Pathology of the GI Tract- Oral cavity and salivary glands (part 2 of 4) Flashcards
what are Tori?
bony outgrowths or exostoses which are typically incidental findings on routine oral examinations; localized, benign bony protrusions
what demographic of people are most at risk for primary infections of HSV?
children between 2 and 4 years of age
If primary HSV infections are not asymptomatic, how do they present?
acute herpetic gingivostomatitis; these lesions can be accompanied by lymphadenopathy, fever, and anorexia
how do the oral lesions of HSV infections appear?
the vesicles range from lesions of a few mm to large bullae; first filled with a clear serous fluid but rapidly rupture to yield a painful, red-rimmed, shallow ulceration.
how can you test for HSV infection?
you can do a Tzanck test
when is the Tzanck test positive?
if acantholytic keratinocytes or multinucleated giant acantholytic keratinocytes are detected
what is the Tzank test looking for?
the viral cytopathic effects that are associated with HSV–> multinucleation
what is the most common fungal infection of the oral cavity and the most frequent cause of human fungal infections?
candidal infections
what are the three factors that influence clinical infection with candida?
the strain of C. albicans; the composition of individual oral flora; the immune status of the patient
what three things are important for the protection against Candida infection?
neutrophils, macrophages, and Th17 cells
how can candida infections be characterized?
thrush; superficial, gray to white inflammatory membrane composed of matted organism enmeshed in a fibrinosuppurative exudate that can be readily scraped off
what are the histologic features associated with candida?
pseudohyphae and budding yeast
what 3 conditions are associated with a compromised immune state that may predispose a person to candida infection?
diabetes mellitus, broad spectrum antibiotics or steroid inhalers, vaginal yeast infection in a pregnant woman
certain fungi have a predilection for the oral cavity and head/neck region; which class did we focus on?
zygomycetes–> Mucor
what is the key predisposing factor associated with these deep fungal infections?
immunosuppression
what are some characteristics of rhinocerebral mucormycosis?
opacification of the sinuses; this organism loves to go to vascular spaces and that’s how it spreads
what is often the first sign of underlying systemic conditions?
oral lesions
what are the oral changes associated with scarlet fever?
fiery red tongue with prominent papillae; white-coated tongue through which hyperemic papillae project
what are the oral changes associated with measles?
spotty enanthema in the oral cavity often precedes the skin rash; ulcerations on the buccal mucosa; koplik spots
what are the oral changes associated with infectious mononucleosis?
acute pharyngitis and tonsillitis that may cause coating with a gray-white exudative membrane; palatal petechiae
what are the oral changes associated with diphtheria?
characteristic dirty white, fibrinosuppurative, tough, inflammatory membrane over the tonsils and retropharynx
what is hairy leukoplakia?
a distinctive oral lesion on the lateral border of the tongue that is usually seen in immunocompromised patients and is caused by EBV
what is the gross presentation of hairy leukoplakia?
white confluent patches of fluffy hyperkeratotic thickenings, almost always situated on the lateral border of the tongue that cannot be wiped off
what population of people are at risk for hairy leukoplakia?
the immunocompromised- HIV patients, cancer therapy, transplant associated immunosuppression, and advancing age
what is the distinctive microscopic appearance of hairy leukoplakia?
the microscopic appearance consists of hyperkeratosis and acanthosis with “balloon cells” in the upper spinous layer
what type of tumors often infiltrate the skin and the gingiva?
tumors with monocytic differentiation
what is a common feature of myeloid neoplasms?
an origin from hematopoietic progenitor cells
what could be a cause of gingival hyperplasia aka an overgrowth of gum tissue around the teeth?
the anti-seizure medication: Dilantin
