Pathology - Full Review Flashcards
1
Q
What is the “Rule of 10s” when regarding tx of cleft lip?
A
Child should ideally be 10 weeks old, weigh 10 lbs, and have 10 g hemoglobin before treating cleft lip
2
Q
Which is most common? Cleft lip alone, cleft palate alone, or both together.
A
Both CL and CP together is most common (45% incidence)
3
Q
What is the minimum manifestation when palatal shelves fail to fuse?
A
Bifid Uvula
4
Q
Cleft palate, mandibular micrognathia, and glossoptosis all together characterize what syndrome?
A
Pierre Robin Sequence
5
Q
Which population gets orofacial clefts most commonly?
A
Native Americans
6
Q
Paramedian lip pits are classic manifestations of what syndrome?
A
Van der Woude Syndrome
7
Q
What are ectopic sebaceous glands? Appear as yellow-ish papular lesions on buccal/labial mucosa
A
Fordyce Granules
8
Q
What happens if epithelium is left behind along the path the thyroid takes from foramen cecum to the neck?
A
Thyroglossal Duct Cyst
9
Q
Fissured tongue is frequently seen with what other pathology?
A
Geographic tongue
10
Q
Hairy tongue is keratin accumulating on what type of papillae?
A
Filiform papilla
11
Q
The mandible will deviate to which side with coronoid hyperplasia?
A
toward the affected side
12
Q
The mandible will deviate toward which side with condylar hyperplasia?
A
toward opposite side
13
Q
A common exostosis occurring on the midline of the palate?
A
Torus Palatinus
14
Q
A focal concavity of the cortical bone in the lingual surface of the mandible?
A
Stafne Defect (aka Lingual mandibular salivary gland depression)
15
Q
The most common non-odontogenic cyst in the oral cavity? (hint: 6mm or greater is pathologic)
A
Nasopalatine Duct Cyst
16
Q
The most common yellow pathology/finding in the mouth
A
Lymphoepithelial cyst (most common around FOM, waldeyer’s ring, ventral tongue, soft palate)
17
Q
What syndrome demonstrates “beaten metal” pattern on a cephalometric x-ray?
A
Crouzon Syndrome
18
Q
How does turner’s hyperplasia occur?
A
A periapical inflammatory disease of the overlying deciduous tooth
19
Q
What is hutchinson’s triad and what disease is it associated with?
A
Triad = Hutchinson’s teeth, interstitial keratitis, 8th nerve deafness
Associated with Congenital Syphilis
20
Q
Most common teeth to be congenitally missing?
A
3rd molars, 2nd premolars, upper lateral incisors
21
Q
Most common supernumerary tooth to see?
A
mesiodens
22
Q
A pt has a funky looking tooth. You count all the teeth, including the anomalous tooth, and the count is normal. What your diagnosis?
A
Gemination
23
Q
A pt has a funky looking tooth. You count all the teeth, including the anomalous tooth, and the count is one short. What your diagnosis?
A
Fusion
24
Q
Pt has fine, wispy hair, lacks sweat glands, has xerostomia, and conical shaped teeth - what’s your diagnosis?
A
Hypohidrotic Ectodermal Dysplasia
25
Taurodontism can be seen associated with what three syndromes?
Kleinfelter's Syndrome (XXY), Amelogenesis Imperfecta, Tricho-Dento-Osseous Syndrome
26
What type of amelogenesis imperfecta has "snow-capped" teeth?
Hypomaturation
27
Diagnose. Pt's x-ray shows bulbous crowns because the roots are so thin.
Dentinogenesis Imperfecta (can also be Dentin Dysplasia Type II)
28
Rootless teeth is characteristic of what autosomal dominant disease?
Dentin Dysplasia Type I
29
Thistle tube-shaped pulpal anatomy is characteristic of what autosomal dominant disease?
Dentin Dysplasia Type II
30
"Ghost teeth" (not very opaque on x-ray) demonstrates what pathology?
