Term
|
Definition
|
|
Term
| giant cell lesions are classified by... |
|
Definition
|
|
Term
| types of giant cell lesions |
|
Definition
1) giant cell granuloma (central or peripheral)
2) central giant cell tumor
3) aneurysmal bone cyst
4) cherubism
5) brown tumor |
|
|
Term
| central giant cell granulomas are not actually.... |
|
Definition
|
|
Term
| are central giant cell granulomas considered neoplastic? |
|
Definition
| no, they are non-neoplastic |
|
|
Term
| are central giant cell granulomas considered neoplastic? |
|
Definition
| no, they are non-neoplastic |
|
|
Term
| 2 types of central giant cell granulomas |
|
Definition
1) non-aggressive *more common)
2) aggressive |
|
|
Term
| central giant cell granulomas usually occur before age... |
|
Definition
|
|
Term
| most central giant cell granulomas arise in the... |
|
Definition
|
|
Term
| central giant cell granulomas have a predilection for M or F? |
|
Definition
|
|
Term
| central giant cell granuloma is usually ___ (symptomatic or asymptomatic) but may cause ____ |
|
Definition
| central giant cell granulomas is usually asymptomatic but may cause *painless expansion |
|
|
Term
| central giant cell granulomas are unlikely to ____ or ____ |
|
Definition
| unlikely to perforate cortex or resorb roots |
|
|
Term
| aggressive type of central giant cell granuloma is associated with 3 clinical features |
|
Definition
1) pain
2) rapid growth
3) tendency to recur |
|
|
Term
| central giant cell granulomas are radiographically uni or multi-locular radilucency? |
|
Definition
| can be either uni or multi locular |
|
|
Term
| central giant cell granulomas are corticated or non-corticated? |
|
Definition
|
|
Term
| central giant cell granulomas can be mistaken for... |
|
Definition
1) ameloblastoma
2) KOT
3) other multi-locular radiolucencies |
|
|
Term
| central giant cell granulomas show what type of cell histopathologically? |
|
Definition
| multi-nucleated giant cells |
|
|
Term
| histophathologic features of central giant cell granulomas show what type of cells in the background? |
|
Definition
| background of ovoid-spindle shaped mesenchymal cells |
|
|
Term
| central giant cell granulomas show extravasated _____ with _____ |
|
Definition
| central giant cell granulomas show extravasated *erythrocytes with *hemosiderin deposition |
|
|
Term
| on histopath. central giant cell granulomas are identical to... |
|
Definition
| brown tumors of hyperparathyroidism |
|
|
Term
| histo: central giant cell granulomas are similar to what lesions? |
|
Definition
|
|
Term
| tx: recurrence rate of central giant cell granulomas |
|
Definition
|
|
Term
| tx: aggressive central giant cell granulomas can be treated with... |
|
Definition
1) corticosteroids
2) calcitonin
3) interferon-alpha-2a |
|
|
Term
| giant cell tumors are most often seen in ____ of ____ |
|
Definition
| giant cell tumors are most often seen in *epiphyses of *long bones |
|
|
Term
| giant cell tumors are (more/less) ____ aggressive than _____ |
|
Definition
| giant cell tumors are *more aggressive than giant cell granulomas |
|
|
Term
| giant cell tumors are _____ lesions with numerous ____ |
|
Definition
| giant cell tumors are *hypercellular lesions with numerous *multinucleated giant cells |
|
|
Term
| aneurysmal bone cyst is not _____ |
|
Definition
|
|
Term
| aneurysmal bone cyst is characterized by... |
|
Definition
| blood filled cavity NOT lined by epithelium |
|
|
Term
| clin: aneurysmal bone cyst has predilication for M/F? |
|
Definition
|
|
Term
| clin: most patients with aneurysmal bone cyst are younger than age... |
|
Definition
|
|
Term
| most aneurysmal bone cysts occur in the mandible/maxilla? |
|
Definition
|
|
Term
| rad: on x-ray aneurysmal bone cysts are...(uni/multi-locular, etc.) |
|
Definition
| expansile, uni or multilocular radiolucency |
|
|
Term
| clin: with aneurysmal bone cysts, ____ and ____ are common |
|
Definition
| teeth displacement and resorption |
|
|
Term
| grossly, aneurysmal bone cysts look like... |
|
Definition
|
|
Term
| histo: walls of aneurysmal bone cysts have... |
|
Definition
| mutli-nucleated giant cells |
|
|
Term
| histo: aneurysmal bone cysts have ___ production |
|
Definition
|
|
Term
| gen: cherubism has a ____ inheritance pattern |
|
Definition
|
|
Term
| gen: cherubism has high ____ and variable ____ |
|
Definition
| high penetrance and variable expressivity |
|
|
Term
| gen: the gene for cherubism is mapped to chromosome ___ |
|
Definition
|
|
Term
| clin: in cherubism, disease usually develops between ages... |
|
Definition
|
|
Term
| clin: cherubism presents with ____ swelling of _____ |
|
Definition
| cherubism presents with *painless bilateral swelling of *posterior mandible |
|
|
Term
| clin: in cherubism, lesions progress until ____ then ____ |
|
Definition
| lesions progress until *puberty, then *stabilize and regress |
|
|
Term
| radiographic features of cherubism |
|
Definition
bilateral, multi-locular radiolucencies *few diseases have multiple multifocal radiolucencies
(osteoclast origin so radiolucent) |
|
|
Term
| rad: where are cherubism lesions found in the jaw? what do they involve? |
|
Definition
| *posterior mandible involving *angle and ramus of mandible |
|
|
Term
| rad: in cherubism, ___ and ____ can be, but are rarely involved |
|
Definition
|
|
Term
| histo: in cherubism, there are ___ cells in ____ |
|
Definition
| there are mutlinucleated giant cells in vascular connective tissue |
|
|
Term
| histo: key feature that distinguishes cherubism from giant cell granuloma |
|
Definition
| eosinophilic deposits around periphery of blood vessels (eosinophilic cuffing) |
|
|
Term
| bone and cartilaginous tumors (variants of normal anatomy) |
|
Definition
1) tori and exostoses
2) osteoma
3) osteoblastoma
4) osteoid osteoma
5) chondroma |
|
|
Term
| gen: tori and exostoses are localized... |
|
Definition
|
|
Term
| gen: tori and exostoses are usually...(one side or bilateral, a/symmetrical) |
|
Definition
|
|
Term
| his: tori and exostoses show normal ____ |
|
Definition
|
|
Term
| tx: treatment for tori and exostoses is only needed for... |
|
Definition
| fabrication of prosthesis |
|
|
Term
| tx: treatment for tori and exostoses is only needed for... |
|
Definition
| fabrication of prosthesis |
|
|
Term
| exostoses are like tori but located... |
|
Definition
| on the facial aspect (not palate or midline) |
|
|
Term
| gen: osteomas are ____ tumors of ____ |
|
Definition
| osteomas are benign tumors of compact bone |
|
|
Term
| gen: osteomas are rarely diagnosed outside ____ |
|
Definition
|
|
Term
| gen: osteomas may arise on ___ of bone or ___ bone |
|
Definition
| osteomas may arise on the *surface of bone (periosteal osteoma) or *within bone (endosteal osteoma) |
|
|
Term
| gen: multiple osteomas are associated with ____ syndrome |
|
Definition
|
|
Term
| clin: osteomas are usually detected in what age population? |
|
Definition
|
|
Term
| clin: osteomas are usually ___ but can cause ____ |
|
Definition
| osteomas are usually *asymptomatic but can cause *painless swelling |
|
|
Term
| clin: osteomas are usually located on the... |
|
Definition
| body of mandible or condyle |
|
|
Term
| rad: radiographically, is an osteoma well circumscribed or not? |
|
Definition
|
|
Term
| his: osteomas are made up of ____ with ____ |
|
Definition
| *compact lamellar bone with *scant fibrofatty marrow |
|
|
Term
| his: osteomas are identical to ____ and ____ |
|
Definition
|
|
Term
| gen: inheritance pattern of Gardner syndrome |
|
Definition
|
|
Term
| gen: Gardner syndrome has ___% penetrance |
|
Definition
|
|
Term
| gen: chromosome Gardner syndrome has been mapped to |
|
Definition
|
|
Term
