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GI 2 > Path slide set 1 > Flashcards

Path slide set 1 Flashcards

1
Q

Classic SCC is preceded by?

A

precancerous lesion

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2
Q

What salivary tumor occurs much more often in males an perhaps reflects the higher prevalence of smoking amoung men

A

Warthin tumor

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3
Q

What causes caries

A

focal demineralization of tooth structure by acidic metabolites of fermenting sugars that are produced by bacteria

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4
Q

How does herpetic stomatitis differ from acute herpetic gingivostomatitis?

A

it occurs at the site of primary inoculation or in adjacent mucosa associated with the same ganglion

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5
Q

Salivary glands secrete this for digestion?

Lubrication?

Protection?

A
  • ptalin/salivary amylase
  • mucus
  • IgA, Lactoferrin, lysozyme
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6
Q

histologically; spectrum of epithelial changes ranging from hyperkeratosis overlying a thickened acanthotic but orderly mucosal epithelium to lesions with markedly dysplastic changes sometimes merging into carcinoma in situ

A

Leukoplakia

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7
Q

intermediate form having characteristics of both leukoplakia and erythroplakia

A

speckled leukoerythroplakia

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8
Q

Major cause of tooth loss before age 35

A

Caries

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9
Q

Theory that multiple independent primary tumors develop as result of years of chronic exposure of the mucosa to carcinogens

A

“field cancerization”

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10
Q

The granular appearance of the cytoplasm of the upper layer of cells in a warthin tumor is due to presence of numerous what?

A

mitochondria . . “oncocytic”

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11
Q

50% found in minor salivary glands. . particularly palatine glands

A

Adenoid cystic carcinoma

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12
Q

MECT1-MAML2 fusion gene

A

mucoepidermoid carcinoma

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13
Q

Periodontitis can be associated with what systemic diseases?

A
  • AIDS
  • Leukemia
  • Crohn disease
  • Diabetes
  • Down syndrome
  • Sarcoidosis
  • Syndromes associated with neutrophil defect
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14
Q

location for periapical cyst

A

apex of teeth

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15
Q

Are Caries painful

A

yes to extent it affects daily life

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16
Q

Complications of Xerostomia

A
  • increased rates of dental caries
  • candidiasis
  • difficulty swallowing and speaking
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17
Q

Survival with a mucoepidermoid carcinoma depends on what?

A

Grade dependent

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18
Q

Most neoplasms of salivary glands arise where

A

parotids

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19
Q

treatment for irritation fibroma

A

complete surgical excision

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20
Q

Size of salivary tumor when first diagnosed

A

4 to 6 cm

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21
Q

second primary tumors in oral cavity

A

rate of development higher compared to other malignancies

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22
Q

Candidiasis remains superficial unless what? then it invades

A

immunosuppression

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23
Q

Distant metastases of SCC

A
  • mediastinal nodes
  • lungs
  • liver
  • Bones
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24
Q

on microscopic exam, there is intracellular and intercellular edema (acantholysis)

A

HSV

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25
Q

When Sjogren syndrome produces dry eyes

A

keratoconjunctivitis sicca

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26
Q

treatment for keratocystic odontogenic tumor

A

complete removal

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27
Q

can be scraped off

A

Candida albicans

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28
Q

describe the inflammatory infiltrate of an aphthous ulcer

A

at first largely mononuclear but secondary bacterial infection may result in a neutrophilic infiltrate

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29
Q

submucosal nodular mass of fibrous connective tissue stroma that occurs primarily on the buccal mucosa along the BITE LINE or the gingiva

A
  • irritation fibroma
  • Traumatic fibroma
  • focal fibrous hyperplasia

All of these are different names for the same thing

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30
Q

Derived from remnants of odontogenic epithelium present within the jaw

A

Odontogenic cysts and tumors

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31
Q

histolgically, Dentigerous cysts are lined by what?

What else is found?

A

a thin layer of stratified squamous epithelium

often there is a dense chronic inflammatory cell infiltrate in connective tissue stroma

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32
Q

What can Sialadenitis be induced by?

A
  • trauma
  • Viral (mumps)
  • Bacterial
  • autoimmune disease
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33
Q

3 major clinical forms of oral candidiasis

A
  • pseudomembranous
  • erythematous
  • hyperplastic
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34
Q

San Joaquin Valley fever complex

A

Cocci

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35
Q

White patch or plaque that cannot be scraped off and cannot be characterized clinically or pathologically as any other disease

A

Leukoplakia

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36
Q

5 year survival if Tobacco related and late stage SCC

A

20%

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37
Q

Periapical cyst is ______ in origin?

