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Test 2 Flashcards

1
Q

Granular Cell tumor

A 
dome shaped nodule/mass on dorsum of tongue
S100-positive
adults with more commonly females
pseudocarcinomatous
nodule on tongue sometimes yellow hue
conservative excision
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2
Q

congenital gingival epulis of the new born

A

crest of alveolar ridge in female babies

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3
Q

melanotic neuroectodermal tumor of infancy (MNTI)

A

maxillary swelling in young children with floating teeth
derived from nueral crest cells.
high urinary vanillylmandelic acid (VMA)
intraosseous lesion accompanied with floating tooth
quickly growing nodule- pigmented

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4
Q

lipoma

A

yellow, well circumscribed. floats in formalin

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5
Q

Multiple endocrine neoplasia 2B syndrome

A

rare- autosomal dominant- mutation of RET proto-oncogene
Triad of neoplasia
1) thyroid cancer (calcitonin secreting)
2) adrenal medulla tumor (chatecholamine secreting)
3) mucosal benign nueromas (tongue lips and eyelids)

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6
Q

neurofibromatosis

A 
von recklinghausen disease
AD 
50% hereditary 50% spontaneous
Type 1 is NF1 gene on chromo 17 (85-97%)
Type 2 NF2 chromosome 22 (bilateral acoustic schwannomas)
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7
Q

criteria for dx of NF1

A

2 of the following

1) six or ore cafe au-lait spots over 5 mm in diameter (15 post pubertal)
2) 2 or more NFs or a plexiform NF
3) freckling in arm pit or groin
3) optic glioma
5) 2 or more lisch nodule (eye pigments)
6) first degree relative with NF1

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8
Q

rhabdomyosarcoma

A

most common solid malignancy of the head andneck in children
fast growing tumor that mimicks dental infections
fetal striated muscle tumor
dx by immunostaining or 2)cytogenic testing (reciprocal translocation)

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9
Q

ewings sarcoma

A

subset of rhabdomyosarcoma? swelling in cheek?

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10
Q

oral non hodgkins lymphoma

A

swelling in lymph

cd20?

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11
Q

burkitts lymphoma

A

translocation 8 and 14

starry sky appearance

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12
Q

HPV associated non keratinizing carcinoma

A

difficultry swallowing- feels like something is stuck in throat
40-60 yrs old (younger thna tobacco related)
nodules/masses in tonsillar regions and base of tongue
overproduction of p16 protein
Smoking weed or cigarettes increaske risk
high risk is HPV 16 and 18
70-90% of orophayngeal cancers
palatine tonsils, soft palate, base of tongue

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13
Q

lymphoepithelial cyst

A

epithelial lines dyst developing withing lymphoid tissue (tonsils)
asymptomativ and appears as yellowish nodules in tonsillar regions

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14
Q

peripheral ossifying fibroma

A 
PDL cells that differentiate and have osseous and cementum-like products
young people due to irritation
pink firm amass anterior to molars
recurrance high
not malignant
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15
Q

pyogenic granuloma

A

bright red- common in uncontrolled diabetes and pregnancy

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16
Q

peripheral giant cell granuloma

A

extraosseous conterpart to central giant cell granuloma
reactive tissue proliferation arising from periosteum or PDL
dark red/puprle firm nodule
cupping resorption of underlying bone characteristic
proliferation of fibroblast-like cells admixed w/ numerous giant cells and hemmorhage
“pork chop appearance”

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17
Q

erythema multiforme

A

hypersensitivity
immune complex deoposition in epithelia
minor ands evere form (steven johnson syndrome)
diffuse painful ulcers (may have vesicles) on labial and buccal mucosa
bulls eye
tx: remove causative agent- topical and systemic corticosteriods (prednisone and NSAIDS)

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18
Q

cinnamon induced hypersensitivity

A

cinnamon: no ulcers
type III hypersensitivity
white plaque on a red background

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19
Q

aluminum chloride hypersensitivity

A

vesicles

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20
Q

apthous ulcers

A

canker sores

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21
Q

minor apthae

A 
95% of cases
1-5 ulcers 
less than 1 cm
painful shallow sharp red borders
10-14 days healing for each ulcer
about 8 weeks
can use systemic steroids
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22
Q

major apthae

A 
1-2 ulcers 5mm-2cm each
crater like
less than 6 weeks healing
secondary infections and scarring common
topical and systemic steroids
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23
Q

herpetiform

A

multiple small shallow painful lesions
weeks-months-years
low dose systemic steroids

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24
Q

behcet syndrome

A

most common in japan and eastern mediterranean countries
apthae like lesions of oral and anogenital mucosae, ocular lesions, athralgian, vasculitis, thrombophlebtos
corticosteroids, colchicine, dapsone, thalidomide

