perio exam 2: ging diseases 2 Flashcards
1
Q
ging lesions of systemic origin
A
- lichen planus
- pemphigoid
- pemphigus vulgaris
- erythematus multiform
- lupus erythematosus
- drug induced mucocutaneous disorders
2
Q
1.lichen planus oral involvement alone is common t/f
A
true
3
Q
1.lichen planus-prevelance as a percent and is it rare in kids?
A
.1-4% yes, rare in kids
4
Q
1.lichen planus-what’s the premalignant potential?
A
.5-2%
5
Q
what are wick ham striae and which mucogingival disorder are they associated with?
A
characteristic skin lesions 1.lichen planus
but lichen planus has various clinical appearances
(papular, reticular, plaque-like, ulcerative, bullous)
6
Q
t/f lichen planus is only in certain areas of the ging?
A
f-can be any area of the oral mucosa
7
Q
papular
A
sm, infmm, congested spot on skin, a pimple
8
Q
reticular
A
mesh; in the form of a network
9
Q
atrophy
A
wasting, decrease in tissue size
10
Q
ulcerative
A
affected with an ulcer, open sore or lesion of the skin or mucosa accompanied by sloughing of infmmed necrotic tissue
11
Q
bulla
A
lg blister or skin vesicle filled w/fl
12
Q
do you think pictures will be on the exam
A
i could see us needing to use vocal to describe stuff…
13
Q
lichen vs. lichenoid lesions
A
“oid”=”like”
14
Q
lichenoid lesions-ex’s
A
an uncertain background
lesions in contact w/dental restorations or associated w/ various meds (NSAIDS, diuretics, b-blockers) or systemic disease like liver diseases
15
Q
lichenoid lesions:tx
A
biopsy but diff than normal
take sample to culture if considering candida
(~38% of OLP have secondary infection)
a tramuatic dental pq control
topical corticalsteroids to control pain, discomfort
16
Q
pemphigoid
A
group of disorders in which antibodies toward components of basement membrane result in detachment of the epi form the ct
17
Q
pemphigoid histology
A
autoantibody rxns vs hemidesmosome and lamina lucida components
complement mediated cell destructive process may be involved in the pathogenesis
18
Q
pemphigoid-three types
A
bullous, benign mucous membrane(only oral), cicatricial (scar forming; more with eyes)
deposits of C3, IgG, and other Ig’s
19
Q
what test can you use w/pemphigoid?
A
NICHOLSKY sign. rubbing of ging creates bulla formation
q-tip–>swipe, see if epi comes off and either redness or removal
20
Q
what forms an intraepithelial bullae in the skin and mucous membranes?
A
pemphigus vulgaris
21
Q
what has a strong medeterian and jewish genetic background?
A
pemphigus vulgaris
22
Q
what has painful desquamative lesions, erosions, or ulcerations and is seen in a middle aged pop, and chronic courses have recurrent bulla formation?
A
pemphigus vulgaris
23
Q
what is associated with acantholysis? and define that term.
A
acantholysis is the histology of pemphigus vulgarism and is due to the destruction of desmosomes. it is pericellular epithelial deposits of IgG and C3.
24
Q
besides acantholysis, what is another histology of pemphigus vulgarism
A
circulating autoantibodies against interepi adhesion molecs
25
can pemphigus vulgarism have major gi/systemic effects?
my notes say yes
26
what's an acute, sometimes recurrent vesiculobullous disease affecting both mucous and skin?
erythema multiform.
bulla rupture and leave extensive scars.
27
oral involvement of erythema multiform: % of cases seen?
25-60%
28
what will the lips look like of a pt w/erythema multiform?
swollen with extensive crust alone v. border
29
what are characteristics of erythema multiform skin lesions?
iris appearance and bullae
| and w/extensive necrosis: Steven johnson syndrome (oral, ocular, genital, skin)
30
erythema multiform is almost only in the elderly t/f
false, any age but mostly in younger pop
31
erythema multiform-what kind of immune reaction?
cytotoxic immune rxn toward keratinocytes mediated by a wide range of factors including herpes and various drugs
32
erythema multiform-histopathology is a key in diagnosis?
no! it's non specific
33
erythema multiform-tx
pq control, local and systemic corticosteroids
34
lupus erythematosus: what disorder?
autoimmune ct disorder in which autoantibodies form to various cellular constituients
35
_____ has central atrophic area with sm white dots surrounded by irradiating fine white striae with a periphery of telangiectasia? (vascular lesion from dilation of a group of sm bv's)
lesions can be ulcerated
lupus erythematosus
36
can lesions of lupus erythematosus be differentiated from leukoplakia or atrophic oral lichen plans?
no. (and it pry means w/out histology it can't be)
37
telangiectasia
associate with lupus erythematosus (she said it means if you pouch on it the tissue blanches)
wiki "or angioectasias (also known as spider veins) are small dilated blood vessels[1] near the surface of the skin or mucous membranes, measuring between 0.5 and 1 millimeter in diameter.[2]"
38
lupus erythematosus had what characteristically shaped skin lesion?
butterfly shaped! (skin around nose and face changes)
39
lupus erythematosus: histology
degen of basal cells and inc WIDTH* of the basement membrane
deposits of various Ig's, C3 and fibrin along the basement membrane
(um, no offense but it doesn't help that she bolded the word "width" when they already destroyed all meaning of the word last unit. but maybe width as height only makes sense in the case)
40
atrophic ging discoid lupus erythematosus
degen of what
deposits of what
systemic forms can be what?