A

inflammatory

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38
Q

What are the 2 malignant neoplasms of salivary glands

A
  • mucoepidermoid carcinoma

- Adenoid cystic carcinoma

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39
Q

Painless, slow-growing, mobile discrete mass within the parotid or submandibular areas or in the buccal cavity

A

Pleomorphic adenoma

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40
Q

offenders for nonspecific bacterial sialadenitis

A

Staph and strep viridans

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41
Q
  • small, poorly encapsulated, infiltrative, gray-pink lesions
    histology: small cells having dark, compact nuclei and scant cystoplasm. spaces bt tumor cells are often filled with hyaline material . . excess basement membrane
A

Adenoid cystic carcinoma

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42
Q

epithelial-lined cysts that arise when the duct of the sublingual gland has been damaged

A

Ranula

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43
Q

number of aphthous ulcers

A

single or multiple

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44
Q

Most common primary malignancy of salivary glands

A

mucoepidermoid carcinoma

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45
Q

Periodontitis can be the origin of what systemic diseases

A
  • infective endocarditis

- pulmonary and brain abscesses

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46
Q

plaque within areas of active periodontitis contains what bacterial?

Specific examples

A

anaerobic and microaerophilic gram-negative

  • Aggregatibacter (Actinobacillus) Actinomycetemcomitans
  • porphyromonas gingivalis
  • prevotella intermedia
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47
Q
  • well demarcated
  • encapsulated but capsule not fully developed
  • cut surface is gray-white with myxoid and blue translucent areas of condroid
  • epithelial elements dispersed within mesenchyme-like background of loose myxoid tissue
A

pleomorphic adenoma

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48
Q

do aphthous ulcers run in families

A

Yes

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49
Q

What do patients with mucocele report

A

history of changes in size of the lesion, especially in association with meals

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50
Q

HSV viral reactivation is called what?

A

Herpetic stomatitis

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51
Q

cough, choriza, conjunctivitis in a child

A

measles

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52
Q

organism for Scarlet fever

A

Group A beta hemolytic strep

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53
Q

What are the two benign neoplasms of salivary glands

A
  • Pleomorphic adenoma

- Warthin tumor (Papillary Cystadenoma Lymphomatosum)

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54
Q

results from either blockage or rupture of a salivary gland duct, with consequent leakage of saliva into the surrounding connective tissue stroma

A

Mucocele

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55
Q

Acute Herpetic gingivostomatitis is accompanied by what other symptoms?

A
  • lymphadenopathy
  • fever
  • anorexia
  • irritability
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56
Q

lack well defined capsules and often infiltrative at margins

histo: cords, sheets, or cystic configurations of squamous, mucous, or intermediate cells

A

mucoepidermoid carcinoma

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57
Q

age for leukoplakia/erythroplakia

A

males 2:1

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58
Q

Bony, hard protrusion on roof of mouth. Can also be on mandible

A

Torus Palatinus

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59
Q

Most common fungal infection of the oral cavity

A

Candida Albicans

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60
Q

Is gingivitis reversible

A

yes

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61
Q

HSV treks along regional nerves and eventually becomes dormant in what ganglion

A

trigeminal

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62
Q

anatomic sites of origin for HPV associated SCCs of oropharnx

A
  • tonsillar crypts
  • base of tongue
  • oropharynx
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63
Q

Age for gingivitis

A

any age but most prevalent and severe in adolescence

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64
Q

chromosomal rearrangement of PLAG1

A

Pleomorphic Adenoma

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65
Q

psuedocysts with cyst-like spaces lined by inflammatory granulation tissue or by fibrous connective tissue. cystic spaces filled with mucin and inflammatory cells, particulcarly macrophages

A

Mucocele

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66
Q

Must be differentiated from other odontogenic cysts because of its aggressive behavior

A

odontogenic keratocyst (OKC) also called keratocystic odontogenic tumor

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67
Q

If a dental plaque is not removed, what happens?

A

it becomes mineralized to form calculus (tartar)

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68
Q

11:19 transolcation

A

mucoepidermoid carcinoma

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69
Q

inflammation of salivary glands is called

A

Sialadenitis

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70
Q

Molcular biology of HPV related SCC

A
  • p16 overexpression encoded by CDKN2A
  • p53
  • RB
  • E6 and E7
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71
Q

Primary HSV infections typically occur in children b/t what ages?

