Pathology Flashcards
Which type of disease of teeth and supporting structure is associated with gingival erythema, edema and bleeding?
Chronic gingivitis
……. Inflammation involving the squamous mucosa, or gingiva, and associated soft tissues that surround teeth
Gingivitis
………….. an inflammatory process that affects the supporting structures of the teeth→
alveolar bone, and
cementum
→ result in destruction of
alveolar bone → tooth loss
Periodontitis
List 3 oral inflammatory lesions?
Aphthous ulcers, herpes simplex virus infections, oral candidiasis
Which oral inflammatory lesions affect the superficial mucosa causing hyperemic base covered by a thin exudate and is familial and is more frequent in the first 2 decades of life
Aphthous ulcers (canker sores)
Which oral inflammatory lesion causes Most orofacial herpetic infections caused by→ herpes simplex virus type 1 (HSV-1), And has large eosinophilic intranuclear inclusions + Adjacent cells commonly fuse to form large multinucleated polykaryons
Herpes simplex virus infection
What is the most common fungal infection of the oral cavity?
Oral candidiasis (thrush)
What are the major clinical forms of oral candidiasis ?
Pseudomembranous
Erythematous
Hyperplastic
The pseudomembranous form of oral candidiasis is called ?
Thrush
List the 5 diseases that are PROLIFERATIVE AND NEOPLASTIC LESIONS OF THE ORAL CAVITY:
Fibrous proliferative lesions (FIBROMAS),
pyogenic granuloma,
leukoplakia,
erythroplakia,
squamous cell carcinoma
Which lesion occur submucosal nodular fibrous tissue masses and most often on the buccal mucosa along the bite line
Fibrous proliferative lesion (fibroma)
Which lesion typically found on the gingiva of children,
young adults, and
pregnant women (pregnancy tumor)
And has an increased number of richly vascular and typically ulcerated→ a red to purple color structures
And is benign
Pyogenic granuloma
Which PREMALIGNANT (PRECANCEROUS)lesion is characterized as a a white patch or plaque that cannot be scraped off and
• cannot be characterized clinically or pathologically as any other disease.
Is Without a known cause
Erythroplakia(higher risk of cancer) and leukoplakia
What is he most common oral cavity cancer especially in the cervical lymph nodes site of metastases?
Squamous cell carcinoma
What are the risk factors for squamous cell carcinoma?
Human papilloma virus HPV
Tobacco
Alcohol
Tp53 mutation
Overexpression of p16
(NOT APC mutation)
What are the list of salivary gland diseases?
Xerostomia
Sialadenitis
Mucocele neoplasms
Pleomorphic adenoma
Mucoepidermoid carcinoma
Which salivary gland disease results in dry mouth and decreases in salivary production,is associated with the autoimmune disorder Sjögren syndrome, in which it usually is accompanied by dry eyes
Xerostomia
What is the pathogenesis of xerostomia?
T lymphocytes attack secretory glands
……… =Inflammation of the salivary glands
Sialadenitis
What is the most common form of sialadenitis?
Mumps
Which duct obstruction of salivary glands by stones causes bacterial sialadenitis?
Sialolithiasis
What the most common inflammatory lesion of the salivary glands
Mucocele; results from blockage or rupture of a salivary gland duct →
leakage of saliva into the surrounding connective tissue
……….. are benign tumors that consist of a mixture of ductal (epithelial) and myoepithelial cells→ exhibit both epithelial and mesenchymal differentiation.
Most common in parotid gland
Represents 50% of benign salivary gland tumors
Pleomorphic adenoma=mixed tumor
What is the most common malignant tumor of the salivary glands ; its morphology is composed of mucus secreting cells as well as mucus-filled vacuoles in the tumor?
MUCOepidermoid carcinoma
What are the 4 types of ODONTOGENIC CYSTS AND TUMORS?