```
degen of basement cells and increased width of the basement membrane
deposits of various Ig's, C3 and fibrin along the basement membrane
discoid forms (mild chronic which affects skin and mucous membranes)
```
systemic forms can be FATAL!
41
drug-induced mucocutaneous disorders: ex
```
ging hyperplasia
erythema multiform
oral ulceration
epi atrophy, superficial sloughing
intense erythema
```
42
drug-induced mucocutaneous disorders: ex drugs
immunosuppresants, ca2+ blockers, anti-epilepsy, anti-malarial, anti-neoplastic (anti-cancer) , methotrexate (leukemia)
43
other ging manifestations of systemic diseases 2 ex's:
gi: crohn's-chronic granulomatous infiltrates of the wall of the gi tract (mucosal folding/defective neutrophil function)
hematological disorders-leukemia-a malignant
hematologicla disorder with abnormal proliferation and development of leukocytes and their precursors in the blood and bone marrow
44
leukemia presents to dentists/periodontists as:
swelling, ulceration, petecchia and erythema of ging
45
% of acute leukemia presenting oral signs to dentists/periodontists
69%
46
do tumors have appearance like ging?
yes. cysts also
47
6 types of periodontal tumors
soft or hard for each:
1reactive process of the tissues
2benign neoplasms
3malignant neoplasma
48
fibroma/focal fibrous hyperplasia
| caused by irritation
reactive process of the soft tissues
49
fibroma/focal fibrous hyperplasia have what type of nodules?
sessile.
this is a reactive process of the soft tissues.
50
cell rich or cell poor hyperplastic collagenous tissue with fibroma/focal fibrous hyperplasia?
cell POOR!
51
with fibroma/focal fibrous hyperplasia can it show hyperkeratinization?
yes
52
differential diagnosis for fibroma/focal fibrous hyperplasia?
giant cell fibroma
53
calcified fibroblastic gramuloma is what reactive process?
soft tissue
54
reddish and ulcerated reactive lesion, with fibrous proliferation in which bone or cementum-like tissue is formed
highly cell rich areas below ulcerated sites
calcified fibroblastic granuloma =st reactive process
55
what's a differential for calcified fibroblastic granuloma ; cfg=st reactive process?
pyogenic granuloma
56
pyogenic granuloma is what reactive process?
st reactive process
57
ulcerated (may resemble purulence); ging margin
reddish or bluish, can be lobulated, sessile, or pedunculated
highly vascular with chronic onfmm cells
pyogenic granuloma =st reactive process
58
differential for pyogenic granuloma?
pregnancy tumor
59
peripheral giant cell granuloma
st reactive process
60
peripheral giant cell granuloma can occur where
can occur anywhere on the ging mucosa
61
peripheral giant cell granuloma
can be pedunculated, sessile, red or purple, commonly ulcerated
62
focal collection of multinucleated osteoclast-like giant cells w/richly cellular and vascular stroma separated by collagenous septa
what is this and where did this probably originate from?
peripheral giant cell granuloma
| the PDL
63
peripheral giant cell granuloma differential:
focal fibrous hyperplasia
64
reactive process of periodontal hard tissues 1!
1. periapical cemental dysplasia
65
reactive hard tissue periapical cemental dysplasia
| is the tooth usually vital?
yes
66
fibrous-osseous cemental lesions, usually no symptoms, periodical bone replaced by cellular fibroblastic tissue through a cementoblastic phase
reactive hard tissue periapical cemental dysplasia
67
reactive hard tissue periapical cemental dysplasia differential
cemento-ossifying fibroma and fibrous dysplasia
68
benign neoplasms of periodontal st (5)
1. hemangioma
2. nervus
3. papilloma
4. verruca vulgaris
5. peripherial odontogenic tumors
69
which benign neoplasms of periodontal st matches:
~frequent tumors of the oral mucosa
flat or raised, sometimes lobulated, soft lesions of blue to red color
asymptomatic but may bleed
blanch on pressure
capillary and cavernous types
1.hemangioma
benign neoplasms of periodontal st
70
which benign neoplasms of periodontal st matches:
| pigmented lesion containing melanocytes in ct
2.nervus
71
t/f 2.nervus (benign neoplasms of periodontal st) is common the the oral mucosa and rarely seen in the palate.
false. it is rarely seen in the mucous and mostly seen in the palate
72
which benign neoplasms of periodontal st matches:
flat, slightly raised lesions or a tumor
black, brown or no pigment
2.nervus (benign neoplasms of periodontal st)
73
nervocellular or brown nevrus located along which layer of epi?
the basal layer
that was for 2.nervus (benign neoplasms of periodontal st)
74
differential diagnosis for 2.nervus (benign neoplasms of periodontal st)?
amalgam tattoos
75
how many different papillomas are present?