A

2 and 4

72
Q

Decreases salivary secretions caused by dehydration may lead to the development of bacterial suppurative parotitis in who?

A

elderly patients with a recent history of major thoracic or abdominal surgery

73
Q

What virus is associated with erythro/leukoplakias

A

HPV

74
Q

distinctive oral lesion on lateral border of the tongue that is usually seen in immunocompromised patients

A

Hairy Leukoplakia

75
Q

what is required for therapy of mucocele

A

complete excision and its accompanying minor salivary gland

76
Q

what predisposed to oral candidiasis

A

immunosuppression

77
Q

dirty white, fibrinosuppurative, tough inflammatory membrane over the tonsils and retropharynx

A

Diptheria

78
Q

shallow, hyperemic ulcerations covered by a thin exudate rummed by a narrow zone of erythema

A

aphthous ulcers

79
Q

in the oropharynx, as many as 70% of SCCs, particularly thoses involving the tonsils, the base of the tongue, and the pharynx, harbor oncogenic variants of what?

A

HPV-16

80
Q

Until proven otherwise by means of histologic evalulation, all leukoplakias must be considered what?

A

precancerous

81
Q

Severe oral infections in the form of gingivitis, pharyngitis, tonsillitis; may extend to produce cellulitis of the neck (Ludwid angina)

A

Pancytopenia (agranulocytosis, aplastic anemia)

82
Q

Age and gender and location for keratocystic odontogenic tumor

A

between 10 and 40 and most common in males within posterior mandible

83
Q

mucoceles most often found where and are result of what

A

lower lip and trauma

84
Q

Can Hairy leukoplakia be scraped off

A

no

85
Q

Sticky, colorless, biofilm that collects b/t and on the surface of teeth

A

Dental plaque

86
Q

predisposing influence for SCC of lower lip

A

Actinic radiation (sunlight) and particularly pipe smoking

87
Q

Raspberry or strawberry tongue

A

Scarlet fever

88
Q

appear as solitary or multiple white patches or plaques, often with sharply demarcated borders

A

leukoplakias

89
Q

Xerostomia is a major feature of what autoimmune disorder and is usually accompanied by what other symptome

A

Sjogren syndrome

Dry eyes

90
Q

epithelial elements dispersed throughout the matrix along with varying degrees of myxoid, hyaline, chondroid (cartilaginous), and even osseous tissue

A

Pleomorphic Adenoma

91
Q

Salivary gland tumors are mobile on palpation except in what case

A

neglected malignant tumors

92
Q

superficial gray to white inflammatory membrane

A

thrush

93
Q

What leads to accumulation of what?

A

dental plaque and calculus

94
Q

Radiographically, unilocular lesion, most often associated with impacted third molar (wisdom) teeth

A

Dentigerous cyst

95
Q

Adenoid cystic carcinomas have a tendency to invade what?

A

perineural spaces . . so pain is a common symptome

96
Q

white, confluent pathenes of fluffy, hyperkeratotic thickenings

A

hairy leukoplakia

97
Q

location of warthin tumor (papillary cystadenoma lymphomatosum)

A

almost exclusively in the parotid

98
Q

age for mucocele

A

all ages but most common in toddlers, young adults, and elderly who are prone to falling

99
Q

Age for benign salivary gland tumors?

Malignant?

A

5th to 7th decades

Later

100
Q

time frame for HSV vesicle

A

spontaneously clear within 3 to 4 weeks

101
Q

What are the most common type of inflammatory salivary gland lesion?

A

Mucocele

102
Q

most common type of odontogenic tumor that arises from epithelium but shows extensive depositions of enamel and dentin

A

Odontoma

103
Q

Favored location for classic SCC

A
  • ventral tongue
  • floor of mouth
  • lower lip
  • soft palate
  • Gingiva (look under dentures)
104
Q

Develops as a result of long standing inflammation of the tooth (pulpitis), which may be caused by advanced carious lesions or by trauma to the tooth in question

A

periapical cyst

105
Q

vesicles are first filled with a clear, serous fluid, but rapidly rupture to yield painful, red-remmed, shallow ulcerations

A

HSV

106
Q

red, velvety, possibly eroded area within the oral cavity that usually remains level with or may be slightly depressed.