Dentigerous cyst, odontogenic keratocysts, Periapical cyst , Ameloblastoma, odontoma
…….. originates around the crown of an unerupted tooth, and results in degeneration of the dental follicle, and is lined by a thin, stratified squamous epithelium
DenTigerous cyst
Where does the odontogenic keratocyst occur ?
Posterior mandible
Why is the differentiation of odontogenic keratocyst important?
Bcz it is Locally aggressive and has a high recurrence rate and must be removed completely
……. has an inflammatory etiology occur at the tooth apex as a result of long- standing pulpitis,
Can cause Necrosis of the pulpal tissue
Periapical cyst
What is the most common type of odontogenic tumor and mimics the enamel and dentin?
Odontoma
What is the name of the condition described as “the presence of intestinal
metaplasia within the esophageal mucosa in”?
Barrett esophagus
Which is the feature seen in autoimmune gastritis?
Increased acid production in stomach
what is vomiting?
forceful emptying of stomach and intestinal contents (chyme) through the mouth
what is nausea?
subjective experience associated with various conditions, including abnormal pain and labyrinthine stimulation (i.e., spinning movement).
What is vomiting (Emesis)
the forceful emptying of stomach and intestinal contents (chyme) through the mouth
What’s nausea?
subjective experience associated with various conditions, including abnormal pain and labyrinthine stimulation (i.e., spinning movement).
What’s retching or dry heaves
is the muscular event of vomiting without the expulsion of vomitus (gagging)
What’s dysphagia?
Difficulty/ pain during swallowing
If a patient is having difficulty in swallowing, which type of dysphagia is that?
Oropharyngeal dysphagia
If a patient is having the food stick to the esophagus after they swallow , which type of dysphagia is that?
Esophageal dysphagia
……. Is a rare form of dysphagia related to
loss of inhibitory neurons in the myenteric plexus with smooth muscle atrophy in the middle and lower portions of the esophagus
Achalasia (state of spasm)
Primary or idiopathic achalasia is characterized by ……….
failure of distal esophageal inhibitory neurons
Secondary achalasia is characterized by…….
Degenerative changes in neural innervation, either intrinsic to the esophagus
within the extraesophageal vagus nerve or the dorsal motor nucleus of the vagus
……….. Trypanosoma cruzi infection causes destruction of the myenteric plexus, failure of LES relaxation, and esophageal dilatation.
Duodenal, colonic, and ureteric myenteric plexuses also can be affected
Chagas disease
What are the causes of Achalasia-like disease that makes Food accumulates above the obstruction
→ distends the esophagus
→causes dysphagia
→ as hydrostatic pressure increases, food is slowly forced past the obstruction into the stomach
• Cough and aspiration can occur; pneumonia
diabetic autonomic neuropathy, infiltrative disorders such as malignancy, amyloidosis, or sarcoidosis, and
lesions of dorsal motor nuclei ←polio or
surgical ablation
What are the clinical features of achalasia (stenosis)(narrowing of the esophagus due to damage to nerves)
Bird’s beak
Dysphagia
Regurgitation
Sense of fullness
Heartburn
Weight loss
Lack of peristalsis; elevated lower esophageal sphincter LES pressure
…….. noncanalized cord replaces a segment of esophagus,
most frequently at or near the tracheal bifurcation,
usually is associated with a fistula connecting the upper or lower esophageal pouches to a bronchus or the trachea
→can result in aspiration, suffocation,
pneumonia
Atresia
……….. scarring due to ingestion of hypochloride and dissociation of connective tissue—> mediastinitis.
Leads to squamous cell carcinoma
Esophageal stenosis
Atresia and esophageal stenosis is characterized as ………
Mechanical obstruction
What’s an example of functional obstruction?
Diverticulum
…….. loss of inhibitory neurons
Achalasia
Which type of hernia is the most common?