| gen: ____ organ systems may be involved in Gardner syndrome |
|
Definition
multiple organ systems
-GI, skin, soft tissues, retina, skeletal, and/or teeth |
|
|
Term
| gen: GI manifestations -- ____ start developing in the ___ decade of life |
|
Definition
| *colonic polyps start developing in the *2nd decade of life |
|
|
Term
| gen: colonic polyps in Gardner syndrome usually develop into... |
|
Definition
|
|
Term
| skeletal manifestations of Gardner syndrome usually present with ____ in the ___, ____, ____ |
|
Definition
| usually present with *multiple osteomas in the *skull, paranasal sinuses and mandible |
|
|
Term
| oral manifestations -- osteomas in the mouth in Gardner syndrome usually occur where? |
|
Definition
| inferior border of mandible, angle, ramus |
|
|
Term
| how many mandibular osteomas are there usually in Gardner syndrome? |
|
Definition
|
|
Term
| oral manifestations -- 2 teeth findings with Gardner syndrome |
|
Definition
1) supernumerary teeth
2) impacted teeth |
|
|
Term
| skin & soft tissue manifestations -- ___ cysts of the skin |
|
Definition
| epidermoid cysts of the skin |
|
|
Term
| skin & soft tissue manifestations -- ____ tumors present as locally aggressive ____ |
|
Definition
| *desmoid tumors present as locally aggressive *fibrous neoplasms |
|
|
Term
| skin and soft tissue manifestations-- increased prevalence of ___ carcinoma |
|
Definition
thyroid carcinoma
*100 fold increase in females |
|
|
Term
| skin and soft tissue manifestations -- pigmented lesions are found where in Gardner syndrom? |
|
Definition
|
|
Term
| tx: specific prophylactic treatment for Gardner syndrome |
|
Definition
|
|
Term
| gen: is osteoblastoma malignant or benign? |
|
Definition
|
|
Term
| clin: osteoblastoma is found where in the jaw? |
|
Definition
|
|
Term
| clin: osteoblastoma usually occurs before what age? |
|
Definition
|
|
Term
| clin: osteoblastoma is associated with ___ not relieved by ___ |
|
Definition
associated with *pain not relieved by *aspirin
*distinguishes from osteoid osteoma |
|
|
Term
| rad: osteoblastoma appearance as a radiolucent lesion with ___ areas of ____ |
|
Definition
| appears as a radiolucent lesion with *patchy areas of *mineralization |
|
|
Term
| his: osteoblastoma appears on histo as mineralized ___ rimmed with ____ |
|
Definition
| mineralized trabeculae rimmed with osteoblasts |
|
|
Term
| his: periphery of osteoblastoma lesion is arranged in ___ |
|
Definition
|
|
Term
| gen: osteoid osteoma is larger or smaller than osteoblastoma? |
|
Definition
|
|
Term
| gen: size of osteoid osteoma lesion? |
|
Definition
|
|
Term
| gen: what relieves pain in osteoid osteoma? |
|
Definition
|
|
Term
| gen: osteoid osteoma is most often found where? (3) |
|
Definition
1) femur
2) tibia
3) phalanges |
|
|
Term
| gen: is a central vascular malformation benign or malignant? |
|
Definition
|
|
Term
| clinical presentation of central vascular malformation |
|
Definition
|
|
Term
| radiographically a central vascular malformation appears as a radiolucency with _____ |
|
Definition
| radiating opacities (sun-burst appearance) |
|
|
Term
| on histo, central vascular malformations look like ____ without ____ proliferation |
|
Definition
| look like vessel of origin without endothelial cell proliferation |
|
|
Term
| desmosplastic fibromas usually occur before age... |
|
Definition
|
|
Term
| part of jaw desmoplastic fibromas are most common in... |
|
Definition
|
|
Term
| most common presenting symptom of desmoplastic fibromas... |
|
Definition
|
|
Term
| desmoplastic fibroma may perforate ___ and involve ___ |
|
Definition
| may perforate *cortex and involve *soft tissues |
|
|
Term
| can desmoplastic fibroma resorb roots of teeth? |
|
Definition
|
|
Term
| his: desmoplastic fibroma has elongated ____ forming bands of ____ |
|
Definition
| elongated *fibroblasts forming bands of *collagen |
|
|
Term
| tx: desmoplastic fibroma is a (benign/malignant) _____ tumor with ____ aggressive behavior |
|
Definition
| tx: desmoplastic fibroma is a *benign tumor with *locally aggressive behavior |
|
|
Term
| tx: desmoplastic fibroma may destroy ____ |
|
Definition
|
|
Term
| gen: langerhans cell histocytosis is also known as... |
|
Definition
|
|
Term
| gen: Langerhans cell histiocytosis is seen with what types of cells? |
|
Definition
1) eosinophils
2) lymphocytes
3) plasma cells
4) giant cells |
|
|
Term
| clin: 3 diseases along clinical spectrum of Langerhans cell histiocytosis |
|
Definition
1) eosinophilic granuloma of bone
2) chronic disseminated histiocytosis
3) acute disseminated histiocytosis |
|
|
Term
| clin: eosinophilic granuloma of bone is characterized by ___ or ____ bone lesions without ____ |
|
Definition
| characterized by *monostotic or *polyostotic bone lesions without *visceral involvement |
|
|
Term
| clin: chronic disseminated histiocytosis has involvement of... |
|
Definition
|
|
Term
| clin: acute disseminated histiocytosis has involvement of... |
|
Definition
1) cutaneous
2) marrow
3) viscera |
|
|
Term
| acute disseminated histiocytosis usually affects... |
|
Definition
|
|
Term
| half of patients with Langerhans cell histiocytosis are under age... |
|
Definition
|
|
Term
| adults with langerhans cell histiocytosis usually don't have... |
|
Definition
|
|
Term
| rad: on xray, langerhans cell histiocytosis looks like ____ radiolucencies without ____ rims |
|
Definition
| looks like *punched out radiolucencies without *corticated rims |
|
|
Term
| in Langerhans cell histiocytosis, teeth look like they're... |
|
Definition
|
|
Term
| his: in langerhan cell histiocytosis histo shows large, pale-staining... |
|
Definition
|
|
Term
| his: a key feature of Langerhan cells on histo... |
|
Definition
Birbeck granules (rod-shaped cytoplasmic structures)
--> differentiate Langerhan cells from other mononuclear phagocytes |
|
|
Term
| his: 3 cells seen on histo in Langerhan cell histiocytosis |
|
Definition
1) mononuclear cells
2) Langerhan cells
3) eosinophils |
|
|
Term
| Langerhan cells are _____ cells |
|
Definition
| dendritic mononuclear cells |
|
|
Term
| Langerhan cells are found in the... |
|
Definition
1) epidermis
2) mucosa
3) lymph nodes
4) bone marrow |
|
|
Term
| tx: 3 treatment option for Langerhan cell histiocytosis |
|
Definition
1) surgery
2) radiation
3) chemotherapy |
|
|
Term
| BENIGN SOFT TISSUE TUMORS (DEC. 8) |
|
Definition
|
|
Term
| nicotine stomatitis is associated with... |
|
Definition
| cigar and pipe smoking, reverse smoking |
|
|
Term
| is nicotine stomatitis pre-malignant? |
|
Definition
|
|
Term
| nicotine stomatitis is a response to... |
|
Definition
|
|
Term
| nicotine stomatitis is common in ___ (M/F) over the age ___ |
|
Definition
|
|
Term
| how does nicotine stomatitis look clinically? |
|
Definition
| red papules (inflamed salivary glands) on white keratotic background |
|
|
Term
| histo features of nicotine stomatitis (3) |
|
Definition
1) hyperkeratosis
2) acanthosis
3) squamous metaplasia of excretory ducts |
|
|
Term
| tx for nicotine stomatitis? |
|
Definition
|
|
Term
| inflammatory papillary hyperplasia is associated with... |
|
Definition
| ill-fitting dentures, poor dental hygiene, continuous denture wear |
|
|
Term
| inflammatory papillary hyperplasia is seen where in the mouth? |
|
Definition
| hard palate beneath the denture base |
|
|
Term
| initial lesion of inflammatory papilary hyperplasia begins where? |
|
Definition
| vault, then spreads laterally |
|
|
Term
| is inflammatory hyperplasia symptomatic? |
|
Definition
|
|
Term
| how does inflammatory papillary hyperplasia look? |
|
Definition
|
|
Term
| inflammatory papillary hyperplasia may show _____, which can look like _____ |
|
Definition
