Pathology2 Flashcards
On a hospital rotation you see an infant who displays bowed legs and muscular weakness. On dental examination you notice a delayed eruption pattern. The child has rickets, which is a deficiency in which vitamin? • vitamin A • vitamin D • vitamin C • vitamin E
vitamin D (Rickets in children, osteomalacia in adults)
Which of the following conditions may be seen in a patient with cerebral palsy? Select all that apply.
• difficulty with mastication and swallowing
• higher incidence of periodontal disease and caries
• attrition of the teeth
• multilocular radiolucencies of the jaws
• difficulty with mastication and swallowing
• higher incidence of periodontal disease and caries
• attrition of the teeth
(Cerebral palsy is a term used to describe a group of disorders affecting body movement and muscle coordination. It is due to an insult to or anomaly of the brain’s motor control centers)
Which of the following diseases is associated with a decrease in caries? • sjogren syndrome • cystic fibrosis • cerebral palsy • down syndrome
cystic fibrosis (probably the result of alterations in saliva and the long-term use of antibiotics)
You are listening to a story about oyster fishing from a fellow classmate concerning his trip to the East Coast. He mentions that he got sick and had to be taken to the ER where he was told he had hepatitis. He is fine now. Which hepatitis is the most likely culprit in your colleague?
• hepatitis A
• hepatitis B
• hepatitis C
hepatitis A — also called infectious, viral , or short-incubation hepatitis
The only oral complication associated with hepatitis is the potential for ? in cases of significant liver damage
abnormal bleeding
Which type of hepatitis is found only in patients with acute or chronic episodes of hepatitis B? • hepatitis A • hepatitis C • hepatitis D • hepatitis E
hepatitis D — this virus causes “serum” or long-incubation hepatitis
Which of the following aid in wound healing? Select: all that apply. • highly vascular areas (i.e., tongue) • hyperthermia • younger age • cortisone • hypothermia
- highly vascular areas (i.e., tongue)
- hyperthermia
- younger age
In which one of the following cases is an incisional biopsy indicated?
• 3-mm well-encapsulated fibroma
• necrotizing sialometaplasia of the hard palate
• 2-mm papilloma of left commissure of lips
• aneurysmal bone cyst
necrotizing sialometaplasia of the hard palate
Epstein-Barr virus (EBV) is associated with all of the following EXCEPT one. Which one is the EXCEPTION? • nasopharyngeal carcinoma • oral hairy leukoplakia • burkitt lymphoma • koplik spots
koplik spots - measles (rubeola) is characterized by Koplik spots, cannot be wiped off and occur opposite the molars
Neck swellings are characteristic of ?
infectious mononucleosis, Hodgkin disease, and tuberculosis
Epithelioid cells and giant cells are derived from macrophages and are important in the development of: • initial inflammation • granulomatous inflammation • acute inflammation • subacute inflammation
granulomatous inflammation
Granulomatous inflammation is characteristically associated with areas of ? necrosis produced by infectious agents, particularly ?
- caseous
* Mycobacterium tuberculosis
A patient you saw yesterday had minor swelling of the submandibular space associated with a carious #31. You prescribed amoxicillin and sent him home. He called today to say the swelling has gotten worse. You squeeze him into the schedule and notice that he has trouble breathing. You call an ambulance to escort him to the ER and tell the paramedics that he has Ludwig’s angina. Ludwig angina is a severe and spreading infection that involves the:
• submental and sublingual spaces only
• submandibular, submental, and sublingual spaces unilaterally
• submandibular and sublingual spaces only
• submandibular, submental, and sublingual spaces bilaterally
submandibular, submental, and sublingual spaces bilaterally
Very important: The most serious complication of Ludwig angina is ?
edema of the glottis (which is a slit-like opening between the true vocal cords).
ESR rises with all of the following EXCEPT one. Which one is the EXCEPTION? • inflammation • administration of hydrocortisone • necrosis • suppuration • pregnancy
administration of hydrocortisone (Elevated sedimentation rates [ESR] are not specific for any disorder but indicate the presence of inflammation)
Your 2-year-old nephew tells you he feels sick and then proceeds to vomit on the kitchen floor. You rush him to the bathroom where you notice toothpaste everywhere and his "SpongeBob" toothpaste tube completely empty. Your aunt asks you, "What is the estimated toxic dose for fluoride ingestion"? Your answer to her is: • 1-2 mg/kg • 5-10 mg/kg • 8-10 mg/kg • 12-15 mg/kg
5-10 mg/kg
? will reduce the absorption of dietary fluoride
The intake of calcium in high doses
fluoride poisoning includes?
- acute: going to hospital
* chronic: whit characteristic signs of osteosclerosis of the bones and dental fluorosis
The most common cause of xerostomia is: • hereditary • medications • tooth decay • mouth breathing
medications
xerostomia can lead to ?