Regional Odontodysplasia
31
Rapid swelling of the sublingual, submandibular, and submental spaces due to an abscessed mandibular molar, is called what?
Ludwig's Angina
32
Swelling along the lateral border of the nose due to an abscessed maxillary anterior/premolar tooth, is called what?
Cavernous Sinus Thrombosis
33
"Punched-out" papillae is a sign for what periodontal pathology?
NUG
34
Differential for desquamative gingivitis.
Lichen planus, mucous membrane pemphigoid, pemphigus vulgaris, SLE, hypersensitivity rxn
35
Drug-related gingival hyperplasia can be associated with what drugs?
Cyclosporin, Phenytoin, Ca channel blockers (amlodipine often seen in SOD clinic)
36
Teeth seen as "floating in air" due to accelerated periodontitis might be a sign of what syndrome?
Papillon-Lefevre Syndrome
37
Strawberry tongue is a sign of what sickness?
Scarlet fever (white during first 2 days of infection, red later on)
38
Pt currently has glossitis and reports they used to have a chancre elsewhere on the body. What's your dx? (hint: sexually transmitted)
Syphilis
39
Sulphur granules exhibited within a yellow discharge represents what pathology?
Actinomycosis
40
Young pt has a scratch near their eye and swelling around the eye. Dx?
Cat-Scratch disease (caused by Bartonella henselae)
41
Pt presents with adherent, but wipeable, white plaques resembling cottage cheese. What's your initial diagnosis?
Pseudomembranous Candidiasis
42
median rhomboid glossitis, angular cheilitis, and denture stomatitis are all examples of _____________ candidiasis.
Erythematous candidiasis
43
Most common site for HSV-1 infection?
Vermillion border - called Herpes Labialis
44
Multinucleation, ballooning degeneration of nucleus and tzanck cells are all histopathologic features of what?
HSV
45
What is HHV-3? And what does it cause?
Varicella-Zoster virus - causes chickenpox and shingles
46
Herpetic lesions appearing unilaterally in a well-demarcated area. Dx?
Shingles
47
What is HHV-4? What does it cause?
Infectious Mononucleosis (EBV) - causes mono, hairy leukoplakia, nasopharyngeal carcinoma
48
What is HHV-5? What does it cause?
Cytomegalovirus - causes mucosal ulcerations seen in AIDS patients
49
What is HHV-8? What does it cause?
Kaposi's Sarcoma Herpesvirus - causes Kaposi's sarcoma on hard palate or gingiva in HIV+ patients
50
Pt has red macules/vesicles on soft palate, a sore throat, fever, and dysphagia. Dx?
Herpangina
51
Pt has swollen salivary glands and it hurts upon salivation. Dx?
Epidemic Parotitis (mumps)
52
Oral manifestations of HIV/AIDs?
candidiasis, oral hairy leukoplakia (EBV), kaposi's sarcoma, non-hodgkin's lymphoma, periodontitis
53
What appears as bilateral thickened, shredded white areas on buccal mucosa (hint: along occlusal plane)
Morsicatio Buccarum
54
Aspirin, bisphosphonates, chlorpromazine, or promazine held in the mouth to dissolve might cause what?
Chemical-related Mucosal Necrosis
55
95% of BRONJ occurs in patients who have received ____________ delivery of bisphosphonates.
Intravenous delivery
56
What is your tx plan modification for a pt taking IV bisphosphonates?
Avoid bone manipulation
57
Pigmentation is seen on anterior facial gingiva in a patient that smokes. Dx?
Smoker's Melanosis
58
Dome-shaped, slightly radiopaque lesion(s) arising from the intact floor of the maxillary sinus.
Antral Pseudocyst
59
Cervicofacial Emphysema can be caused by what?
Introduction of air into subcutaneous or fascial spaces, possibly by using an air-driven handpiece during oral surgery
60
One or two fungiform papillae on the tongue are swollen and painful. Dx?