| pseudoepitheliomatous hyperplasia, which can look like squamous cell carcinoma |
|
|
Term
| histo of inflammatory papillary hyperplasia can show (2) |
|
Definition
1) pseudoepitheliomatous hyperplasia (papillary growths covered by hyperplastic, stratified squamous epithelium)
2) sialadenitis (salivary glands present) |
|
|
Term
| tx for inflammatory papillary hyperplasia |
|
Definition
|
|
Term
| other names for epulis fissuratum |
|
Definition
-inflammatory fibrous hyperplasia
-denture injury tumor
-denture epulis |
|
|
Term
| epulis fissuratum is caused by... |
|
Definition
|
|
Term
| clinically epulis fissuratum looks like... |
|
Definition
| single or multiple folds of hyperplastic tissue in alveolar vestibule |
|
|
Term
| epulis fissuratum is most commonly seen in... (M/F) |
|
Definition
|
|
Term
| epulis fissuratum is commonly seen where in the mouth? |
|
Definition
| anterior mandible or maxilla |
|
|
Term
| on histo, epulis fissuratum shows... |
|
Definition
-hyperkeratosis
-papillary hyperplasia
-pseudoepitheliomatous hyperplasia
-sialadenitis |
|
|
Term
|
Definition
| surgical removal of extra gingiva |
|
|
Term
| a fibroma is the most common.... |
|
Definition
| "tumor" of the oral cavity |
|
|
Term
|
Definition
| reactive hyperplasia of fibrous connective tissue in response to irritation or trauma |
|
|
Term
| most common location for a fibroma |
|
Definition
|
|
Term
| are fibromas seen more commonly in M or F? |
|
Definition
|
|
Term
| common age range for fibroma |
|
Definition
|
|
Term
| are fibromas usually symptomatic or asymptomatic? |
|
Definition
|
|
Term
| on histo, a fibroma is a nodular mass of densely collagenized ______ covered by ______ |
|
Definition
| fibrous connective tissue covered by stratified squamous epithelium |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| giant cell fibroma is usually not associated with... |
|
Definition
|
|
Term
| giant cell fibroma occurs in patients ____ (younger/older) than those with fibroma? |
|
Definition
|
|
Term
| giant cell fibromas occur more in M/F? |
|
Definition
|
|
Term
| 50% of giant cell fibromas occur where in the mouth? |
|
Definition
|
|
Term
| ____ is a variant of giant cell fibroma that occurs ____ (location) |
|
Definition
| retrocuspid papilla is a variant that occurs lingual to mandibular canines |
|
|
Term
| are retrocuspid papillas uni or bilateral? |
|
Definition
|
|
Term
| retrocuspic papillas are a _____ that disappear with ____ |
|
Definition
| normal variant that disappear with age |
|
|
Term
| on histo, giant cell fibromas look like a mass of ____ |
|
Definition
| vascular fibrous connective tissue |
|
|
Term
| the hallmark on histo of giant cell fibrosis is... |
|
Definition
| large stellate fibroblasts that may have several nuclei |
|
|
Term
| the rete ridges in giant cell fibrosis appear.... |
|
Definition
|
|
Term
| tx for giant cell fibroma |
|
Definition
|
|
Term
| is recurrence common in giant cell fibroma? |
|
Definition
|
|
Term
| pyogenic granuloma is poorly named because.... |
|
Definition
| it is not pyogenic and is not a granuloma |
|
|
Term
| specific population pyogenic granulomas are commonly found in... |
|
Definition
|
|
Term
| the surface color of a pyogenic granuloma is ___ and is often ____ |
|
Definition
| red-pink-purple and is often ulcerated |
|
|
Term
| are pyogenic granulomas symptomatic? |
|
Definition
|
|
Term
| pyogenic granulomas may ____ easily |
|
Definition
|
|
Term
| pyogenic granulomas are commonly found where in the mouth? on what surface? |
|
Definition
| facial part of gingiva on anterior maxilla |
|
|
Term
| lesion that resembles pyogenic granulomas... |
|
Definition
|
|
Term
| where are epulis granulomatosa found? |
|
Definition
| healing extraction socket |
|
|
Term
| why do epulis granulomatosa form? |
|
Definition
| reaction to bony sequestra in socket |
|
|
Term
| on histo, pyogenic granulomas look like a ____ proliferation of _____ tissue |
|
Definition
| vascular proliferation of granulation tissue |
|
|
Term
| endothelium lined channels in pyogenic granuloma have a lot of____ |
|
Definition
|
|
Term
| tx for pyogenic granuloma |
|
Definition
| conservative excision + remove irritants (if present) |
|
|
Term
| peripheral giant cell granuloma is caused by... |
|
Definition
| reaction to irritation or trauma |
|
|
Term
| peripheral giant cell granuloma is the soft tissue counterpart of... |
|
Definition
| central giant cell granuloma |
|
|
Term
| peripheral giant cell granuloma occurs on the ____ only |
|
Definition
|
|
Term
| size of peripheral giant cell granuloma |
|
Definition
|
|
Term
| peripheral giant cell granulomas are seen commonly in what age range? |
|
Definition
|
|
Term
| even though peripheral giant cell granuloma develops in the soft tissue it an cause ____ of bone |
|
Definition
|
|
Term
| if you can't tell if lesion originated in the bone (central giant cell granuloma) or soft tissue (peripheral giant cell granuloma) the patient must be worked up for... |
|
Definition
| hyperparathyroidism (associated with central giant cell granuloma) |
|
|
Term
| on histo in peripheral giant cell granuloma you see ___ cells on a background of ____ |
|
Definition
| multinucleated giant cells on a background of ovoid/spindle shaped mesenchymal cells |
|
|
Term
| overlying mucosa of peripheral giant cell granuloma can be... |
|
Definition
| ulcerated (50% of the time) |
|
|
Term
| tx for peripheral giant cell granuloma |
|
Definition
|
|
Term
| do peripheral giant cell granulomas recur? |
|
Definition
|
|
Term
| peripheral ossifying fibroma occurs only on... |
|
Definition
|
|
Term
| peripheral ossifying fibroma frequently appears... |
|
Definition
|
|
Term
| size of peripheral ossifying fibroma |
|
Definition
|
|
Term
| peripheral ossifying fibroma is seen in what ages? |
|
Definition
|
|
Term
| are peripheral ossifying fibromas seen more in M/F? |
|
Definition
|
|
Term
| where are peripheral ossifying fibromas found in the mouth? |
|
Definition
|
|
Term
| on histo, the peripheral ossifying fibroma is a ____ proliferation with _____ |
|
Definition
| fibrous proliferation with mineralized product |
|
|
Term
| tx for peripheral ossifying fibroma |
|
Definition
|
|
Term
| do peripheral ossifying fibromas recur? |
|
Definition
|
|
Term
| traumatic ulcerative granuloma is more prevalent in M/F? |
|
Definition
|
|
Term
| where are traumatic ulcerative granulomas most commonly found in the mouth? |
|
Definition
|
|
Term
| on histo of traumatic ulcerative granuloma you see ____ tissue with many ____ |
|
Definition
| granulation tissue with many eosinophils |
|
|
Term
| tx for traumatic ulcerative granuloma |
|
Definition
|
|
Term
| time it takes for traumatic ulcerative granuloma lesion to heal |
|
Definition
|
|
Term
| verruciform xanthoma is ____ epithelium seen on the ___, ____, _____ |
|
Definition
| hyperplastic epithelium seein on the mouth, skin and genitalia |
|
|
Term
| verruciform xanthoma has a characteristic accumulation of... |
|
Definition
| lipid-laden histiocytes (macrophages) beneath the epithelium |
|
|
Term
| is verruciform xanthoma associated with HPV? |
|
Definition
|
|
Term
| population and age group verruciform xanthoma is seen in... |
|
Definition
|
|
Term
| half of verruciform xanthoma oral lesions occur where in the mouth? |
|
Definition
| gingiva or alveolar mucosa |
|
|
Term
| the surface of a verruciform xanthoma is covered by... |
|
Definition
| a thick layer of parakeratin |
|
|
Term
|
Definition
1) squamous papilloma
2) condyloma acuminatum |
|
|
Term
| squamous papilloma is malignant or benign? |
|
Definition
|
|
Term
| squamous papilloma is a proliferation of what type of tissue? |
|
Definition
| stratified squamous epithelium |
|
|
Term