- rampant tooth decay
* periodontal disease
The most common disease causing xerostomia is ?
Sjogren syndrome that occurs predominantly in postmenopausal women
Where in the oral cavity is malignant melanoma most commonly found? • tongue and mandibular alveolar ridge • buccal mucosa and pharyngeal pillars • palate and maxillary gingiva • mucobuccal fold of lower lip
palate and maxillary gingiva
Name the malignant, epithelial cell tumor that characteristically begins as a papule and enlarges peripherally, developing a central crater that erodes, crusts, and bleeds.
basal cell carcinoma (rarely metastasizes)
primary cause of the basal cell carcinoma is ?
excessive sun or x-ray exposure.
A 62-year-old patient comes into your office complaining of his loose lower molars. The health history reveals recent lower back pain. On a hunch, you send him down the hall to the orthodontist to take a lateral skull radiograph that reveals "punched-out" radiolucencies. You will refer this patient to the physician suspecting a diagnosis of: • non-hodgkin lymphoma • hodgkin lymphoma • multiple myeloma • langerhans cell disease
multiple myeloma (also known as “Plasma Cell Myeloma”)
The most common type of malignant melanoma is: • superficial spreading melanoma • lentigo maligna melanoma • acral-lentiginous melanoma • nodular melanoma
superficial spreading melanoma
Skin cancer is a very common malignancy in the United States. Of the different types, ? is most common followed by ?, and the least common is ?
- basal cell carcinoma
- squamous cell carcinoma
- malignant melanoma.
When using the TNM method in assessing the prognosis and therapy of malignant neoplasms, the N represents:
• the presence of nikolsky sign
• the presence of nodules
• the presence of regional lymph node involvement
• the presence of erythroplakia
the presence of regional lymph node involvement
• T = size of the primary tumor
• N = presence of regional lymph node involvement
• M = presence of distant metastases
The most common site of squamous cell carcinoma of the tongue is the: • dorsum • ventral surface • tip • posterior lateral border
posterior lateral border
Of the following types of squamous cell carcinomas, which is the least common?
• squamous cell carcinoma of the palate
• squamous cell carcinoma of the nasopharynx
• squamous cell carcinoma of the oropharynx
• squamous cell carcinoma of the maxillary sinus
squamous cell carcinoma of the nasopharynx
At which growth stage is metastasis most likely for malignant melanoma? • "horizontal" growth phase • "circular" growth phase • "vertical" growth phase • "radial" growth phase
“vertical” growth phase
Malignant melanoma is an uncommon neoplasm of the oral mucosa. It exhibits a definite predilection for ?
the palate and the maxillary gingival alveolar ridge.
Cancer of which oral cavity structure is most commonly associated with mortality? • lip • tongue • floor of mouth • buccal mucosa
tongue
Metastases from tongue cancer are relatively common at the time of primary treatment. In general, metastatic deposits from SCC of the tongue are found in the lymph nodes of the neck, usually on the ipsilateral side. The first nodes to become involved are ? at the angle of the mandible.
the submandibular or jugulodigastric nodes
- the 5-year survival rate for SCC is ?;
* with neck metastasis, it is ?.
- 45% to 50%
* 25%
A 47-year-old HIV+ patient is referred from his physician to you because of an exophytic growth in the maxillary left mucobuccal fold. Unable to find an odontogenic source, a biopsy was done. A starry-sky morphology was found and a dismal diagnosis of Burkitt lymphoma was made. Which virus is thought to be responsible for this lymphoma? • herpes virus • epstein-barr virus • cytomegalovirus • human papillomavirus
epstein-barr virus
The Epstein-Barr virus is associated with ?
- Burkitt lymphoma
- infectious mononucleosis,
- oral hairy leukoplakia,
- nasopharyngeal carcinoma
At the age of 9, poet Lucy Grealy was diagnosed with Ewing sarcoma of the jaw. Although rare in females, and rare in the jaw, Ewing sarcoma most often presents radiographically as:
• multiple radiolucent/radiopaque lesions resembling “cotton ball” or “cotton wool” appearance
• multiple “punched-out” radiolucencies
• “moth-eaten” destructive radiolucencies of medulla and erosion of the cortex with expansion
• lytic lesion that may be ill-defined or sharply defined
“moth-eaten” destructive radiolucencies of medulla and erosion of the cortex with expansion
Histologically, it is often difficult to distinguish this tumor from a neuroblastoma or a reticulum cell sarcoma, however, the cells of Ewing sarcoma contain ?
glycogen
A 15-year-old patient presents to his physician because of localized pain in his right femur and rapidly enlarging swelling. A radiograph of the area shows a "sun-ray" appearance. Which is a likely diagnosis for this patient based on incidence? • chondrosarcoma • osteosarcoma • scleroderma • chronic osteomyelitis
osteosarcoma