Sliding hiatal hernia (type 1)
What is sliding hiatal hernia type 1
the most common
*the proximal portion of the stomach moves into the thoracic cavity through the esophageal hiatus (=an opening in the diaphragm for the esophagus and vagus nerves)
Is associated with GERD
Which type of hiatal herniation is associated with GERD (gastroesophageal reflux disease)
Type 1 sliding hiatal hernia
What is Paraesophageal hiatal hernia (type 2) ?
the herniation of the greater curvature of the stomach through a secondary
opening in the diaphragm alongside
the esophagus.(stomach is herniated through an opening other than that of esophageal opening)
What is the most frequent site of ectopic gastric mucosa (acid released by gastric mucosa within the esophagus can result in)?
upper third of the esophagus
Ectopia is the
Displacement of an organ
………is the condition where Instead of returning directly to the heart, venous blood from the gastrointestinal tract is delivered to the liver via
the portal vein before reaching the inferior vena cava.
Esophageal varices
Diseases that impede portal blood flow cause ………… →development of Esophageal varices, an important cause of massive and frequently life-threatening bleeding.
portal hypertension
What are the risk factors of ESOPHAGEAL VARICES
Liver cirrhosis
Alcoholism
Increase portal pressure
HBV
What are the clinical features of ESOPHAGEAL VARICES
Melena (due to rupturing of the vessels)
Hematemesis
The most common esophageal lacerations are ………→ often induced by severe retching or vomiting
Mallory-Weiss tears
What’s the difference between Mallory weiss syndrome and Boerhaave’s syndrome?
Mallory: the laceration is one the gastric side of the gastroesophageal junction, and hematemesis
Boerhaave: laceration of the lower thoracic esophagus, Hamman’s sign (crushing sound of heart due to pneumomediastinum , chest pain and shock, and inflammation of chest area
What is the difference between GASTROESOPHAGEAL REFLUX DISEASE (GERD)= REFLUX ESOPHAGITIS and nonerosive reflux disease (NERD)?
the reflux of acid and pepsin or bile salts from the stomach into the esophagus → causes esophagitis with mucosal injury in GERD, while in NERD there is no mucosal injury
What are the complications of reflux esophagitis or GERD OR NERD
esophageal ulceration,
hematemesis, melena,
stricture development, and
Barrett esophagus, a precursor lesion to esophageal carcinoma.
What is a precursor lesion to esophageal carcinoma?
Barrett esophagus
……. arises in a background of Barrett esophagus and long-standing GERD
Adenocarcinoma
The pathogenesis of esophageal adenocarcinoma includes……?
Chromosomal abnormalities and TP53 mutation are present in the early stages of esophageal adenocarcinoma
Squamous cell carcinoma is associated with which infection?
Human papilloma virus infection
What is the morphology of squamous cell carcinoma?
Presence of keratin bodies
Gastric polyps may be a result of ……?
epithelial or stromal cell hyperplasia, inflammation,
ectopia, or
neoplasia
What are the types of gastric polyps?
Inflammatory and hyperplastic polyps
And
Fundic gland polyps
Which gastric polyps can or cannot develop to become cancerous?
Fundic gland polyps can never progress to become malignant, while Inflammatory and Hyperplastic Polyps can become precancerous in situ lesion given their size more than 1.5cm
Which type of gastric polyp is associated with familial adenomatous polyposis (FAP)?
Fundic gland polyps
The incidence of sporadic lesions of …………has increased markedly as a result of the widespread use of proton pump inhibitors→
likely results from increased gastrin secretion, in response to reduced acidity, and
glandular hyperplasia driven by gastrin
Fundic Gland Polyps
All gastrointestinal adenomas exhibit …….
epithelial dysplasia
The risk for development of adenocarcinoma in gastric adenomas is related to the size of the lesion and is particularly elevated with lesions greater than …. cm in diameter
2
Gastric adenocarcinoma’ symptoms resemble those of ……….—> dyspepsia, dysphagia, and nausea
Chronic gastritis
What is one of the risk factors for gastric adenocarcinoma?
