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OSPE > Upper GI > Flashcards

Upper GI Flashcards

1
Q

What drugs is implicated in this condition?

A

Phenytoin

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2
Q

What condition does this patient have?

A

Diabetes

[Periodontitis]

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3
Q

Identify this condition and mutation associated with it.

A

Peutz-Jegher syndrome, SKT11 gene mutation

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4
Q

Identify this lesion

A

Oral Melanoma

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5
Q

What drug is implicated in this condition?

A

sulphonamides

[Stevens-Johnson syndrome]

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6
Q

Identify this lesion and list its 4 causes?

A

Target lesions seen in Erythema multiforme

Etiologies:

  1. HSV
  2. Drugs
  3. Carcinoma and Lymphoma
  4. Collagen Vascular disease
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7
Q

Describe the lesion seen in Erythema multiforme?

A

Self limited symmetrical lesion, seen especially on the hands. [+/- mucous membrane involved]

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8
Q

What condition does this patient have?

A

Addison disease

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9
Q

What abnormality might indicate pharyngeal cancer?

A

Asymmetric tonsils or lingula

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10
Q

Age group associated with this lesion

A

frquenct in first two decades

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11
Q

Diagnose and describe this lesion

A

Aphthous Ulcers

  • Superficial mucosal ulcer that have a hyperemic base covered by a thin exudate and rimmed by a narrow zone of erythem
  • Resolves spontaneously 7-10 days [can recurr]
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12
Q

Epidemiology of this condition

A
  • Unknown etiology, tends to be familial
  • affects 40% of population
  • frequent in first 2 decades of life

[Aphthous Ulcers]

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13
Q

What conditions are associated with this lesion?

A

Celiac

IBD

Behcet disease

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14
Q

What are the viral and bacterial causes of this condition?

A

Bacterial:

  • Streptococcus pharyngitis [Group A b-hemolytic streptococcus]

Viral:

  • Adenovirus
  • Rhinovirus
  • Influenza
  • Coronavirus
  • RSV
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15
Q

What is this lesion? Describe it.

A

Tonsilitis [Viral]

Swelling and redness

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16
Q

What is this lesion? Describe it

A

Bacterial tonsilitis

Exudate

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17
Q

How to diagnose this lesion?

A

Monospot test

[quick screening Gray-white exudative test detects heterophil membrane antibodies caused by the EBV]

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18
Q

List all you know about this condition

A
  1. Epstein-Barr virus (EBV)
  2. Children and young adults
  3. Classic triad: fever, pharyngitis, lymphadenopathy
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19
Q

What is a complication of this condition?

A

respiratory failure due to pseudomembrane formation or aspiration

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20
Q

What is the causative organism?

A

C diphtheria

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21
Q

How to prevent this condition?

A

Immunization

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22
Q

What is the cause of this condition and how is it spread?

A
  • Cause: Group A β-hemolytic streptococci
  • Spread: by inhalation
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23
Q

Describe the presentation of a patient with this condition

A
  1. Pharyngitis
  2. Fever
  3. Rash
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24
Q

What condition does this patient have?

A

Scleroderma

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25
Q

What condition does this patient have?

A

SLE

26
Q

What condition does this patient have?

A

Sjögren syndrome

27
Q

What condition does this patient have and what other signs might we see in the oral cavity?

A

IDA

Signs of IDA:

  • atrophy
  • mucosal pallor
  • atrophic glossitis
28
Q

What is the sign and what does this point to?

A
  • Magenta tongue
  • Pernicious anemia
29
Q

What condition does this point to ?

A
  • hematopoietic neoplasms or coagulopathies
    • signs:
      • Hemorrhage
      • Gingival bleeding
30
Q

Diagnose

A

Kaposi sacroma [associated with HIV]

Description of lesion:

  • Spindle cells
  • Slit-like vessels with blood
31
Q

Diagnose

A

Kaposi sacroma [red/purple nodule]

32
Q

Diagnose

A

HIV-related neoplasm: Lymphoma [aggressive b cell lymphomas]

33
Q

List all oral lesion associated with HIV?

A
  1. Aphthous ulcers
  2. Fungal, Viral and Bacterial infections
  3. Neoplasms:
    • Lymphoma
    • Kaposi sarcoma
34
Q

What is the lesion?

A

Hairy leukoplakia (Epstein-barr virus)

35
Q

Describe the lesion

A
  • superficial vesicles and bullae that rupture easily, leaving shallow erosions covered with dried serum and crust
  • Oral lesions persists for months before dermatological lesions appear
36
Q

Diagnose this lesion and explain the pathophysiology of this disease

A
  • pemphigus vulgaris
  • antibody in pemphigus vulgaris reacts with desmoglein 3, a component of desmosomes of lower epidermis
37
Q

What is this lesion and what conditions is it associated with?

