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Oral Pathology test 2 > Week 4 > Flashcards

Week 4 Flashcards

1
Q

Can Leukoplakia be definitively Diagnosed via a biopsy?

A

NO, the Pathologist will simply say that it is a high probability, but the diagnosis can only be made by the clinician.

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2
Q

What is the most important about CLINICAL characteristics while LOOKING at the lesion for leukoplakia?

A

The margins are EXTREMELY well defined.

-No feathering, very distinct change from normal to “white”

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3
Q

Two broad categories for Leukoplakia?

How do you decide between them?

A

Homogenous and NON-Homogenous

The clinical look of the lesion.

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4
Q

Frictional keratosis has what clinical appearance that would NOT make it Leukoplakia?

A

Feathered margins! Not well defined.

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5
Q

Clinical look of homogenous Leukoplakia? (3)

A
  1. Smooth
  2. Cracked Mud
  3. Slightly opaque
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6
Q

Clinical look of NON-homogenous Leukoplakia? (3)

A
  1. Rough
  2. Very Opaque
  3. Ragged margins
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7
Q

Differential for Leukoplakia? (5)

A
  1. Frictional Keratosis
  2. Lichen Planus
  3. SLE
  4. Candida
  5. Hairy Leukoplakia (HHV-4)
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8
Q

Most to least common location of Leukoplakia? (3/5)

  1. Most common
  2. (2)
  3. (2)
A
  1. Vestibule (most common)
  2. Palate, Lip
  3. Tongue, FOM
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9
Q

Most common sites positive for malignancy? (5)

A
  1. FOM
  2. Tongue
  3. lip
  4. Palate
  5. Vestibule
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10
Q

Is the severity of Leukoplakia (malignant transformation) worse for those with risk factors (smoking) or without?

A

It is more often that when a Leukoplakia presents, that if there is not a risk factor, it is MORE likely to be malignant!

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11
Q

Proliferative Verrucous Leukoplakia.
-Who?
-

A

60-70 Y.o. Women (women over 40)

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12
Q

Proliferative Verrucous Leukoplakia

-Clinical presentation?

A
  1. Multiple NON-homogenous white plaques

2. Recurring plaques

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13
Q

Proliferative Verrucous Leukoplakia

-Malignancy rates

A

80-100% Transformation to Cancer

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14
Q

Fraction of the Epithelium that is dysplastic to Term as Mild, moderate, severe, and In Situ?

A

Mild-33%
Mod-50%
Sev-66%
In Situ- 100%

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15
Q

Most white lesions have this descriptive characteristic (morphology)?

A

Most white lesions are PLAQUES

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16
Q

4 Reasons the lesions appear white

A
  1. Less vascularity
  2. Hyperplasia
  3. Thickened keratin
  4. Edema
17
Q

White lesion examples

that CAN be wiped off

A
  1. Pseudomembranous candidiasis
  2. Burns
  3. Sloughing traumatic lesions
  4. Na+ Lauryl Sulfate Rxn
18
Q

First two concerns when a white lesion is found?

A
  1. How long?

2. Can I scrape it off the surface?

19
Q

Leukoedema

-What is pathognomonic for Leukoedema

A

Disappears when stretched

20
Q

Leukoedema

  • Pain?
  • Race?
  • Bilateral?
A

Pain: Painless
Race: African Americans
Bilateral: Yes, bilateral lesions

21
Q

Leukoedema HISTOPATHOLOGY (2)

  • Nuclei/Cytoplasm
  • Layer of _________ Edema
A
  • Nuclei are Pyknotic (small, bold, purple)

- Spinous Layer has INTRAcellular swelling

22
Q

Leukoedema treatment?

23
Q

White Sponge Nevus

  • Pain
  • Age
  • Bilateral?
A

Pain-NONE
Age-PrePubertal
Bilateral-YES

24
Q

White Sponge Nevus

  • Other involved locations(4)
  • 1 Location specifically NOT involved
A
  1. Eso NOT involving the EYES
  2. Anus
  3. Vagina
  4. Vulva
25
Q

White Sponge Nevus

-Where do you find the oral lesions?

A

ANYWHERE!!!!

26
Q

White Sponge Nevus
Histopathology(2)
-Perinuclear
-The epithelium is ortho or Para?

A

Perinuclear eosinophilic condensation of Cytoplasm
***of the Prickle cells

Parakeratosis (should be ortho)

27
Q

White Sponge Nevus treatment?

28
Q

Hereditary Benign Intraepithelial Dyskeratosis

  • Age
  • Race?
  • HBID/Witkop’s disease
A
  • Age is BABY

- Race is Triracial, white, Native American and African American

29
Q

Hereditary Benign Intraepithelial Dyskeratosis

-Lesion locations (2)

A

Oral (anywhere)

Eyes

30
Q

Hereditary Benign Intraepithelial Dyskeratosis

-Location of oral lesions

31
Q

Hereditary Benign Intraepithelial Dyskeratosis

-Histopath(3)

A

Hyperplasia
Intracellular edema (with acanthosis)
Big ass Keratinocytes

32
Q

Hereditary Benign Intraepithelial Dyskeratosis treatment?

A

NONE

*Refer to Ophthalmologist

33
Q

Reactive lesions List them (6)

A
  1. Frictional Hyperkeratosis
  2. Tobacco Keratosis
  3. Nicotine Stomatitis
  4. Hairy Leukoplakia
  5. Hairy Tongue
  6. Sloughing from Na+ Lauryl Sulfate
34
Q

Frictional Hyperkeratosis

-Cause?

A

Traumatic, repetitive movements

35
Q

Frictional Hyperkeratosis

-Location

A

Found near occlusal table (buccal, Labial, and Lingual)

36
Q

Frictional Hyperkeratosis

-Histopath (2)

A

Hyperkeratosis (like a callus)

LOW inflammation

37
Q

Frictional Hyperkeratosis

-Treatment

A

Fix frictional problem

38
Q

$$$$$$$ latin term for Cheek biting (2)

A

Morsicatio buccarum/Lingulum/Labiorum

-Or frictional keratosis

Oral Pathology test 2 (2 decks)

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