| oral squamous papilloma is induced by what virus? what types? |
|
Definition
|
|
Term
| where does squamous papilloma usually present in the mouth? |
|
Definition
| lips, tongue, soft palate |
|
|
Term
| squamous papilloma lesions look like a... |
|
Definition
|
|
Term
| condyloma acuminatum is a proliferation of what type of tissue? where? |
|
Definition
| stratified squamous epithelium of genitals, perianal region, mouth, larynx |
|
|
Term
| condyloma acuminatum is associated with what virus? what types? |
|
Definition
| HPV types 2, 6, 11, 53, 54 |
|
|
Term
| what 2 types of HPV are associated with anogenital condyloma acuminatum lesions? |
|
Definition
|
|
Term
| condyloma acuminatum has a ___ and ___ connective tissue core |
|
Definition
|
|
Term
| name for cells infected with HPV |
|
Definition
| koilocytes (crinkled nucleus with clear zone around) |
|
|
Term
| anogenital lesions of condyloma acuminatum infected with what 2 types of HPV show increased risk of malignant transformation? |
|
Definition
|
|
Term
| NEOPLASTIC SOFT TISSUE LESIONS |
|
Definition
|
|
Term
| #1 most common mesenchymal neoplasm |
|
Definition
|
|
Term
| is a lipoma benign or malignant? |
|
Definition
|
|
Term
| most lipomas occur where? |
|
Definition
|
|
Term
| most patients with lipomas are older than... |
|
Definition
|
|
Term
| on histo, lipoma is composed of... |
|
Definition
|
|
Term
| on histo, lipoma fat cells are in a ____ arrangement |
|
Definition
|
|
Term
|
Definition
fibrolipoma
angiolipoma
myxoid lipoma
spindle-cell lipoma
pleomorphic lipoma |
|
|
Term
| a granular cell tumor is a proliferation of... |
|
Definition
|
|
Term
| granular cell tumors are most often found where in the mouth? |
|
Definition
|
|
Term
| are granular cell tumors most often in M/F? |
|
Definition
|
|
Term
| how do cells look on histo of granular cell tumor? |
|
Definition
| polygonal cells with abundant pale eosinophilic, granular cytoplasm and small nuclei |
|
|
Term
| there can be ____ in granular cell tumors that make it look like squamous cell carcinoma |
|
Definition
| pseudoepitheliomatous hyperplasia |
|
|
Term
| stain for neural cells in granular cell tumor |
|
Definition
|
|
Term
| congenital epulis occurs where? in what population? |
|
Definition
| alveolar ridges of newborns |
|
|
Term
| congenital epulis is seen more in M/F? |
|
Definition
|
|
Term
| where are congenital epulis usually found in the mouth? |
|
Definition
| maxilla, around lateral incisor or canine |
|
|
Term
| congenital epulis look like what other soft tissue tumor on histo? |
|
Definition
granular cell tumor
...but no neural differentiation and no pseudoepitheliomatous hyperplasia |
|
|
Term
| neurofibroma is the most common ____ tumor |
|
Definition
|
|
Term
| on histo of neurofibroma you see interlacing bundles of ____ with ____ nuclei |
|
Definition
| bundles of spindle-cells with wavy nuclei |
|
|
Term
| how many forms of neurofibromatosis are there? what's the most common type? |
|
Definition
|
|
Term
| another name for Type 1 neurofibromatosis |
|
Definition
| von Recklinghausen's disease |
|
|
Term
| Type 1 neurofibromatosis is inherited in a ____ pattern and has been mapped to chromosome ___ |
|
Definition
| autosomal dominant; mapped to chromosome 17 |
|
|
Term
| characteristic features of neurofibromatosis (4) |
|
Definition
1) multiple neurofibromas on the body
2) cafe au lait macules
3) Crowe sign: axillary freckles
4) lisch nodules: translucent brown-pigmented spots on the iris |
|
|
Term
| when does neurofibromatosis often develop? |
|
Definition
|
|
Term
| type of cancer that can develop from neurofibromatosis |
|
Definition
| malignant peripheral nerve sheath tumor |
|
|
Term
| schwannomas are most often found where in the mouth? |
|
Definition
|
|
Term
| on histo, schwannoma can have 2 patterns... |
|
Definition
1) Antoni A pattern
2: Antoni B pattern |
|
|
Term
| in Antoni A pattern of schwannoma, there are ____ shaped Schwann cells that form a _____ arrangement around ____ |
|
Definition
| spindle-shaped Schwann cells form a palisaded arrangement around Verocay bodies |
|
|
Term
| Antoni B pattern of schwannoma is less ____ and ____. There are ____ cells in lose _____ stroma |
|
Definition
| less cellular and organized; there are *spindle cells in lose *myxomatous stroma |
|
|
Term
|
Definition
1) palisaded encapsulated neuroma
2) traumatic neuroma |
|
|
Term
| most cases of palisaded encapsulated neuroma are where? |
|
Definition
|
|
Term
| what age group are palisaded encapsulated neuromas most common in? |
|
Definition
|
|
Term
| most common oral sites of palisaded encapsulated neuroma |
|
Definition
| hard palate and maxillary labial mucosa |
|
|
Term
| is palisaded encapsulated neuroma associated with neurofibromatosis or multiple endocrine neoplasia (MEN 2b)? |
|
Definition
|
|
Term
| traumatic neuroma is a proliferation of ____ after ____ to a ____ |
|
Definition
| proliferation of neural tissue after damage to a nerve bundle |
|
|
Term
| traumatic neuromas affect M/F? |
|
Definition
|
|
Term
| are traumatic neuromas painful? |
|
Definition
|
|
Term
| where are traumatic neuromas most commonly found in the mouth? |
|
Definition
| mental foramen area, tongue, lower lip |
|
|
Term
| on histo, traumatic neuromas show... |
|
Definition
| mature, myelinated nerve bundles with fibrous connective tissue stroma |
|
|
Term
| inheritance pattern of multiple endocrine neoplasia syndrome... |
|
Definition
|
|
Term
| MEN is a group of rare conditions characterized by... |
|
Definition
| multiple tumors and hyperplasia of endocrine organs |
|
|
Term
| MEN Type 1 is characterized by... |
|
Definition
1) tumors/hyperplasias of the parathyroid, pituitary gland, adrenal cortex, pancreas
2) peptic ulcerations
3) gastric hypersecretions |
|
|
Term
| another name for MEN Type 1 |
|
Definition
|
|
Term
| MEN Type 2a is characterized by... |
|
Definition
1) medullary carcinoma of the thyroid
2) multiple pheochromocytomas of the adrenal medulla
3) parathyroid hyperplasia or adenoma |
|
|
Term
| another name for MEN Type 2a |
|
Definition
|
|
Term
| MEN Type 2b/MEN Type 3 is a mutation in what protooncogene? |
|
Definition
|
|
Term
| MEN Type 2b/MEN Type 3 is characterized by... |
|
Definition
| same findings as Type 2a + multiple neuromas |
|
|
Term
| clinical features of MEN Type 2b |
|
Definition
1) marfan-like body build
2) neuromas in eyelid, conjunctiva or cornea
3) oral neuromas on: lips, anterior tongue, bilateral lesions at commisures |
|
|
Term
| type of carcinoma very common in MEN 2b... |
|
Definition
medullary carcinoma of the thyroid
*very aggressive |
|
|
Term
| lab values of patients with MEN 2b show elevated levels of... |
|
Definition
|
|
Term
| histo of MEN 2b shows hyperplasia of ____ and thickening of ____ |
|
Definition
| hyperplasia of nerve bundles and thickening of perineurium |
|
|
Term
|
Definition
|
|
Term
| hemangioma of infancy is more common in M/F? |
|
Definition
|
|
Term
| hemangioma of infancy is the most common tumor of what age group? |
|
Definition
|
|
Term
| types of vascular malformations |
|
Definition
1) capillary
2) venous
3) lymphatic
4) arteriovenous |
|
|
Term
| intrabony vascular malformations are most common in what part of the mouth? |
|
Definition
|
|
Term
| lymphatic malformation is more common in what part of the mouth? |
|
Definition
|
|
Term
| lymphatic malformations have a ____ surface |
|
Definition
pebbly
(look like tapioca pudding) |
|
|
Term
|
Definition
|
|
Term
| white lesions may appear white because of... |
|
Definition
1) membrane or plaque covering mucosa
2) thickened keratin layer (hyperkeratosis)
3) thickened spinous layer (hyperplasia)
4) accumulation of fluid within epithelium
5) alteration of epithelium |
