalexin) cross-allergenic to penicillin?
YES! (erythromycin is ok)
Which antibiotic is able to achieve a higher concentration in bone than in serum? (aka good for treating osteomyelitis)
Clindamycin
Why can’t you take antiobiotics together that are cidal and static (ie penicillin + tetracycline)
they can’t do their job while the other is working
Penicillin is NOT broad spectrum so it WON’T cause ______.
-Which antibiotic WILL cause superinfection?
superinfection
-tetracycline
Are tetracyclines for gram - or +?
BOTH! BROAD spectrum
Quinidine is a drug to treat:
-Works by increasing:
arrhythmias
-Increasing refractory period of cardiac muscles
Besides nitroglycerin, what can be used for angina?
propranolol
Diuretic drugs work by:
DECREASING renal reABSORBTION of sodium (so it doesn’t reabsorb sodium and you pee it out)
NSAIDS (aspirin) MOA for…
- Analgesic effects:
- Antipyretic effects:
- Bleeding time:
- inhibits prostaglandin synthesis
- inhibits prostaglandin synthesis in hypothalamic temp regulation center
- inhibits thromboxane A2 synthesis preventing platelet synth
Which hurts liver (hepatotoxic) aspirin or acetaminophen?
ACETAMINOPHEN (why it’s limited in norco)
What’s the DOC for a child with a fever?
-Which causes Reyes syndrome?
Acetaminophen
-aspirin
Which nsaid produces less GI disturbance than aspirin
Ibuprofen (NOT acetaminophen only cuz it’s not an nsaid)
What treats opioid overdose?
-What’s used to help morphine addicts?
Naloxone
-Methadone
Opioids MOA:
Bind to specific receptors (mu receptors) in the CNS
What drug is used to prevent laryngospasm?
succinylcholine
What effect does atropine/scopolamine have salivary secretions?
-on the heart?
- decreases
- tachycardia (blocks VAGAL reflex control of heart rate)
Alpha or beta-adrenergic blocking drugs act by:
Competitive inhibition of postjunctional adrenergic receptors
A drug that produces the greatest MAXIMUM EFFECT is one with the highest _____
efficiacy
Benzodiazepam MOA:
modulate GABA
Do barbiturates possess analgesic properties?
NO
Which drug reverses the effects of benzodiazepam?
Flumazenil
Antidepressants and antipsycotics MOA
Blockage of dopaminergic sites in the brain
Steroids cause ulcers where?
Gastric
General anesthesia is more rapid if it is (more/less) soluble in blood
LESS (doesn’t dissolve in blood, and goes to where it needs to)
Bisphosphonate MOA:
INHIBIT osteoclast
