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Year2 GI Exam I > Path I > Flashcards

Path I Flashcards

1
Q

epithelium type of oral cavity

A

squamous, focally keratinized

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2
Q

what is in the pulp of our teeth

A

nerves, capillaries, lymphatics, CT

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3
Q

what makes up cementum of our teeth

A

hydrozyapatite and collagen that is anchored by the periodontal ligament

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4
Q

role of periodontal ligament

A

anchors cementum
procides nutrients and vascularity for cemetoblasts
mulipotential cells

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5
Q

what makes up dentin of teeth

A

odontoblasts

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6
Q

what are the primary colonizers of the oral cavity

A

strep mutans
actinomyces
neisseria
veillonella

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7
Q

what are the secondary colonizeers of the oral cavity

A

fusobacterium nucleatum
prevotella intermedia
porphyromonas gingivalis
capnocytophaga species

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8
Q

what are the late colonizers of the oral cavity

A 
campylobacter rectus
eikenella corrodens
actinobacillus
actinomyetem comitans
treponema
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9
Q

supragingival plaques are usually from what

A

dental caries- S mutans
endodontic infection
periapical abscess

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10
Q

subgingival plaques are usually from what

A 
peridontal infection
gingivitis- P intermedia
Peridontitis: R gingivitis in adults, actinomyetem comitans in children
pericoronitis
fascial space infection
osteomyelitis
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11
Q

what dissolves the enamel on teeth

A

plaque+lactic acid+lowpH

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12
Q

what are major risk factors for destroying enamel

A 
frequency of sugar exposure
processed foods
xerostomia
medications
sjogren disease
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13
Q

complications from dental caries

A

periosteal abscess, fistula to skin

radicular periapical cyst

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14
Q

sings of cavernous sinus thrombosis

A

HA, lateral gaze palsy and horizontal diplopia

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15
Q

What is ludwigs angina

A

cystic mass or inflammation form carie that causes tongue to be pushed on airway

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16
Q

what is gingivitis

A

inflammation of the gingiva

erythema, edema, bleeding

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17
Q

what type of microbes are found on peridontium in active periodontitis

A

anaerobes and microaerophillic gram -

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18
Q

names of top culprits in adult periodontitis

A

actinobaccilus
actinomycetem comitans
prevotella intermedia

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19
Q

what are signs of periodontitis

A

loose teeth, infection, bad breath, tooth loss

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20
Q

what classifies moderate and severe periodontal disease

A

moderate- 4-5 mm connection lost

severe >6 mm connection loss

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21
Q

what parts of teeth are affected by periodonitits

A

cementum, periodontal ligament and alveolar bone

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22
Q

what systemic diseases can cause to periodontisis

A 
AIDS
leukemia
DM
sarcoidosis
congenital:kostmanns disease and chediak higashi
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23
Q

what is kostmanns disease

A

severe congenital neutropenia

LL37 protein

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24
Q

what is chediak higashi syndrome

A

agranulocytosis, cycli neutropenia

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25
Q

what is an apthous ulcer

A

canker sore
painful ulceration of oral cavity mucosa
single ulcer with red halow surrounding central white-yellowish membrane

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26
Q

What are the 2 herpes viruses

A

HSV-1 orofacial

HSV-2 genital

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27
Q

test for herpes

A

Tzanck, multinucleated giant cells

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28
Q

what are the 2 patterns of initial HSV-1 infection

A

90% asymptomatic or mild transient orofacial blisters

10% acute herpetic gingivostomatitis- numerous mucosal ulcers

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29
Q

what does oral candidiasis look like

A

white cheesy, velvety

easily scraped away with little or no bleeding

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30
Q

what will candida show on PAS stain

A

pseudo-hyphae

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31
Q

2 factors that can lead to oral hairy leukoplakia?

what does it look like?

A 
immune suppression (HIV) + EBV
lateral border of tongue, does NOT scrape off
32
Q

What can cause a black hairy tongue

A

smoking and bad oral hygiene

33
Q

what are you testing when using heterophile Ab test

A

EBV-monospot test

if agglutinates, have EBV

34
Q

what is an irritation fibroma

A

result in repetitive trauma
reactive fibroelastic tissue
Tx with surgical excision
usually on tongue or buccal mucosa

35
Q

what type of tissue is pyogenic granuloma

A

reactive granulation tissuew

36
Q

pyogenic granulomas are common in what patients

A

pregnancy

and in children

37
Q

95% of oral cavity cancers are what?

the other 5%?