|
|
Term
| white lesion that can be scraped off |
|
Definition
|
|
Term
| 3 lesions that can sometimes be mistaken for white lesions, but are not actually white lesions...(3) |
|
Definition
1) ulcers/burns
2) fordyce granules
3) tonsiloliths/sialoliths |
|
|
Term
| DEVELOPMENTAL WHITE LESIONS |
|
Definition
|
|
Term
| 2 types of developmental white lesions |
|
Definition
1) leukoedema
2) genodermatoses |
|
|
Term
|
Definition
1) white sponge nevus
2) hereditary benign intraepithelial dyskeratosis
3) pachyonychia congenita
4) dyskeratosis congenita |
|
|
Term
| inheritance pattern of white sponge nevus |
|
Definition
|
|
Term
| another name for white sponge nevus |
|
Definition
|
|
Term
| white sponge nevus has high ___ and variable ____ |
|
Definition
| high penetrance and variable expressivity |
|
|
Term
| white sponge nevus is a defect of ______ |
|
Definition
|
|
Term
| when do white sponge nevus lesions appear? |
|
Definition
| at birth or early childhood |
|
|
Term
| clinically, how do white sponge nevus lesions look? they are ____ plaques on _____ |
|
Definition
| thick, white plaques on bilateral buccal mucosa (or other mucosal surfaces) |
|
|
Term
| on histo, white sponge nevus has prominent ____ and _____ with peri-nuclear _____ |
|
Definition
| prominent hyperkeratosis and acanthosis with peri-nuclear eosinophilic condensation |
|
|
Term
| tx for white sponge nevus |
|
Definition
|
|
Term
| inheritance pattern of hereditary benign intraepithelial dyskeratosis (HBID) |
|
Definition
|
|
Term
|
Definition
| Witkop-Von Sallmann syndrome |
|
|
Term
| what population is HBID seen in? |
|
Definition
| tri-racial north carolina isolate (native american/african american/white) |
|
|
Term
| when do HBID lesions develop? |
|
Definition
|
|
Term
| where are HBID lesions seen? |
|
Definition
|
|
Term
| HBID presents clinically with thick white plaques on... |
|
Definition
|
|
Term
| what bad thing can HBID cause? |
|
Definition
|
|
Term
| key histo feature of HBID |
|
Definition
cell within a cell: epithelial cell appears to be surrounded or engulfed by an adjacent epithelial cell
-there's also parakeratin and acanthosis |
|
|
Term
|
Definition
| none, referral to opthalmologist |
|
|
Term
| inheritance pattern of pachyonychia congenita |
|
Definition
|
|
Term
| 2 types of pachyonychia congenita |
|
Definition
1) Jadassohn-Lewandowsky type
2) Jackson-Lawler type |
|
|
Term
| Jadassohn-Lewandowsky type has a mutation in keratin ___ (#) and (does/doesn't) have oral lesions |
|
Definition
| keratin 16 mutation and does have oral lesions |
|
|
Term
| Jackson-Lawler type has a mutation in keratin ___ (#) and (does/doesn't) have oral lesions |
|
Definition
| keratin 17 mutation and does not have oral lesions |
|
|
Term
| in pachyonychia congenita, ____ can be lifted up because of _____ |
|
Definition
| nails can be lifted up because of keratinaceous accumulation under nail bed |
|
|
Term
| in pachyonychia congenita, hyperkeratosis of ___ and ____ surfaces leads to ____ lesions |
|
Definition
| palmar and plantar surfaces leads to callous-like lesions |
|
|
Term
| the oral lesions in Jadassohn-Lewandowsky type are ___ (color) plaques that involve the ____ |
|
Definition
| white plaques that involve the lateral edges and dorsal surface of tongue |
|
|
Term
| white lesions in Jackson-Lawler type disease only occur in child/adult teeth? |
|
Definition
only in adult teeth
*no white lesions in neonatal teeth |
|
|
Term
| in Jackson-Lawler type disease ___ and dyspnea results from involvement of |
|
Definition
| hoarseness and dyspnea result from laryngeal involvement |
|
|
Term
| is tx needed for oral lesions of pachyonychia congenita? |
|
Definition
|
|
Term
| 2 other names for dyskeratosis congenita |
|
Definition
1) Cole-Engman syndrome
2) Zinsser-Cole-Engman Syndrome |
|
|
Term
| inheritance pattern of dyskeratosis congenita |
|
Definition
|
|
Term
| patients with dyskeratosis congenita are susceptible to...(2) |
|
Definition
| aplastic anemia and squamous cell carcinoma |
|
|
Term
clinical features of dyskeratosis congenita
1) ____ of face, neck and chest
2) dysplastic changes of ____
3) oral findings -- tongue and buccal mucosa develop ____ that progress to ____ and then ____
4) ____ disease |
|
Definition
1) hyperpigmentation of face, neck and chest
2) dysplastic changes of nails
3) tongue and buccal mucosa develop bullae then erosions and then leukoplakias
4) periodontal disease |
|
|
Term
| at what age are clinical features evident in dyskeratosis congenita? |
|
Definition
|
|
Term
| on the tongue and mucosa, you see ____ |
|
Definition
| hyperkeratosis (white lesions) |
|
|
Term
| the leukoplakias can become ____ in dyskeratosis congenita |
|
Definition
|
|
Term
| on histo in dyskeratosis congenita, you see _____, _____. ____ may be seen at later stages |
|
Definition
you see hyperorthokeratosis, epithelial atrophy
dysplasia may be seen at later stages |
|
|
Term
|
Definition
|
|
Term
| 4 types of infectious white lesions |
|
Definition
1) candidiasis
2) squamous papilloma/verruca vulgaris
3) mucous patch
4) oral hairy leukoplakia |
|
|
Term
| oral hairy leukoplakia is seen in what patient population? |
|
Definition
| immunocompromised patients |
|
|
Term
| clinical presentation (look & location) of oral hairy leukoplakia |
|
Definition
| vertical white striations on ventrolateral aspect of tongue |
|
|
Term
| oral hair leukoplakia is related to what type of infection? |
|
Definition
|
|
Term
| IMMUNE MEDIATED WHITE LESIONS |
|
Definition
1) lichen planus
2) Graft Versus Host Disease
3) Lupus |
|
|
Term
| lichen planus presents clinically with _____ on ____ mucosa |
|
Definition
| spiderweb striations on buccal mucosa |
|
|
Term
| graft versus host disease has a similar clinical presentation to... |
|
Definition
|
|
Term
|
Definition
1) nicotine stomatitis
2) frictional hyperkeratosis
3) smokeless tobacco keratosis |
|
|
Term
| 3 types of frictional hyperkeratosis |
|
Definition
1) linea alba
2) chronic biting injury
3) benign alveolar ridge keratosis |
|
|
Term
| frictional hyperkeratosis is a ____ induced ____ plaque |
|
Definition
| trauma induced white plaque |
|
|
Term
| how long can you wait to reevaluate a patient with suspected frictional hyperkeratosis |
|
Definition
|
|
Term
| you can only re-evaluate a patient for frictional hyperkeratosis if.... |
|
Definition
1) reactive etiology is deemed likely
2) irritant is eliminated |
|
|
Term
| smokeless tobacco keratosis can cause loss of ___ and ___ in area of tobacco contact |
|
Definition
| loss of gingiva and periodontal disease |
|
|
Term
| the mucosa in contact with the tobacco feels... |
|
Definition
|
|
Term
| on histo, smokeless tobacco keratosis has ___ and ___ epithelium |
|
Definition
| hyperkeratotic and acanthotic epithelium |
|
|
Term
| leukoplakia is a ______ that cannot be.... |
|
Definition
| white patch or plaque that can not be characterized clinically or pathologically as any other disease |
|
|
Term
| leukoplakia is a diagnosis of... |
|
Definition
|
|
Term
| what type of disease frequently (85%) present as leukoplakia |
|
Definition
|
|
Term
| patients with leukoplakias are usually older than... |
|
Definition
|
|
Term
| proliferative (verrucous) leukoplakia is a _____ leukoplakia |
|
Definition
| multifocal and recurrent leukoplakia |
|
|
Term
| proliferative verrucous leukoplakia transforms into ___ or ____ |
|
Definition
| verrucous carcinoma or squamous cell carcinoma |
|
|
Term
| is proliferative verrucous leukoplkia more common in M/F? |
|
Definition
|
|
Term
|
Definition
1) (leukoplakia)
2) epithelial dysplasia
3) squamous cell carcinoma |
|
|
Term
microscopic features of oral epithelial dysplasia...