A
  1. Pyostomatitis Vegetans
  2. Ulcerative colitis and Crohn’s disease
38
Q

Describe this lesion

A

[lichen planus]

Oral:

  • white net-like lesion in buccal mucosa
  • lesions resolves within 1-2 years leaving behind post-inflammatory hyperpigmentation

Dermatologic:

  • Papular purple lesions [violaceous color]
  • Lesions symmetrically distributed, on flexor surfaces of extremities, glans penis, & oral mucosa
39
Q

Diagnose

A

lichen planus

40
Q

What is the first indication that a patient has Crohn’s disease?

A

oral manifestation

[oral ulcers are deeper than aphthous ulcers and are typically persistent]

41
Q

Diagnose this lesion and describe it

A

ameloblastoma

  • cystic, slow growing
  • locally invasive [indolent course]
    • rarely malignant/metastatic
  • causes severe abnormalities of face and jaw
42
Q

Biopsy of a patient complaining of a slow growing cyst on his jaw. What is the diagnosis and describe its histology?

A

ameloblastoma

  1. Composed of nests, strands or cords of ameloblastic epithelium separated by small amounts fibroconnective tissue stroma
  2. cyst arises from odontogenic epithelium
43
Q

What factors are associated with this lesion?

A
  1. trauma
  2. allergies
  3. exposure to ultraviolet light
  4. extremes of temperature
  5. upper- respiratory tract infections
  6. pregnancy
  7. menstruation
  8. immunosuppression
44
Q

Primary infection, latency and secondary infection of this disease

A
  • Primary infection: 2-4 yrs [most asymptomatic] via saliva
    • manifests as acute herpetic gingivostomatitis in 10% to 20% with abrupt onset of vesicles and ulcerations
  • Latency in sensory nerve ganglion cells
  • Secondary infection:
    • groups of small vesicle on lips, nasal orifices, buccal mucosa, gingiva, and hard palate
45
Q

describe the following:

A
  • Molding
  • Multinucleated giant cells
  • Nuclear inclusions (Cowdry A)
  • Ground glass (Cowdry B)
46
Q

Describe the microscopic feature of this lesion

A
  • Ballooned cells with large eosinophilic intranuclear inclusions
  • Adjacent cells commonly fuse to form large multinucleated polykaryons
47
Q

Diagnose and describe this lesion

A
  • Thrush [CANDIDIASIS]
  • superficial, curdlike, gray to white inflammatory membrane composed of matted organisms enmeshed in a fibrinosuppurative exudate that can be readily scraped off to reveal an underlying erythematous base.
    • Superfical in mildly compromised
    • spreads in severely immunocompromised patients
48
Q

Diagnose

A

Candidiasis

[pseudohyphae with no septations, resembles ginger]

49
Q

Diagnose and describe this lesion

A

Fibromas

  • submucosal nodular fibrous tissue masses that are formed when chronic irritation results in reactive connective tissue hyperplasia
  • They occur most often on thebuccal mucosa along the bite line.
50
Q

Diagnose this oral lesion

A

Fibromas

51
Q

What is the treatment of this condition?

A
  • complete surgical excision and removal of source of irritation

[Fibromas]

52
Q

What is the treatment of this condition?

A
  • complete surgical excision and removal of source of irritation

[Pyogenic fibromas]

53
Q

What would happen if this condition is left untreated?

A
  1. may regress
  2. mature into dense fibrous mass
  3. develop into peripheral ossifying fibromas
54
Q

What gives this lesion its appearance?

A

richly vascular and typically ulcerated, which gives them a red to purple color

55
Q

Which of the following lesion has a greater risk for developing into squamous cell carcinoma?

A

the one of the right [Erythroplakia]

56
Q

Describe the gross appearance of this lesion

A

White plaque that cannot be scraped off and cannot be characterized as any other disease

[Leukoplakia]

57
Q

Describe the gross morphology of this lesion

A

Red velvety that is usually level with the surrounding mucosa or slightly depressed

58
Q

Epidemiology of this lesion

A
  1. 40-70 yrs.
  2. 2:1 male to female
  3. associated with tobacoo use
  4. much greater risk for malignant transformation than leukoplakia
59
Q

Epidemiology of this lesion

A
  • ~3% of the world’s population has leukoplakic lesions, of which 5% to 25% are dsyplastic and at risk of SCC
60
Q

Examination of a smoker shows the following. What is the pathophysiology of this condition?

A
  1. Exposure to carcinogens
    • Exposure to tobacco shows mutation in TP53 + RAS
  2. Infection with high risk variants of HPV
    • Tend to occur in the tonsillar crypts or the base of the tongue and harbor oncogenic “high-risk”
      subtypes [HPV-16]
    • Often overexpress p16
    • better prognosis than HPV -ve tumors
61
Q

What are the clinical forms of this condition?

A
  1. Pseudomembranous
  2. Erythematous
  3. Hyperplastic
62
Q

What is the gross appearance of this lesion?

A

[SCC]

Early lesion

  • raised, firm, pearly plaques or roughened, verrucous mucosal thickenings

Late lesion

  • ulcerated, protruding masses that have irregular and indurated or rolled borders

Both maybe superimposed on leukoplakia or erythroplakia

OSPE (12 decks)

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