Localized Transient Lingual Papillitis
61
What painful, non-vesicular lesion is commonly seen on movable mucosa?
Recurrent aphthous stomatitis
62
Joint pain, aphthous lesions, genital ulcers, and ocular involvement are characteristics of what syndrome?
Behcet's Syndrome
63
What is a multisystem granulomatous disorder of unknown cause, and seen more commonly in African Americans?
Sarcoidosis
64
Cheilitis granulomatosa, facial paralysis, and fissured tongue when seen together are characteristic of what syndrome?
Melkersson-Rosenthal Syndrome
65
Strawberry gingivitis is an early manifestation of what granulomatous disease?
Wegener's Granulomatosis
66
Mast cell degranulation leads to histamine release, and is mediated by what immunoglobulin?
IgE hypersensitivity reactions
67
Differential diagnosis when you see a papillary-like surface lesion in the mouth?
1. squamous papilloma
2. verruca vulgaris (wart)
3. condyloma acuminatum (sexual transmission)
4. verruciform xanthoma
68
verruca vulgaris is caused by what?
Herpes type 2, 4, 6 or 40
69
Condyloma acuminatum (considered an STD) is caused by what?
HPV-6 or 11 most commonly (also 16, 18 and 31)
70
What brown lesion becomes more pronounced with sun exposure?
Ephelis (aka freckle)
71
What brown lesion doesn't become more pronounced with sun exposure?
Actinic Lentigo
72
What is a freckle called when inside the mouth?
Oral Melanotic Macule
73
Usually seen more in African American females, what pigmentation occurs on oral mucosa due to irritation?
Oral Melanoacanthoma
74
Order the types of leukoplakia ranked from highest to lowest chance to be pre-cancerous.
1. Erythroleukoplakia (highest chance of cancer)
2. Leukoplakia
3. Erythroplakia (lowest chance)
75
Name a white keratotic change on the palate associated with smoking.
Nicotine Stomatitis
76
Name a common premalignant lesion caused by cumulative UV radiation exposure over a person's lifetime.
Actinic Keratosis
77
What do you call it when the lower lip becomes atrophied, smooth and blotchy from long-term UV exposure?
Actinic Cheilosis
78
Most common sites for oral SCCA?
1. Posterior lateral tongue
2. ventral tongue
3. FOM
4. soft palate
5. gingiva
79
Snuff dipper's cancer is also called what?
Verrucous carcinoma
80
The first sign of nasopharyngeal carcinoma is what?
cervical lymph node metastases
81
Lesion is found during an H&N exam, and it demonstrates rolled borders and telangiectatic blood vessels. Dx?
Basal Cell Carcinoma
82
What causes basal cell carcinoma?
UV exposure and frequent sunburns
83
What increases risk for melanoma?
fair complexion, light hair, a tendency to sunburn easily, acute sun exposure
84
What is the ABCDE system used to describe clinical features of melanoma?
```
Asymmetry
Border irregularity
Color variation
Diameter greater than 6mm
Evolving lesions (it changes appearance)
```
85
Where are mucoceles most often seen?
1. lower lip
2. FOM (called a ranula)
3. anterior tongue
4. buccal mucosa
86
An epithelium-lined cavity that arises from salivary gland tissue and can occur in minor or major glands.
Salivary duct cyst
87
Sialoliths are most common where?
Submandibular gland duct
88
Locally destructive inflammatory condition of the salivary glands on the palate, usually associated with dental injections
Necrotizing Sialometaplasia
89
What gland is likely to have a malignant tumor?
Sublingual
90
Minor salivary gland tumors are more likely to be malignant if it's in these locations:
lower lip, tongue, retromolar pad
91
What is the most common benign salivary gland neoplasm?
Pleomorphic Adenoma
92
What is the most common malignant salivary gland neoplasm?