1) ___ hyperplasia
2) increased number of _____
3) nuclear ____ and ____
4) cellular _____
5) ___ shaped rete ridges |
|
Definition
1) basal cell hyperplasia
2) increased number of mitotic figures
3) nuclear enlargement and hyperchromaticity
4) cellular pleomorphism
5) tear-drop shaped rete ridges |
|
|
Term
| criteria for mild, moderate, severe and carcinoma-in-situ oral epithelial dysplasia |
|
Definition
mild: lower 1/3 of epithelium
moderate: lower 2/3 of epithelium
severe: greater than 2/3 of epithelium
carcinoma-in-situ: full-thickness of epithelium |
|
|
Term
| common places to find leukoplakias that are dysplastic or are carcinoma |
|
Definition
| floor of mouth (#1), lower lip (#2), tongue (#3) |
|
|
Term
| NON-SQUAMOUS HEAD AND NECK CANCER (JAN. 5) |
|
Definition
|
|
Term
| most common oral cancer... |
|
Definition
|
|
Term
| incidence of squamous cell carcinoma increases with... |
|
Definition
|
|
Term
| squamous cell carcinoma is usually caused by ___ and ___ |
|
Definition
|
|
Term
| metastatic spread of squamous cell carcinoma is usually via... |
|
Definition
|
|
Term
| non-squamous head and neck cancers found in children (4) |
|
Definition
1) leukemia/lymphoma
2) neuroblastoma
3) Ewing's sarcoma
4) Rhabdomyosarcoma |
|
|
Term
| cancers found in children are all _____ (appearance) |
|
Definition
|
|
Term
| childhood leukemia with oral manifestations presents as... |
|
Definition
| gingival enlargement or bleeding |
|
|
Term
| neuroblastoma usually involves the jaws only by... |
|
Definition
|
|
Term
| Ewing's sarcoma is a ____ differentiated sarcoma of ____ |
|
Definition
| *poorly differentiated sarcoma of *bone |
|
|
Term
| rhabdomyosarcoma are childhood sarcomas of _____ |
|
Definition
|
|
Term
| non-squamous head and neck cancers found in adults (6) |
|
Definition
1) leukemia/lymphoma
2) salivary gland malignancies
3) metastatic cancers
4) nasopharyngeal carcinoma
5) osteosarcoma
6) melanoma |
|
|
Term
| leukemic ____ may occur in adults |
|
Definition
|
|
Term
| lymphoma presents as a ___ in the _____ or ___ in adults and is often ____, simulating an abscess |
|
Definition
| presents as a *mass in the *palate or *vestibule, and is often *fluctuant, simulating an abscess |
|
|
Term
| salivary gland malignancies are more common in what population? |
|
Definition
|
|
Term
| salivary gland malignancy presents as a ____ growing ____ unless ____ involvement causes ____ |
|
Definition
| *slow growing *swelling unless* nerve involvement causes *weakness |
|
|
Term
| metastases to the oral cavity are most commonly seen where in the mouth? where is 2nd most common location? |
|
Definition
| posterior jaw then soft tissue |
|
|
Term
| prognosis for metastases to the oral cavity is good/poor? |
|
Definition
|
|
Term
| sources for oral metastases... |
|
Definition
1) breast
2) lung
3) GI
4) thyroid
5) prostate
6) kidney |
|
|
Term
| nasopharyngeal carcinoma is more common in M/F? |
|
Definition
|
|
Term
| what population usually gets nasopharyngeal carcinoma? |
|
Definition
| geographic predilection -- Asia, Pacific Rim |
|
|
Term
| risk factors for nasopharyngeal carcinoma |
|
Definition
|
|
Term
| nasopharyngeal carcinoma presents as a ____ |
|
Definition
|
|
Term
| nasopharyngeal carcinoma frequently metastasizes where? |
|
Definition
|
|
Term
| what may be the earliest suspicious finding in nasopharyngeal carcinoma? |
|
Definition
| neck mass around cervical nodes |
|
|
Term
| prognosis for nasopharyngeal carcinoma |
|
Definition
|
|
Term
| 2 incidence peaks in oral osteosarcoma... |
|
Definition
|
|
Term
| the elderly patients with oral osteosarcoma have ____ disease |
|
Definition
|
|
Term
| most common site of oral osteosarcoma |
|
Definition
|
|
Term
| early signs of oral osteosarcoma... |
|
Definition
1) loss of lamina dura
2) asymmetric widening of PDL space |
|
|
Term
| _____ is seen later in oral osteosarcoma |
|
Definition
|
|
Term
| with ____ the prognosis for oral osteosarcoma is pretty good |
|
Definition
| early, aggressive surgery |
|
|
Term
| prognosis for elderly patients' with Paget's disease and oral osteosarcoma |
|
Definition
|
|
Term
| patients with oral mucosal melanoma are what age? |
|
Definition
|
|
Term
| most common sites of oral mucosal melanoma |
|
Definition
|
|
Term
| appearance of oral mucosal melanoma |
|
Definition
| brown/black macule with irregular borders |
|
|
Term
| SQUAMOUS CELL CARCINOMA (JAN. 9) |
|
Definition
|
|
Term
|
Definition
| growth that is capable of independent and non-controlled growth even after cessation of the stimulus that first initiated its growth |
|
|
Term
| neoplasms can be ____ or ____ |
|
Definition
|
|
Term
|
Definition
| malignant neoplasms of mesenchymal tissue |
|
|
Term
| population sarcomas most often occur in? |
|
Definition
|
|
Term
| sarcomas metastasize via ____ to ____ or ____ and are usually _____ (deep/superficial) |
|
Definition
| metastasize via *blood vessels to *lung or *other vascular organs and are usually *deep |
|
|
Term
|
Definition
| malignant neoplasms of epithelial origin |
|
|
Term
| carcinomas metastasize via ____ to ____ and are usually _____ (deep/superficial) |
|
Definition
| metastasize via *lymphatics to *lymph nodes and are usually *superficial |
|
|
Term
| squamous cell carcinoma is the ____ (#) most common malignancy in the US |
|
Definition
|
|
Term
| squamous cell carcinoma is the ____ (#) most common malignancy world wide |
|
Definition
|
|
Term
| risk factors for squamous cell carcinoma |
|
Definition
-cigarette smoking
-alcohol
-areca nut
-immunosuppression
-family history of cancer
-HPV |
|
|
Term
| pre-malignant squamous cell carcinoma lesions (3) |
|
Definition
1) leukoplakia
2) erythroplakia
3) submucous fibrosis |
|
|
Term
| definition of a leukoplakia |
|
Definition
| white plaque that does not rub off and does not conform clinically or histopathologically to any known oral white lesion |
|
|
Term
| leukoplakia is a diagnosis of.... |
|
Definition
|
|
Term
| leukoedema disappears when... |
|
Definition
| you stretch the mucosa because the fluid is pushed out |
|
|
Term
| leukoplakia lesions on the ____, ___ and ____ have a higher association with dysplasia or carcinoma than other sites |
|
Definition
| floor of the mouth, ventral tongue, soft palate |
|
|
Term
| localized leukoplakia can be ____ or ____ |
|
Definition
| homogenous or non-homogenous |
|
|
Term
| ____ leukoplakia has a strong association with dysplasia |
|
Definition
|
|
Term
| mild dysplasia occurs in how much of the epithelium? |
|
Definition
|
|
Term
| moderate dysplasia occurs in ___ of the epithelium |
|
Definition
|
|
Term
| leukoplakias can be ____ or ____ |
|
Definition
| dysplastic of non-dysplastic |
|
|
Term
| non-dysplastic leukoplakias on histo show... |
|
Definition
| hyperkeratosis, acanthosis, chronic inflammation |
|
|
Term
| proliferative leukoplakia is... |
|
Definition
| white plaque that persists and spreads |
|
|
Term
| proliferative leukoplakia is usually associated with... |
|
Definition
|
|
Term
| proliferative leukoplakia will almost always develop into... |
|
Definition
|
|
Term
| type of carcinoma proliferative leukoplakia usually becomes ___ and some becomes ____ |
|
Definition
| squamous cell carcinoma, some become verrucous carcinoma |
|
|
Term
| does verrucous carcinoma metastasize? |
|
Definition
|
|
Term
| erythroplakia is common or uncommon? |
|
Definition
| uncommon (unlike leukoplakia) |
|
|
Term
| erythroplakia usually looks... |
|
Definition
| red, velvety, usually painless plaque or macule |
|
|
Term
| >90% of erythroplakia lesions are ____ or ____ at the time of biopsy |
|
Definition
| carcinoma-in-situ or invasive carcinoma |
|
|
Term
| signs of squamous cell carcinoma |
|
Definition
1) leukoplakia
2) erythroplakia
3) proliferative leukoplakia
4) mass
5) nonhealing ulcer |
|
|
Term
| how often do proliferative leukoplakias progress to squamous cell carcinoma? |
|
Definition
|
|
Term
| are squamous cell carcinoma lesions encapsulated? |
|
Definition
| no (invades surrounding structures) |
|
|
Term
| verrucous carciinoma is associated with... |
|
Definition
|
|
Term
| clinically, verrucous carcinoma looks like a ___ mass on the ____, ____ or _____ |
|
Definition
| warty mass on the alveolar ridge, buccal mucosa or palate |
|
|
Term
| fastest type of squamous cell carcinoma in men under age 40 |
|
Definition
| HPV associated oropharyngeal squamous cell carcinoma |
|
|
Term
| what type of HPV is associated with HPV associated oropharyngeal squamous cell carcinoma |
|
Definition
|
|
Term
| HPV associated oropharyngeal squamous cell carcinoma is highly associated with... |
|
Definition
| number of sexual partners (regardless of sexual preference) |
|
|
Term
| does HPV associated oropharyngeal squamous cell carcinoma have a better/worse prognosis than conventional squamous cell carcinoma? |
|
Definition
|
|
Term
| pigmented lesions can be ____ or ____ |
|
Definition
|
|
Term
| types of exogenous (non-melanin associated) pigmentation |
|
Definition
1) amalgam tattoo
2) elective tattoo
3) other foreign body tattoos
4) heavy metal pigmentation |
|
|
Term
| ____ are the most common pigmented lesion in the oral cavity |
|
Definition
|
|
Term
| ways in which amalgam can be incorporated into the mouth |
|
Definition
1) abrasions with amalgam dust
2) amalgam pieces fal into extraction sites
3) endodontic retrograde fillings
4) amalgam particles drivin into mucosa from pressure of turbine drills |
|
|
Term
| examples of other exogenous foreign bodies (besides amalgam) that can cause foreign body tattoos |
|
Definition
1) graphite from a pencil
2) asphalt in a motor vehicle accident
3) heavy metal pigmentation |
|
|
Term
| examples of heavy metals that can cause pigmentation |
|
Definition
1) argyria: chronic exposure to silver compounds
-bluish-gray color of skin and mucosa
2) bismuth: reacts with hydrogen sulfide produced by oral bacteria (*pepto bismol!)