A

95- squamous cell carcinoma

5- adenocarcinomas of salivary glands

38
Q

70% HPC in oral pharynx is what type

A

type 16

39
Q

describe progression of squamous cell carcinoma in oral cavity

A

hyperkeratosis
low grad dysplasia
high grade dysplasia (carcinoma in situ)
invasive carcinoma

40
Q

what decides whether cancer has capacity to metastasize

A

crosses BM

41
Q

what is leukoplakia

A

white patch that cannot be scraped off

d/t keratin

42
Q

what must you do inpatient with hyperkeratosis in mouth

A

biopsy to evaluate if has premalignant changes

43
Q

what is erythroplakia

A

red patch
more ominous becuase eroded mucosa
90% dysplasia or CIS, some SCC

44
Q

oral cavity SCC are at what stage usually

A

II-III

45
Q

what is stage II SCC

A

> 2 cm, <4 cm no spread

46
Q

stage III SCC

A

> 4cm or spread to one cervical lymph

47
Q

stage IV SCC

A

multiple or node>3cm, spread to other tissues or metastasized

48
Q

Tx stage I-II SCC of oral cavity

A

wide local excision or RT

49
Q

Tx stage III-IV SCC or oral cavity

A

excision + RT +/- chemo

50
Q

what does SCC look like hist from oral cavity

A

keratin pearls

51
Q

HPV assoc tumors of oral cavity have better or worse prognosis?

A

better

52
Q

tumors found in salivary glands are more likely benign or malignant?

A

benign

53
Q

clinical presentation of mump

A

acute onset b/l tender sself limited swelling of parotid or other salivary glands
2+ days

54
Q

complications from mumps

A

testicular inflammation– sterility

55
Q

distribution of sjogren syndrome

A

9F:1M peaks at mid 20s and mid 50s

auto-immune etiology

56
Q

what is in mild form of sjogrens

A

dry eyes and mouth

57
Q

what is severe form sjogrens

A

dry eyes and mouth
florid salivary gland enlargement, adenopathy, vaginal dryness, joint dryness
risk of NHL in 5%

58
Q

What Ab do you look for in Sjogrens

A

SS-A Ro

SS-B La

59
Q

what is angular cheilitis

A

corners of mouth are dry

seen in sjogrens

60
Q

what is the most common lesion of salivary glands

A

mucocele, mucous retention cyst

61
Q

causes of mucoceles

A

blockage or rupture of minor salivary gland duct leading to saliva blockage, pooling and distention
increased tension leakage into adjacent CT

62
Q

most common site of mucocele

A

lower lip from trauma

63
Q

Tx mucocele

A

complete excision that includes mucocele and source minor salivary gland lobule

64
Q

what is a sialolith

A

aggregation of dehydrated mucous usually from blockage at terminal end of duct

65
Q

steps leading to bacterial sialadenitis

A

duct obstruction (unilateral)
stasis
bacteria cause inflammation
acute process leads to chronic inflammation and gland destruction and fibrosis

66
Q

what are the benign tumors of salivary glands

A 
pleomorphic adenoma (mixed)
warthin tumor
67
Q

what are the common malignant tumors of salivary glands

A

mucoepidermoid carcinoma
adenocarcinoma
adenoid cystic carcinoma

68
Q

where are pleomorphic adenomas found? what do they arise from?

A

parotid, submandibular/sublingual

arises from multipotential basal myoepithelial cells

69
Q

what tumor has 2 cell types but is benign

A

pleomorphic adenoma

70
Q

best course of action if find a mixed adenoma

A

follow closely because potential to become malignant

71
Q

what is a warthin tumor

A

papillary cystadenoma lymphomatosum

parotid

72
Q

describe patients more liley to have warthin tumor

A

M in 50s-60s that smokes

73
Q

characteristic histo of warthin tumor

A

double layer eosinophilic epithelial cells over lymphoid stroma

74
Q

predominant site of mucoepidermoid carcinoma

A

parotid

75
Q

what is most important prognostically for mucoepidermoid carcinoma

A

the grade
low grade is locally aggressibe and rarely metastasizes
high grade is invasive and frequently metastasizes

76
Q

tumor of adenoid cystic carcinoma infiltrates where

A

peripheral nerve making it hard to Tx because there are skip or non-contiguous extensions

Year2 GI Exam I (18 decks)

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