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Resi > Test 2 > Flashcards

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
Q

lichen planus

A 
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
Q

mucous membrane pemphigoid

A

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
Q

pemphigus vulgaris

A 
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
Q

medications that produce pigmentations

A

antimalarials (chloroquinone, quinidine, quinacrine)
chemotherapeutics (doxorubicin, busulfan, cycloposphamide, 5-FU)
ketoconazole

29
Q

smokers melanosis

A

localized gingival pigmentation

30
Q

burtons line

A

heavy metal sulfide (interaction between heavy metal and bacterial hydrogen sulfide)
battery manufacturing plants, plastics, printing, paint
lead and silver

31
Q

ephilis

A

freckle
darkens with exposure to sun
increased production of melanin w.o increase in melanocytes

32
Q

solar lentigo

A

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
Q

melanatic macule

A

brown macule on vermillion border or oral mucosa.
little to no change over time
increased production of melanin with no change in melanocytes

34
Q

multiple melanotic macules

A 
post inflammatory
smokers
chronic polychlorinated biphenyls exposure
medications
peuts jeger sundrome
mccune-albright syndrom
35
Q

oral melanoacanthoma

A

rapidly enlarging (several cm in weeks) spontaneously resolves
exclusivly in AA, 20-30s, mostly females
dendritic, melanin-laden cells throughout epithelial thickness

36
Q

nevus

A

malformation that may invlolve various skin or mucosal elements besides melanocytes
TX: complete excision with histopathologic evaluation

37
Q

acquired melanocytic nevi

A

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
Q

congenital melanocytic nevus

A

small or large (greater than 20 cm)

large has risk for malignant transformation

39
Q

blue nevus

A

melanocytes are deep in CT
can reach 2 cm
2nd most common type of nevus in mouth
nearly always on palate

40
Q

melanoma ABCDE

A 
asymmetry
border irregularity
color variation
diameter
evolving lesion
41
Q

melanoma growth

A

radial- along surface

vertical- deep

42
Q

melanoma tx

A

extensive radical surgical treatment

may need adjunctive treatment

43
Q

parotid gland

A

stensons duct, only serous acini

44
Q

sublingual gland

A

whartons, purely mucous acini

45
Q

submandibular

A

mixed serous and mucous acini

46
Q

acute bacterial parotitis

A

malaise, anorexia, dehydration, fever, purulent exudate, pain excacerbated by eating and drinking

47
Q

viral parotitis

A

mumps- paramyxovirus

IgG and IgM specific swab

48
Q

salivary gland tumor distribution and malignancy

A 
parotid- 65%
acessory- 25%
submandibular- 10%
sublingual - 1%
benign: 60%
most common is pleomorphic adenoma
49
Q

parotid malignancy

A

2/3 benign, 1/3 malignant

50
Q

ssubmandibular malignancy

A

half and half

51
Q

sublingual malignancy

A

mostly malignant

52
Q

accessory salicary malignancy

A

palate: half and half
upper lip: mostly benign
lower lip: mostly malignant
retromolar: mostly malignant

53
Q

mucocele/ranula

A

most common in lower lip
most common in 1-3 decade
trauma causes rupture of duct
tx: remove it with feeding gland

54
Q

cyst of blandin nuhn

A

mucocele on ventral tongue

55
Q

salivary duct cyst

A

palate and FOM most common sites

true cyst- lined with glandular epithelium

56
Q

shogrens

A

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
Q

mucoepidermoid carcinoma

A

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
Q

polymorphic low grade adenocarcinoma

A 
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
Q

pleomorphic adenoma

A

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
Q

warthins tumor

A

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
Q

adenoid cystic carcinoma

A

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
Q

sialolith

A

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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