Partial gastrectomies for PUD—> leads to atrophy of gastric epithelium —> gastric cancer
What are the some factors associated with development of gastric adenocarcinoma?
Mutations
H. Pylori
Epstein-Barr virus (EBV)
Which mutations causes gastric adenocarcinoma?
CDH1 mutation
the loss of E-cadherin function
TP53 mutation
P16 mutation
APC mutation
What is the most common cause chronic gastritis?
H.pylori
what is the pathogenesis of chronic gastritis?
associated with increased production of proinflammatory proteins→
interleukin-1β (IL-1β) and
tumor necrosis factor (TNF).
…….. mutations are uncommon in EBV-positive gastric tumors
TP53
Epstein barr virus is a disease of …….
Monocytes
Which type of the lauren classification of gastric cancers that causes linitis plastica(leather bottle)?
Diffuse gastric cancers
Dysplasia and adenoma are precursors of ……
Intestinal type gastric cancer
While the diffuse gastric cancers have no precursor lesions
Epstein barr virus contins …….
Mucin vacuoles
endocrine cell hyperplasia,
chronic atrophic gastritis, and
Zollinger Ellison syndrome
Are associated with which type of cancer?
Gastric neuroendocrine (carcinoid) tumors
High-grade neuroendocrine tumors, termed neuroendocrine carcinoma are most common in …..
Jejunum
…….. causes kinking of the bowel
Neuroendocrine carcinoma
What are the molecules secreted from neuroendocrine carcinoma?
Chromogranin & synaptophysin +++
• CD56, NSE, Leu7, INSM1
….. =duodenal gastrin-producing NET (neuroendocrine tumor)
Gastrinomas
The most important prognostic factor for gastrointestinal neuroendocrine tumors is …….
Location
What is most common genetic change underlying the pathogenesis of gastrointestinal stromal tumor (GISTs)?
gain-of-function mutations of the gene encoding the tyrosine kinase KIT, the receptor for stem cell factor.
(&SDH &PDGFRA)
Which is the only malignancy to be treated with antibiotics?
Lymphoma (MALToma)
Adenomas most frequently occur in ……..?
duodenum and jejunum
The incidence of malignancy in adenoma is greater in ……
Villous,large, and multiple type adenomas
Which mutation causes Peutz–Jeghers syndrome
LKB1 gene mutation
Ppl with Peutz–Jeghers syndrome have an increased risk of developing which type of polyps ?
Hemartomatous polyps in small intestine
What is the clinical features in a patient with Peutz–Jeghers syndrome?
Atypical pigmentation in lips oral mucosa, palms, soles, & digits
People with Peutz–Jeghers syndrome have an increased risk of what complication ?
increased risk of both GI and extra-intestinal malignancy, including adenocarcinoma of the stomach, small bowel, and colon.
Adenocarcinoma is mostly present in the ……
Duodenum
Neuroendocrine tumors are mainly found in ……
Ileum
Neuroendocrine tumors infiltrate which layer of the intestinal mucosa?
mucosa is often intact over the tumor. Infiltration of the SUBMUCOSA is the rule, and extension into the muscularis propria is common
Which tumor shows Roset-like structures?
Neuroendocrine tumors
WNET (neuroendocrine) tumor may be associated with the …………. in tumors that have metastasized to the liver,
carcinoid syndrome
In which syndrome can we see sclerosis on skin?
Carcinoid syndrome
Carcinoid syndrome is caused by ……. secretion
serotonin
Carcinoid syndrome is characterized by ……
Hypertension
Watery stools
What are the difference between the symptoms of acute appendicitis and Meckel’s diverticulum?
Meckel diverticulum: afebrile, person turns pale, causes right lower quadrant pain, causes blood loss, lasts for more than a month.
Acute appendicitis: fever, vomiting, abdominal pain that doesn’t last for more than a month, loss of appetite, diarrhea,