3) lead: blue-black line of lead sulfide |
|
|
Term
| oral symptoms of lead poisoning |
|
Definition
1) excessive salivation
2) metallic taste
3) tongue tremor & bruxism |
|
|
Term
| endogenous melanin associated pigmentation |
|
Definition
|
|
Term
|
Definition
|
|
Term
| types of developmental pigmentation |
|
Definition
1) racial pigmentation (physiologic)
2) ephelides (freckles)
3) lentigo simplex
4) melanocytic nevi
5) (melnotic macules) |
|
|
Term
| physiologic pigmentation occurs in what population? |
|
Definition
|
|
Term
| physiologic pigmentation is due to increased ____, not increased ____ |
|
Definition
melanotic activity NOT increased melanocyte number
*normal melanocyte number |
|
|
Term
| common site of physiologic pigmentation |
|
Definition
|
|
Term
| on histo, where is normal melanin pigmentation found? |
|
Definition
|
|
Term
| ephelides occur mostly in what population? |
|
Definition
| light-skinned individuals |
|
|
Term
| where do ephelides usually occur? |
|
Definition
|
|
Term
| lentigines (lentigo simplex) is due to intrinsic defect in... |
|
Definition
|
|
Term
| do lentigines have any change with sun exposure? |
|
Definition
|
|
Term
| do lentigines have malignant transformation? |
|
Definition
|
|
Term
| clinical description of oral melanotic macules |
|
Definition
| flat, brown, localized mucosal discoloration |
|
|
Term
| places in the mouth where oral melanotic macules are found |
|
Definition
| vermilion border, gingiva |
|
|
Term
| oral melanotic macules can be caused by... |
|
Definition
| reactivity or developmental |
|
|
Term
| are oral melanotic macules found more in M/F? |
|
Definition
|
|
Term
| definition of a nevus: ______ _______ malformation of the skin/mucosa which is not due to _____ causes |
|
Definition
| *circumscribed *stable malformation of the skin/mucosa which is not due to *external causes |
|
|
Term
| types of melanocytic nevi |
|
Definition
1) acquired melanocytic nevus
2) blue nevus
3) halo nevus
4) spitz nevus
5) congenital nevus |
|
|
Term
| acquired melanocytic nevus (nevomelanocytes) are due to mutations in... |
|
Definition
|
|
Term
| where are acquired melanocytic nevus usually found in the mouth? |
|
Definition
| hard palate, buccal mucosa, gingiva |
|
|
Term
| a junctional nevus is found where in the skin? |
|
Definition
| the nevomelanocytic nests are at the basal layer near the junction of the epithelium and connective tissue |
|
|
Term
| 3 terms used to describe locations in the skin layers of nevomelanocytes |
|
Definition
1) junctional nevus
2) compound nevus
3) intradermal nevus |
|
|
Term
| appearance of a junctional nevus |
|
Definition
|
|
Term
| a compound nevus is found where in the skin? |
|
Definition
| in connective tissue and epithelium |
|
|
Term
| how does a compound nevus look? |
|
Definition
| elevated papule, brown or tan |
|
|
Term
| an intradermal nevus is found where in the skin? |
|
Definition
|
|
Term
| how does an intradermal nevus look? |
|
Definition
| papillomatous or smooth surface, may have hair growth |
|
|
Term
| what type of nevomelanocyte gradually loses pigmentation? |
|
Definition
|
|
Term
|
Definition
1) common blue nevus
2) cellular blue nevus |
|
|
Term
| how does a common blue nevus look? |
|
Definition
|
|
Term
| are blue nevi found more in M/F? |
|
Definition
|
|
Term
| how do cellular blue nevi look? |
|
Definition
| macular or dome blue/black lesion |
|
|
Term
| are cellular blue nevi commonly found in the oral cavity? |
|
Definition
|
|
Term
| in a blue nevus, where are melanocytes located in the skin? |
|
Definition
|
|
Term
| appearance of a halo nevus |
|
Definition
| pigmented papule/macule surrounded by 2-3 mm of hypopigmented zone |
|
|
Term
| the hypopigmented in a halo nevus is caused by... |
|
Definition
| immune reaction against nevus cells |
|
|
Term
| spitz nevi are found in what population? |
|
Definition
|
|
Term
| are spitz nevi found more in M/F? |
|
Definition
|
|
Term
| does a spitz nevus grow rapidly? |
|
Definition
| yes! very quickly...should be biopsied |
|
|
Term
| histologically, a spitz nevus looks similar to.... |
|
Definition
|
|
Term
| prognosis of a spitz nevus |
|
Definition
| benign with god prognosis |
|
|
Term
| congenital melanocytic nevi are found in what % of newborns? |
|
Definition
|
|
Term
| 3 categories of congenital melanocytic nevi |
|
Definition
|
|
Term
| clinically, a congenital melanocytic nevus can look... |
|
Definition
| smooth, pebbly or verrucous |
|
|
Term
| congenital melanocytic nevi have a ___% malignant transformation except for ____ nevi which have a greater % transformation |
|
Definition
| 1% malignant transformation rate except for giant nevi which have a 6-12% rate |
|
|
Term
| tx for congenital melanocytic nevus? |
|
Definition
|
|
Term
| a dysplastic nevus can be caused by... |
|
Definition
| familial (inherited) or sporadic |
|
|
Term
| dysplastic nevi are a precursor for ___% of ____ cases |
|
Definition
|
|
Term
| clinical features of a dysplastic nevus |
|
Definition
1) irregular borders
2) color is not uniform
3) flat or raised |
|
|
Term
| where are dysplastic nevi commonly found? |
|
Definition
Men --> trunk
Women --> calves |
|
|
Term
| types of endogenous reactive pigmentation |
|
Definition
1) actinic lentigo
2) smoker's melanosis
3) oral melanoacanthosis
4) post inflammatory pigmentation
5) melasma |
|
|
Term
|
Definition
|
|
Term
| prevalence of actinic lentigo |
|
Definition
| greater than 90% of whites over 70 y/o |
|
|
Term
| clinically, how do actinic lentigos look? |
|
Definition
|
|
Term
| smoker's melanosis is caused by... |
|
Definition
| inflammation as a protective response |
|
|
Term
| is smoker's melanosis seen more in M/F? |
|
Definition
| females (hormones have a synergistic effect) |
|
|
Term
| oral melanoacanthosis is seen in what population? |
|
Definition
|
|
Term
| is oral melanoacanthosis seen more in M/F? |
|
Definition
|
|
Term
| how does oral melanoacanthosis look clinically? |
|
Definition
| flat or slightly raised brown to black macules |
|
|
Term
| oral melanoacanthosis grows ____ after _____ |
|
Definition
| grows *rapidly after *trauma |
|
|
Term
| tx for oral melanoacanthosis? |
|
Definition
| none -- spontaneously resolves |
|
|
Term
| in oral melanoacanthosis melanocytes are seen in the ____, not only the basal layer |
|
Definition
|
|
Term
|
Definition
| symmetrical hyperpigmentation of the sun-exposed facial skin |
|
|
Term
|
Definition
1) the pill
2) pregnancy
3) increased levels of estrogen and progesterone |
|
|
Term
|
Definition
| hydroquinone & tretinoin (bleaching creams) |
|
|
Term
| types of neoplastic endogenous melanin associated pigmentation |
|
Definition
1) cutaneous melanoma
2) oral melanoma |
|
|
Term
| cutaneous melanoma is seen in what population? |
|
Definition
| bond or red headed, blue-eyed individuals |
|
|
Term
| is oral melanoma seen more in M/F? |
|
Definition
|
|
Term
| where is oral melanoma most commonly seen in the mouth? |
|
Definition
| palate and maxillary gingiva |
|
|
Term
| prognosis of oral melanoma |
|
Definition
| poor, 15% 5 year survival |
|
|
Term
| is metastasis common in oral melanoma? |
|
Definition
|
|
Term
| what does the ABCDE of skin lesions stand for? |
|
Definition
| asymmetry, border irregularity, color variation, diameter, evolving |
|
|
Term
| prevalence of drug-induced pigmentation (%) |
|
Definition
| 10-20% of all acquired hyperpigmentation |
|
|
Term
| 4 mechanisms of drug-induced pigmentation |
|
Definition
1) melanin accumulation: increased production or decreased clearance by macrophages
2) triggering medication accumulation
3) synthesis of special pigments
4) deposition of iron |
|
|
Term
| 2 commonly used drug that can cause pigmentation |
|
Definition
1) hydroxychloroquine (anti-malarial)
2) minocycline |
|
|
Term
| systemic diseases that have pigmentation associated with them |
|
Definition
1) Peutz Jeghers syndrome
2) Addison disease
3) Albright syndrome
4) Neurofibromatosis |
|
|
Term
| Peutz Jeghers syndrome is characterized by... |
|
Definition
1) freckles around the mouth, nose, anus, genitals
2) intestinal polyps |
|
|
Term
| people with Peutz Jeghers syndrome have increased risk of malignant tumors where? |
|
Definition
| colon (main)...also pancreas, breast, genital tract |
|
|
Term
| addison disease is caused by... |