Mucoepidermoid Carcinoma
93
What is the most common "tumor" in the oral cavity? (hint: caused by trauma/irritation)
Fibroma
94
You find two giant cell fibromas lingual to the mandibular anterior teeth. What is this called?
Retrocuspid Papilla
95
______ _________ (aka ___________ ________ _______) is associated with the flange of an ill-fitting denture.
Epulis Fissuratum (aka Inflammatory Fibrous Hyperplasia)
96
Reactive tissue growth on the palate under an ill-fitting denture
Inflammatory Papillary Hyperplasia
97
A bright red nodule on the gingiva, and seen commonly in pregnant women.
Pyogenic Granuloma
98
A purple nodule on gingiva that might cause cupping resorption of underlying alveolar bone.
Peripheral Giant Cell Granuloma
99
A pale-colored nodule on the anterior gingiva.
Peripheral Ossifying Fibroma
100
Your differential for a bump on the gums:
1. Pyogenic Granuloma
2. Peripheral giant cell granuloma
3. Peripheral ossifying fibroma
4. Fibroma
101
Any patient with a neurofibroma should be evaluated for _____________.
neurofibromatosis
102
Coast of California café au lait macules, neurofibromas, Crowe's sign, and Lisch nodules together all represent what disease?
Neurofibromatosis Type I
103
What kind of hemangioma blanches during dioscopy?
Cavernous hemangiomas
104
A person born with a vascular malformation called Port Wine Stain has what developmental condition?
Sturge-Weber Angiomatosis
105
A person with petechiae, ecchymosis, or hematomas may be exhibiting what disorder?
Thrombocytopenia
106
What kind of leukemia is caused by the Philadelphia Chromosome?
Chronic Myeloid Leukemia (CML)
107
"Punched-out radiolucencies in the skull represents what two pathologies?
1. Langerhans Cell Histiocytosis (also see floating teeth)
| 2. Multiple Myeloma (also see Bence Jones proteins in urine)
108
Reed-Sternberg Cells are seen in what hematologic malignancy?
Hodgkin's Lymphoma
109
Blue sclera and Wormian bones in the skull demonstrate what inherited bone disease?
osteogenesis imperfecta
110
Prolonged eruption of deciduous teeth, delayed eruption of permanent teeth, and numerous supernumerary teeth characterize what disease?
Cleidocranial dysplasia
111
A unilocular RL lesion in posterior mandible on women that is NOT associated with a tooth or symptoms.
Focal osteoporotic marrow defect
112
Increased radiodensity of unknown cause
Idiopathic osteosclerosis
113
radiodensity associated with pulpal inflammation
condensing osteitis
114
radiodensity with a RL rim associated with the apex of multiple anterior teeth or one posterior tooth.
Cemento-osseous dysplasia
115
radiodensity associated with the root of a tooth and the PDL is obscured.
Cementoblastoma
116
Pt complains their hats don't fit anymore and that their upper teeth have gaps between them
Paget's disease of bone
117
Patchy slcerotic areas of the maxilla have cotton wool or cotton roll appearance.
Paget's Disease
118
A RL most common in the anterior mandible and crosses the midline, and appears identical to Brown Tumor of Hyperparathyroidism.
Central Giant Cell Granuloma
119
An empty or fluid-filled cavity within the mandible that shows domelike projections that scallop between the roots of several teeth.
Traumatic Bone Cyst
120
Upon panoramic x-ray, there is ballooning distention. Upon biopsy, the surgeon says it looked like a blood-soaked sponge.
Aneurysmal Bone Cyst
121
On the radiograph, it looks like fine ground glass opacification.
Fibrous Dysplasia
122
What two syndromes are associated with polyostotic fibrous dysplasia?
1. Jaffe-Lichtenstein Syndrome
2. McCune-Albright Syndrome
* coast of Maine café au lait spots in both*
123
Cemento-osseous dysplasia occurs mostly in what population?