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25
lichen planus
``` chronic immunologically mediated middle aged female predilection bilateral reticular- whickham straie plaque- thick white plaques papular- white papules erosive: bollous lesions finger nails get weird and ruffled BX: hyperkeratosis, saw tooth rete ridges, destruction of basal layer, civatte bodies, lymphocytic infiltrate TX: triamcinolone acetonide suspension ```
26
mucous membrane pemphigoid
autoimmune to basement membrane hemidesosomes (BP230, BP180, Beta4, laminin) cause subepithelial blistering vesicles or bullae, erosions, niolsky sign, painful most serious complication is ocular lesions (symblepharone) (25% of cases) progressive to blindness require bipsy for dx (deep punch (2 mm) cut in half. one half goes in formalin the other in michels temporary fixatove for IF) histo: seperation between epi and CT IF positive for igG and C3 on basement membrane tx: topical steroids, doxycycline, systemic immune suspression (prednisone)
27
pemphigus vulgaris
``` rare- potentially fatal autoimmune jews M:F 50-60 yrs mucosal dominant (minimal skin lesions) mucocutaneous- extensive skin blisters and erosions nikolsky sign autoantibodies against desmosomes acantholysis (seperation of keratinocytes from one another) Tzanck cells IgG, IgM, and C3 on IF TX; steroids and immunosuppresive. clobetasol, triamcinolone, antifungals plasmapheresis: remove antibodies IV Immunoglobulin therapy ```
28
medications that produce pigmentations
antimalarials (chloroquinone, quinidine, quinacrine) chemotherapeutics (doxorubicin, busulfan, cycloposphamide, 5-FU) ketoconazole
29
smokers melanosis
localized gingival pigmentation
30
burtons line
heavy metal sulfide (interaction between heavy metal and bacterial hydrogen sulfide) battery manufacturing plants, plastics, printing, paint lead and silver
31
ephilis
freckle darkens with exposure to sun increased production of melanin w.o increase in melanocytes
32
solar lentigo
reactive tan brown spots on older white people no change in color with sun exposure inc in melanocytes, melanin, and elongation with clubbing of rete ridges
33
melanatic macule
brown macule on vermillion border or oral mucosa. little to no change over time increased production of melanin with no change in melanocytes
34
multiple melanotic macules
``` post inflammatory smokers chronic polychlorinated biphenyls exposure medications peuts jeger sundrome mccune-albright syndrom ```
35
oral melanoacanthoma
rapidly enlarging (several cm in weeks) spontaneously resolves exclusivly in AA, 20-30s, mostly females dendritic, melanin-laden cells throughout epithelial thickness
36
nevus
malformation that may invlolve various skin or mucosal elements besides melanocytes TX: complete excision with histopathologic evaluation
37
acquired melanocytic nevi
mole can undergo malignant transformation (low risk) stages 1) junctional- brown-black macule 2) compound- slightly raised less pigmentd 3) intradermal (intramucosal) raised and nodular- pink can be hairy of verrucous
38
congenital melanocytic nevus
small or large (greater than 20 cm) | large has risk for malignant transformation
39
blue nevus
melanocytes are deep in CT can reach 2 cm 2nd most common type of nevus in mouth nearly always on palate
40
melanoma ABCDE
``` asymmetry border irregularity color variation diameter evolving lesion ```
41
melanoma growth
radial- along surface | vertical- deep
42
melanoma tx
extensive radical surgical treatment | may need adjunctive treatment
43
parotid gland
stensons duct, only serous acini
44
sublingual gland
whartons, purely mucous acini
45
submandibular
mixed serous and mucous acini
46
acute bacterial parotitis
malaise, anorexia, dehydration, fever, purulent exudate, pain excacerbated by eating and drinking
47
viral parotitis
mumps- paramyxovirus | IgG and IgM specific swab
48
salivary gland tumor distribution and malignancy
``` parotid- 65% acessory- 25% submandibular- 10% sublingual - 1% benign: 60% most common is pleomorphic adenoma ```
49
parotid malignancy
2/3 benign, 1/3 malignant
50
ssubmandibular malignancy
half and half
51
sublingual malignancy
mostly malignant
52
accessory salicary malignancy
palate: half and half upper lip: mostly benign lower lip: mostly malignant retromolar: mostly malignant
53
mucocele/ranula
most common in lower lip most common in 1-3 decade trauma causes rupture of duct tx: remove it with feeding gland
54
cyst of blandin nuhn
mucocele on ventral tongue
55
salivary duct cyst
palate and FOM most common sites | true cyst- lined with glandular epithelium
56
shogrens
increased RF (rheumatoid factor), antinuclear anitbody (ANA), SS-a, SS-B common to also have rhumatoid arthritis and lupus mucosal dryness, rampant caries shirmir test: see how wet the eyes are rose bengal- ocular dye tx: use sialagogue, antifungal for candida, crowns, freuqnet check ups
57
mucoepidermoid carcinoma
most common malignant salivary gland neoplasm 2nd most common neoplasm (after pleomorphic adenoma) mucous and epidermoid cells most common in parotid, than minor glands. if in bone its central mucoepidermoid carcinoma grades based on: - ratio of mucous vs epidermoid cells (ore mucous less severe grade) - cystic vs solid (more cystic= more low grade) - degree of cytotopic atypia (more atypical higher grade)
58
polymorphic low grade adenocarcinoma
``` 3rd most common salivary malignancy usually minor gland issue rarely metastasize, recur 1/3 of time tx: excision associated with tingling sensation orange peel appearance ```
59
pleomorphic adenoma
benign mixed tumor (epthelial and mesenchymal tissue) bone cartilage and fat 10% of malignant transformation (typically after 20 years) risk factors of malignancy - length and reoccurance - histo of hyalinization areas -increased mitotic rate Not associated with malignancy (capsular violation, increased cellularity, areas of necrosis)
60
warthins tumor
parotid gland in adult men (smoking is big cause) second most common tumor in parotid after pleomorphic adenoma frequently a multicentric tumor within same gland
61
adenoid cystic carcinoma
high grade salivary gland cancer numbness neurotropism!!!!! high rate of recurrance and late metastasis (10 yrs) tx: wide surgical excision swiss cheese on histo, usually with a nerve
62
sialolith
localized process (no correlation to kidney stone) plug-bacetrial-and cellular debris 70-90% in submandibular due to tortuous duct get CBCT or occlusal milk or cut out

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