A

erythroplakia

107
Q

Mucicarmine stains this reddish pink

A

mucoepidermoid carcinoma

108
Q

What clinical form of oral candidiasis is most common and what is it also called

A

pseudomembranous . . also known as thrush

109
Q

95% of head and neck cancers are what histological type?

A

squamous cell carcinomas (SCC)

110
Q

inflammatory process that affects the supporting structures of the teeth (periodontal ligaments), alveolar bone, and cementum

A

periodontitis

111
Q

When multiple keratocystic odontogenic tumors are found, patients should be evaluated for what?

A

nevoid basal cell carcinoma syndrome (Gorlin syndrome)

112
Q

Epidermal cells sometimes develop esosinophilic INTRANUCLEAR VIRAL INCLUSIONS, or several cells may fuse to produce MULTINUCLEATED POLYKARYONS

A

HSV

113
Q

broad based budding yeast

A

Blasto

114
Q

composed of variable mixtures of squamous cells, mucus-secreting cells, and intermediate cells

A

Mucoepidermoid carcinoma

115
Q

`Location of mucoepidermoid carcinoma

A

Mainly parotids but also account for large fraction of salivary gland neoplasms in other glands, particularly the minor salivary glands

116
Q

compare long term survival of HPV-positive SCC to HPV negative

A

greater

117
Q

Reactivation of latent HSV is associated with what?

A
  • trauma
  • allergies
  • UV light exposure
  • URI
  • pregnancy
  • menstruation
  • immunosuppression
  • exposure to temperature extremes
118
Q

histologically, cyst lined with a thin layer of keratinized stratified squamous epithelium with a prominent basal cell layer and a corrugated epithelial surface

A

keratocystic odontogenic tumor

119
Q

inflammation of oral mucosa surrounding teeth

A

gingivitis

120
Q

Arises from odontogenic epithelium and show NO ectomesenchymal differentiation

A

Ameloblastoma

121
Q

The likelihood of a salivary gland tumor being malignant is inversely proportional to what?

A

size of the gland

122
Q

Gingivitis is result of what?

A

poor oral hygiene

123
Q

What glands are affected by mumps

A

major ones particularly parotids

124
Q

Bats, birds, caves

A

histo

125
Q

2 subtypes of odontogenic cysts

A

inflammatory or developmental

126
Q

if a ranula becomes so large that it has dissected through the connective tissue stroma connecting the two bellies of the mylohyoid muscle

A

plunging ranula

127
Q

Why is it thought that HPV related cancers of oropharynx will surpass HPV related cervical cancer?

A

they are not readily accessible or amenable to cytologic screening for premalignant lesions

128
Q

inflammatory lesion typically found on the gingiva of children, young adults, and pregnant women

A

pyogenic granuloma (pregnancy tumor)

129
Q

Decreased secretory function may also predispose to secondary bacterial invasion, as sometimes occurs in patients receiving what?

A

long term phenothiazines

130
Q

cyst that originates around the crown of an unerupted tooth and is thought to be the result of fluid accumulation between the developing tooth and the dental follicle

A

Dentigerous cyst

131
Q

What during delivery predisposes infant to oral thrush

A

vaginal yeast infections

132
Q

Therapy for gingivitis

A

aimed at reducing the accumulation of plaque and calculus via regular brushing, flossing, and dental visits

133
Q

virus that causes hairy leukoplakia

A

EBV

134
Q

Gland for pleomorphic adenoma

A

60% of the parotid tumors and less common in submandibular and rare in minor glands

135
Q

Most common pathogenic factor for leuko/erythroplakias

A

tobacco . . alcohol also contributes

136
Q

50% of adenoid cystic carcinomas disseminate where decades after primary tumor removal

A

bone, liver, brain

137
Q

pale gray surface punctuated by narrow cystic or cleftlike spaces filled with mucinous or serous secretions.

on microscope: spaces lined by DOUBLE LAYER of neoplastic epithelial cells resting on dense lymphoid stroma with germinal centers

A

Warthin tumor

138
Q

5 year survival for early stage and tobacco related SCC

A

80%

139
Q

gene and chromosome for Gorlin syndrome?

A

PTCH on chromosome 9

140
Q

Maculopapular, vesiculobullous eruption that sometimes follows an infection elsewhere, ingestion of drugs, development of cancer, or a collagen vascular disease; when it involves the lips and oral mucosa it’s called stevens-johnson syndrome

A

Erythema multiforme . . . life threatening

141
Q

What does a dental plaque contain?

