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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
What condition does this patient have?
SLE
26
What condition does this patient have?
Sjögren syndrome
27
What condition does this patient have and what other signs might we see in the oral cavity?
**IDA** Signs of IDA: * atrophy * mucosal pallor * atrophic glossitis
28
What is the sign and what does this point to?
* Magenta tongue * Pernicious anemia
29
What condition does this point to ?
* hematopoietic neoplasms or coagulopathies * signs: * Hemorrhage * Gingival bleeding
30
Diagnose
Kaposi sacroma [associated with HIV] Description of lesion: * Spindle cells * Slit-like vessels with blood
31
Diagnose
Kaposi sacroma [red/purple nodule]
32
Diagnose
HIV-related neoplasm: Lymphoma [aggressive b cell lymphomas]
33
List all oral lesion associated with HIV?
1. Aphthous ulcers 2. Fungal, Viral and Bacterial infections 3. Neoplasms: * Lymphoma * Kaposi sarcoma
34
What is the lesion?
Hairy leukoplakia (Epstein-barr virus)
35
Describe the lesion
* 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
Diagnose this lesion and explain the pathophysiology of this disease
* pemphigus vulgaris * antibody in pemphigus vulgaris reacts with desmoglein 3, a component of desmosomes of lower epidermis
37
What is this lesion and what conditions is it associated with?
1. Pyostomatitis Vegetans 2. Ulcerative colitis and Crohn's disease
38
Describe this lesion
[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
Diagnose
lichen planus
40
What is the first indication that a patient has Crohn's disease?
oral manifestation [oral ulcers are deeper than aphthous ulcers and are typically persistent]
41
Diagnose this lesion and describe it
***ameloblastoma*** * cystic, slow growing * locally invasive [indolent course] * rarely malignant/metastatic * causes severe abnormalities of face and jaw
42
Biopsy of a patient complaining of a slow growing cyst on his jaw. What is the diagnosis and describe its histology?
***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
What factors are associated with this lesion?
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
Primary infection, latency and secondary infection of this disease
* 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
describe the following:
* Molding * Multinucleated giant cells * Nuclear inclusions (Cowdry A) * Ground glass (Cowdry B)
46
Describe the microscopic feature of this lesion
* Ballooned cells with large eosinophilic intranuclear inclusions * Adjacent cells commonly fuse to form large multinucleated polykaryons
47
Diagnose and describe this lesion
* 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
Diagnose
Candidiasis [pseudohyphae with no septations, resembles ginger]
49
Diagnose and describe this lesion
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
Diagnose this oral lesion
Fibromas
51
What is the treatment of this condition?
* complete surgical excision and removal of source of irritation [Fibromas]
52
What is the treatment of this condition?
* complete surgical excision and removal of source of irritation [Pyogenic fibromas]
53
What would happen if this condition is left untreated?
1. may regress 2. mature into dense fibrous mass 3. develop into peripheral ossifying fibromas
54
What gives this lesion its appearance?
richly vascular and typically ulcerated, which gives them a red to purple color
55
Which of the following lesion has a greater risk for developing into squamous cell carcinoma?
the one of the right [Erythroplakia]
56
Describe the gross appearance of this lesion
White plaque that cannot be scraped off and cannot be characterized as any other disease [Leukoplakia]
57
Describe the gross morphology of this lesion
Red velvety that is usually level with the surrounding mucosa or slightly depressed
58
Epidemiology of this lesion
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
Epidemiology of this lesion
* ~3% of the world’s population has leukoplakic lesions, of which 5% to 25% are dsyplastic and at risk of SCC
60
Examination of a smoker shows the following. What is the pathophysiology of this condition?
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
What are the clinical forms of this condition?
1. Pseudomembranous 2. Erythematous 3. Hyperplastic
62
What is the gross appearance of this lesion?
[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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