Middle-aged African American females
124
Upon radiograph, you notice a mixed RL/RO lesion that is resorbing roots and causing a downward bowing of the inferior cortex of the mandible. Dx?
Ossifying Fibroma
125
A RO lesion with RL rim that is painful. Aspirin does NOT relieve pain.
Osteoblastoma
126
A RL lesion with a small RO center that is painful at night. Aspiring relieves the pain.
Osteoid Osteoma
127
Spiking resorption and a sunburst appearance on the occlusal radiograph.
Osteosarcoma
128
The pt has numb-chin syndrome and the x-ray shows ill-defined borders of a "moth eaten" looking lesion
Metastatic Carcinoma of the Jaw
129
Unilocular lesion involving the crown of an unerupted 3rd molar. Appears to attach at the CEJ
Dentigerous Cyst
130
Child has lost a deciduous tooth and now the gingiva in that spot is nodular and purple. Dx?
Eruption Cyst. No tx needed.
131
Lesion grows in an anterior-posterior direction. Surgeon said there was a cheese-like material in the cyst. Dx?
Keratocystic Odontogenic Tumor (aka OKC)
132
What syndrome are KOT's (aka OKC's) associated with?
Gorlin syndrome (nevoid basal cell carcinoma syndrome)
133
What gene causes gorlin syndrome?
PTCH gene
134
A RL that occurs along the lateral root surface, usually in mandibular premolar/canine/lateral incisor area.
Lateral periodontal cyst
135
This lesion is usualy found around the crown of an unerupted canine/incisor and has ghost cells which can calcify within the lesion.
Calcifying Odontogenic Cyst (GORLIN CYST)
136
What is the most common clinically significant odontogenic tumor?
Ameloblastoma
137
This multicystic mandibular lesion is described with a soap bubble or honeycombed appearance in the ramus of the mandible.
Ameloblastoma
138
This asymptomatic RL lesion attaches beyond the CEJ of a maxillary canine and shows snowflake calcifications on the x-ray. Dx?
Adenomatoid Odontogenic Tumor
139
This lesion is associated with an impacted mandibular molar and shows "driven snow" pattern on the x-ray. Dx?
Calcifying Epithelial Odontogenic Tumor (CEOT)
| aka PINDBORG TUMOR
140
Looks like a dentigerous cyst around the crown of an unerupted tooth, but it has enamel and dentin deposition inside the lesion like an odontoma. Name?
Ameloblastic Fibro-Odontoma
141
The most common odontogenic tumor:
odontoma
142
Compound odontomas look like ______, and complex odontomas look like ________.
```
compound = tooth-like
complex = a blob
```
143
A pt has freckle-like lesions on the hands, perioral skin and oral mucosa. Dx?
Peutz-Jegher's Syndrome
144
What syndrome has freckling on hands and in/around mouth, has intestinal polyps, and are 18x more likely to develop malignant cancer?
Peutz-Jegher's Syndrome
145
Looks like desquamative gingivitis and has intraepithelial split on histo slide.
Pemphigus vulgaris
146
Looks like desquamative gingivitis and has interepithelial split on histologic exam (split at basement membrane)
Mucous Membrane Pemphigoid
147
Leukoerythematous lesion with whickam striae.
Reticular Lichen Planus
148
Systemic Lupus Erythematosis demonstrates this kind of rash in 50% of cases.
Malar rash (butterfly shape on face)
149
A lack of vitamin B2 might cause what two manifestations?
angular cheilitis, glossitis
150
Anemia, whether it be iron deficiency or pernicious, can cause what oral manifestation?
atrophic glossitis
151
What is your differential for a RL lesion around an unerupted tooth?
1. dentigerous cyst
2. ameloblastoma
3. Calcifying odontogenic tumor (can have calcifications)
4. Adenomatoid odontogenic tumor
5. calcifying epithelial odontogenic tumor (can have calcifications)
6. ameloblastic fibro-odontoma (can have calcification)