A

mixture of bacteria, salivary proteins, and desquamated epithelial cells

142
Q

time for herpetic stomatitis

A

7 to 10 days

143
Q

Nonspecific bacterial sialadenitis is usually secondary to what?

A

Ductal obstruction produced by stones (Sialolithiasis)

144
Q

Radiographically, well-defined unilocular or multiolcular radiolucencies

A

keratocystic odontogenic tumor

145
Q

Acute pharyngitis and tonsillitis that may cause coating with a gray-white exudative membrane; enlargement of lymph nodes in neck; palatal petechiae

A

infectious mononucleosis

146
Q

A lack of salivary secretions is a major complication of what therapy

A

Radiation

147
Q

Classic pathogenesis for squamous cell carcinomas

A

tobacco and alcohol

148
Q

What immunologic disorders may aphthous ulcers be associated with

A
  • Celiac disease
  • IBD
  • Behcet disease
149
Q

color for mucocele

A

blue translucent hue

150
Q

smoking and Warthin tumors

A

8 times greater risk

151
Q

Benign tumor that consist of a mixture of ductal (epithelial) and myoepithelial cells and therefore show both epithelial and mesenchymal differentiation

A

Pleomorphic adenoma

152
Q

Local expansion of SCC

A

submandibular glands and cervical nodes

153
Q

age for leukoplakia/erythroplakia

A

any age but usually 40 to 70

154
Q

intercellular bridges and cytokeratin positive

A

SCC

155
Q

common, often recurrent, exceedingly painful, superficial oral mucosal ulcerations of unknown etiology

A

Aphthous ulcers (canker sores)

156
Q

Koplik spots

A

Measles

157
Q

Painful enlargement and sometimes a purulent ductal discharge and UNILATERAL involvement of a single gland

A

Nonspecific sialadenitis

158
Q

Erythroplakia compared to Leukoplakia

A
  • risk of malignant transformation much higher
  • less common
  • more ominous
159
Q

Resolution of an Aphthous ulcer

A

typically spontaneously in 7 to 10 days

160
Q

Xerostomia

A

dry mouth

161
Q

Rarely show orderly epidermal maturation. Virtually all show SEVERE dysplasia, carcinoma in situ, or minimally invasive carcinoma

A

Erythroplakia

162
Q

if a carcinoma arises in a pleomorphic adenoma, it is reffered to as what?

A

carcinoma ex pleomorphic adenoma or a malignant mixed tumor . . . super agressive

163
Q

describe growth and invasion of ameloblastoma

A

commonly cystic, slow growing, and locally invasive but has an indolent curse in most cases

164
Q

What likely contributes to the reddish clinical appearance of erythroplakia

A

an intense subepithelial inflammatory reactions with vascular dilation

165
Q

What cures a dentigerous cyst

A

complete removal

166
Q

clinical presentation for HPV type SCC

A
  • no preceding/precancerous lesion

- Non specific symptoms such as sore throat, ear ache, pain on swallowing (odynophagia), weight loss

167
Q

Leukoplakias may occur anywhere in oral cavity but favor what locations

A
  • buccal mucosa
  • floor of mouth
  • ventral surface of tongue
  • palate
  • gingiva
168
Q

Molecular biology of classic SCC

A
  • TP53 on chromosome 7
  • NOTCH
  • p63 protein
169
Q

What drug can cause striking fibrous enlargement of the gingivae?

A

phenytoin (dilantin) . . for siezures

170
Q

Age and gender for salivary gland neoplasms

A

usually adults and slight female predominance

171
Q

Age for aphthous ulcers

A

first 2 decades

172
Q

Tzanck test

A

HSV

173
Q

microscopically: hyperparakeratosis and acanthosis with “balloon cells” in upper spinous layers

A

Hairy leukoplakia

174
Q

oral SCC in individuals younger than 40 with no known risk factors like smoking and alcohol?

A

HPV

175
Q

Nonspecific bacterial sialadenitis most often involves what glands

A

major, particularly submandibular

176
Q

What increases the risk of pleomorphic adenomas

A

Radiation

177
Q

what drugs can eliminate or alter the normal bacterial flora of the mouth and can result in oral candidiasis

A

broad spectrum antibiotics or steroid inhalers

GI 2 (13 decks)

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