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GI2 E1 > salivary gland > Flashcards

salivary gland Flashcards

robbins

1
Q

dry mouth from decrease production of saliva=

A

xerostomia

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2
Q

in what population is xerostomia most common

A

> 70 y.o

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3
Q

what is xerostomia most frequently a result of

A

= side effect of meds= antichol, anti-depressant, anti-psychotic, diuretic, anti-hypertensive, antihistamine
sedative, M relaxant, analgesic

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4
Q

describe the clinical presentation of xerostomia

A

dry mucosa

atropy of the papillae of the tongue with fissuring and ulcerations

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5
Q

what are some complications secondary to xerostomia

A

increased rates of dental caries
candidiasis
difficulty swallowing and speaking

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6
Q

what is sialadenitis and what can cause it

A

inflammation of the salivary gland

can be induced by trauma, infection, autoimmune disese

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7
Q

what are the most common type of inflammatory salivary gland lesion

A

mucoceles = blockage or rupture of a salivary gland duct resulting in leakage of saliva into surrounding CT

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8
Q

what is the most common form of viral sialadenitis

A

mumps (paramyxovirus)

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9
Q

What is keratoconjunctivitis sicca?

A

dry eyes

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10
Q

Where are mucoceles most commonly found?

A

lower lip resulting from trauma

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11
Q

in what population are mucoceles most common

A

toddlers, YA, elderly who are more prone to falling

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12
Q

“fluctuant swellings of the lower lip that have a blue translucent hue, and changes in size especially with meals”

A

mucoceles

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13
Q

[mucoceles] the cystic spaces are filled with ____ and _____

A

mucin and inflammatory cells (Mø)

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14
Q

what is the treatment of mucoceles

A

complete removal of the cyst and gland or else will recurr

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15
Q

what is a ranula

A

Epithelial-lined cysts that arise when duct of sublingual gland has been damaged

= a real cyst

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16
Q

what is a plunge ranula

A

a cyst that has dissected through the CT stroma connecting the two bellies of the mylohyoid M

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17
Q

what is the connection between sialolithiasis and sialadenitis

A

nonspecific bacterial sialadenitis (most often of the major salivary glands) is usually secondary to ductal obstruction produced by stones (sialolithiasis)

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18
Q

what are the most common offenders in nonspecific bacterial sialadenitis

A

S. aureus

strep viridans

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19
Q

decreased salivary secretions caused by dehydration may lead to development of ____ _______ in ____ patients with a recent history of major ____ __ ____ ____

A

bacterial suppurative parotitis

elderly

thoracic or abdominal surgery

20
Q

sialolithiasis can be associated with what development

A

overt suppurative necrosis and abscess formation, unilaterally with a painful enlargement and sometimes purulent ductal discharge

21
Q

what is the most common benign tumor of the salivary gland

A

pleomorphic adenoma

22
Q

what are the two most common malignant tumors of the salivary gland

A

mucoepidermoid carcinoma

adenocarcinoma

23
Q

most salivary gland tumors arise within the ____ gland

A

parotid

24
Q

the likelihood of a salivary gland tumor being malignant is more or less ____ ___ to the size of the gland

A

inversely proportional

25
Q

salivary gland tumors mostly present in ____, with slight __ predominance. warthin tumors more often occur in ____, perhaps due to the historically higher prevalence of ____. benign tumors more often appear in the ____ to _____ decades of life, with malignant ones tending to appear somewhat ____

A

adults, female
males, smoking
fifth, seventh, later

26
Q

neoplasms in the parotid glands produce what distinctive physical exam finding

A

swellings in front of and below the ear, 4-6 cm in diameter and mobile on palpation

27
Q

____ are benign tumors of the salivary gland consisting of a mixture of ductal (epithelial) and myoepithelial cells, show both ____ and ____ differentiation

A

pleomorphic adenomas, epithelial and mesenchymal

i.e. epithelial elements, with varying degress of myxoid, hyaline, chondroid, osseous tissue

28
Q

pleomorphic adenomas are often associated with what gene mutation

A

PLAG1 overexpression –> upregulates expression of genes that increase cell growth

29
Q

mass rarely exceeding 6 cm, rounded, well demarcated, encapsulated but expansile growth produces protrusions into the surrounding gland, grey-white with some blue

A

pleomorphic adenoma

30
Q

trx for pleomorphic adenoma

A

total parotidectomy (most are in the parotid gland)

31
Q

a carcinoma arising in a pleomorphic adenoma is called a _______ and tends to complete ___ the pre-existing pleomorphic adenoma

A

carcinoma ex pleomorphic adenoma or malignant mixed tumor

overrun and replace

32
Q

what is the prognosis of a pleomorphic adenoma

A

mortality rate of 30-50% at 5 years

33
Q

the second most common salivary gland neoplasm is ____ ___ and it almost exclusively arises in _____

A

warthin tumor

the parotid gland

34
Q

in what population will you likely see a warthin tumor

A

males, 50s-70s, smokers

35
Q

round to oval encapsulated masses 2-5 cm in diameter, arising in the superficial parotid gland where they are readily palpable.
mucinous or serous secretions

pale gray surface punctuated by narrow cystic or cleftlike spaces lined by double layer of epithelial cells resting on a dense lymphoid stroma

squamous metaplasia with germinal centers

A

warthin tumors

36
Q

neoplasms of the salivary gland composed of variable mixtures of squamous cells, mucus-secreting cells, and intermediate cells

A

mucoepidermoid carcinoma

37
Q

genetic mutations associated with mucoepidermoid carcinoma

A

(11;19) (q21;p13) translocation–> MEC1+ MAML2 fusion gene–> perturbs Notch and cAMP dependent signalling

38
Q

salivary grand tumors that can grow as large as 8 cm, well circumscribed and contain small mucin containing cysts

cords, sheets, or cystic configuration of squamous, mucous, or intermediate cells

A

mucoepidermoid carcinoma

39
Q

what is the prognosis of mucoepidermoid carcinomas

A

low grade= 5 year survival of 90%

high grade= 5 year survival of 50%

40
Q

anti-RoSSA and anti-LaSSB, decreased amylase in the saliva

A

sjogren syndome

41
Q

what is the treatment for mucocele

A

take out the nodule and its associated minor salivary gland

if not the whole thing, will recur

42
Q

carcinoma found in minor glands (specifically palatine)

A

adenoid cystic carcinoma

43
Q

(tumor in gland) small, poorly encapsulated, gray-pink. the spaces between the tumor cells are often filled with a hyaline material

A

adenoid cystic carcinoma

44
Q

describe the progression of adenoid cystic carcinoma

A

slow growing, tendency to invade perineural spaces, 50% will disseminate to bone, liver, brain

45
Q

describe the prognosis of adenoid cystic carcinoma

A

worse in smaller GLANDS

GI2 E1 (19 decks)

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