2-3
4-5
7-8
4-5
76
which benign neoplasms of periodontal st matches:
exophytic, pedunculated, or sessile
reddish/normal or whitish/gray color
papilloma
77
which benign neoplasms of periodontal st matches:
a granular/moruloid or filiform/digitated surface
("like a flower" lol)
papilloma
A benign neoplasm of periodontal st!
78
t/f HPV is commonly found with one of the benign neoplasms of periodontal soft tissues?
true
human papilloma virus goes with papillomas orally too
I guess verruca vulgarism also has some HPV associations 2&4
79
which benign neoplasms of periodontal st matches:
lips and palate are the main locations
sessile, exophytic or raised lesion w/ a whitish surface
papillomatous surface w/hyperkeratinazation and elongated rete ridges
verruca vulgaris
80
t/f verruca vulgaris is more common orally compared tot he skin
false-more common in skin than oral mucosa
81
t/f verruca vulgaris is associated with HPV types 1& 3
false. i dunno if those exist
| it's associated with HPV 2 & 4
82
peripherial odontogenic tumors
benign neoplasms of periodontal SOFT TISSUE
83
benign neoplasms of periodontal soft tissue: match
non-ulcerated sessile or pedunculated ging lesions
generally detached in the st around unerupted teeth
histopathology is similar to intraosseous forms of tumors
peripherial odontogenic tumors
reminder: benign neoplasms of periodontal SOFT TISSUE!
84
t/f peripherial odontogenic tumors- generally detached in the st around erupted teeth
false unerupted teeth
85
benign neoplasms of periodontal HARD TISSUE (3)
```
1ameloblastoma
2sq odontogenic tumor
3benign cementoblastoma
"sab or bas"
or A Sot Bc
```
86
benign neoplasms of periodontal HARD TISSUE:matching
derived from odontogenic epi
well-circumscribed radiolucency
1. ameloblastoma
87
benign neoplasms of periodontal HARD TISSUE:matching
derived from the PDL, pry from the epi rests of malassez
often associated with which root surface?
rarely seen
2. sq odontogenic tumor
| and it is often on the lateral root surface (me-so buccally?)
88
benign neoplasms of periodontal HARD TISSUE:matching
slow growing neoplasm forming lard tissue around the apex of the tooth
radiopacity typically surrounded by a radiolucent margin
3. benign cementoblastoma
89
benign neoplasms of periodontal HARD TISSUE: which has a radiolucency and which a radio opacity?
1. ameloblastoma=radiolucency
| 3. benign cementoblastoma=radiopacity
90
malignant neoplasms of the periodontal soft tissues: (4)
1. sq cell carcinoma
2. metastasis to the ging
3. kaposi's sarcoma
4. malignant lymphoma
91
malignant neoplasms of the periodontal soft tissues: matching:
mandible
post to premolars
nodular lesions, often with ulceration and surrounding leukoplakia
regional lymph-node metastasis is common
1. sq cell carcinoma
92
malignant neoplasms of the periodontal soft tissues: matching:
majority are intraosseous (less in soft tissues) (wait this is under the st heading though....?)
soft tissue metastasis from lung cancer
most common of the metastasis cases are carcinoma and not sarcoma
2. metastasis to the ging
93
malignant neoplasms of the periodontal soft tissues: match
skin lesions followed by oral lesions
ging is the second most detected site after ____?
re-occurance with aids
3. kaposi's sarcoma
most common is the palate
(w/well controlled hiv should not see this)
94
malignant neoplasms of the periodontal soft tissues: match
primary malignant lymphoma is rare or common is the oral cavity?
occurs in HIV pts frequently
4.malignant lymphoma
| rare in oral cavity, common in hiv pts
95
malignant neoplasms of the periodontal hard tissues: 2
1. osteosarcoma
| 2. langerhans cell disease (histiocytosis X)
96
malignant neoplasms of the periodontal hard tissues:
match
clinical and radiographic exams are required
widening of ldl is common
1. osteosarcoma
97
1. osteosarcoma (malignant neoplasms of the periodontal hard tissues)
____% of all osteosarcomas are in jaws?
7%
98
histiocytosis x originates from what cells?
langerhans cells (histiocytosis x=2. langerhans cell disease)
99
manifestations in jaws are seen in what ___% of all langerhans cell disease (histiocytosis X)?
10-20%
40-50%
33-96%
10-20%
100
what are frequent symptoms of langerhans cell disease (histiocytosis X)?
swelling, tenderness, pain, loosening of the teeth
101
name the random 5 cyst list:
1. ging cyst
2. lateral periodontal cyst
3. infmm paradental cyst
4. odontogenic kertaocyst
5. radicular cyst\
102
diff b/t tumor and cyst?
cyst=empty sac filled with fluid and surrounded by epi