|
Definition
| chronic adreno-cortical insufficiency |
|
|
Term
| cause of endogenous non-melanin pigmentation |
|
Definition
|
|
Term
| causes of vascular pigmentation |
|
Definition
1) hemangioma
2) vascular malformation
3) varix & thrombus
4) hemorrhagic lesions (petechiae, purpura, ecchymoses) |
|
|
Term
| hemangiomas are the most common neoplasm in what population? |
|
Definition
|
|
Term
| are hemangiomas more common in M/F? |
|
Definition
|
|
Term
|
Definition
1) congenital (present at birth)
2) infantile (present soon after birth) |
|
|
Term
| when do vascular malformations present? |
|
Definition
|
|
Term
| vascular malformations expand _____ with _____ |
|
Definition
|
|
Term
| 3 types of vascular malformations |
|
Definition
1) ateriovenous
2) lymphatic
3) venous |
|
|
Term
| first paranasal sinus to develop... |
|
Definition
|
|
Term
| by the ____ month of life the maxillary sinuses can be seen radiographically as a triangle near the _____ |
|
Definition
| by the *5th month of life the sinuses can be seen near the *infraorbital foramen |
|
|
Term
| final growth of the maxillary sinus occurs after eruption of what teeth? |
|
Definition
|
|
Term
| largest paranasal sinus... |
|
Definition
|
|
Term
|
Definition
| bony opening that drains the maxillary sinus into the nose |
|
|
Term
| where is the ostium located in the nose? |
|
Definition
| above the middle turbinate |
|
|
Term
| apices of what teeth are closest to the sinus floor? then what other teeth in order of frequency? |
|
Definition
mesiobuccal root of the 2nd molar
then 1st, 3rd, 2nd premolar |
|
|
Term
| what is the schnaiderian membrane? |
|
Definition
| membrane of the maxillary sinus |
|
|
Term
| what type of epithelium is the schnaiderian membrane? |
|
Definition
| ciliated pseudostratified epithelium |
|
|
Term
| the schnaiderian membrane is what type of gland? |
|
Definition
|
|
Term
| the sphenoid sinus is very close to... |
|
Definition
|
|
Term
| where does the sphenoid sinus drain into? |
|
Definition
|
|
Term
| how many frontal sinuses are there? |
|
Definition
|
|
Term
| what drains the frontal sinus? |
|
Definition
|
|
Term
| where does the frontal sinus drain into? |
|
Definition
|
|
Term
| sinuses most often involved in sinusitis |
|
Definition
| anterior sinuses: maxillary and anterior ethmoid |
|
|
Term
|
Definition
| sphenoid and posterior ethmoid |
|
|
Term
| why are the maxillary and anterior ethmoid most often involved in sinusitis? |
|
Definition
| because they have drainage under the middle concha so they have drain upwards |
|
|
Term
| why are the sphenoid and posterior ethmoid sinuses less often involved in sinusitis? |
|
Definition
| they drain downward into the nose (instead of upward) |
|
|
Term
| are anaerobic infections more or less likely in small sinuses? why? |
|
Definition
| less likely because all part of the sinus are reached by blood and oxygen |
|
|
Term
| is it easier or harder to get antibiotics to the sinus via the blood supply in a small sinus? |
|
Definition
|
|
Term
| are anaerobic infections more or less likely in a large sinus cavity? why? |
|
Definition
| more likely because some areas of the sinus aren't reached by blood and oxygen |
|
|
Term
| is it easier or harder to get antibiotics to an area in a large sinus? |
|
Definition
|
|
Term
| acute allergic rhinitis is mediated by what cell? |
|
Definition
|
|
Term
| chronic allergic rhinitis is mediated by what type of cell? |
|
Definition
|
|
Term
| labs that should be done for allergic rhinitis |
|
Definition
IgE level
RAST screening antigen |
|
|
Term
| treatment for allergic rhinitis |
|
Definition
1) topical nasal steroid spray: decrease nasal swelling
2) antihistamine: interfere w/ mast cell release
3) saline spray: keep area moist |
|
|
Term
| viruses that can cause sinusitis |
|
Definition
1) adenovirus
2) influenza
3) rhinovirus |
|
|
Term
| how do viruses cause sinusitis? |
|
Definition
| interfere with ciliary function |
|
|
Term
| what can cause sinusitis? |
|
Definition
1) virus
2) edematous mucosa |
|
|
Term
| there can be _____ in addition to sinusitis |
|
Definition
|
|
Term
| things that can cause sinusitis (4 categories) |
|
Definition
1) bacterial
2) viral
3) fungal
4) parasites |
|
|
Term
| fungal sinusitis is found in what patient population? |
|
Definition
| immunocompromised patients |
|
|
Term
|
Definition
1) organism exposure: S. pneumoniae, H. influenze
2) anatomic predisposition to obstruction: septal deviation, large turbinate, nasal polyps
3) mucosal dysfunction: allergies, viral inflammation, thickened mucosa, cystic fibrosis
4) immunosuppression: HIV, steroids |
|
|
Term
|
Definition
1) purulent rhinorrhea
2) facial pain
3) fever |
|
|
Term
| exam findings of sinusitis |
|
Definition
1) inflamed middle meatus
2) mucopurulent secretions from the sinus
3) sinuses tender to palpation
4) transillumination of the sinus (opacification) |
|
|
Term
| way to get adequate sample of sinusitis for culture and gram stain |
|
Definition
| antral lavage (NOT nasal swab) |
|
|
Term
| predisposing factors that will cause sinusitis |
|
Definition
1) organisms can cause scarring and narrowing of the ostium or drainage pathway
2) dry mucus (caused by cold weather) has increased viscosity and decreased mucociliary transport |
|
|
Term
|
Definition
1) antibiotics
2) sinus lavage (*only for maxillary sinus)
3) humidification
4) decongestants
5) topical steroids
6) surgery |
|
|
Term
| what is an oroantral fistula? |
|
Definition
| connection between mouth and sinus |
|
|
Term
| chronic sinusitis can cause ____ loss of _____ epithelium and replacement by ____ epithelium |
|
Definition
| chronic sinusitis can cause *irreversible loss of *ciliated epithelium and replacement by *stratified squamous epithlium |
|
|
Term
| symptoms needed for diagnosis of chronic sinusitis |
|
Definition
| sinusitis which persists beyond 4 weeks |
|
|
Term
| treatment for chronic sinusitis |
|
Definition
| surgery to remove diseased tissue and facilitate drainage |
|
|
Term
| organisms that an cause fungal sinusitis |
|
Definition
| aspergilllus, candida, mucor, rhizopus |
|
|
Term
| treatment for fungal sinusitis |
|
Definition
1) treat underlying disease (usually immunocompromised patients)
2) surgical debridement
3) antifungal agents |
|
|
Term
| complications of aspergillus sinusitis |
|
Definition
1) meningitis
2) brain abscess
3) epidural and subdural abscess
4) orbital abscess |
|
|
Term
|
Definition
1) mucosal cyst
2) polyps
3) papilloma
4) fibro-osseous disorders (ex. fibrous dysplasia)
5) juvenile angiofibroma
6) encephalocele |
|
|
Term
| malignant pathology in the sinus |
|
Definition
primary cancers
1) squamous cell carcinoma
2) adenocarcinoma
3) melanoma
4) lymphoma
metastatic cancers: breast, lung, thyroid, kidney, prostate |
|
|
Term
| why do people get infections? |
|
Definition
1) host susceptibility
2) virulence of pathogens |
|
|
Term
|
Definition
1) bacterial
2) fungal
3) viral
4) mycobacterial
5) spirochetal
6) rickettsial
7) retroviral
8) prion |
|
|
Term
| 3 types of bacterial infections |
|
Definition
1) caries
2) periodontal disease
3) soft tissue infections |
|
|
Term
| caries needs what 3 things? |
|
Definition
1) bacteria
2) fermentable sugar (substrate)
3) tooth |
|
|
Term
| periodontal disease is infection of.... |
|
Definition
|
|
Term
| most common bacteria associated with caries |
|
Definition
|
|
Term
| palatal abscess is most commonly associated with what tooth? why? |
|
Definition
| lateral incisor because of very deep lingual pit (dens invaginatus) |
|
|
Term
| what is a parulis? where does it usually run? |
|
Definition
| tract inside of a palatal abscess that usually runs to an infected tooth (the source of infection) |
|
|
Term
| actinomycosis is an example of a ___ infection found in the ____ |
|
Definition
| bacterial infection found in the soft tissue |
|
|
Term
| how does actinomycosis appear clinically? |
|
Definition
| firm swelling with drainage usually in the area of an infected tooth |
|
|
Term
| when draining actinomycosis, you see ______ |
|
Definition
| sulfur granules (yellowish granules within pus) |
|
|
Term
| soft tissue bacterial infections are usually associated with what? |
|
Definition
poor neutrophil function, immunocompromise
--> redued numbers or poor functioning |
|
|
Term
| soft tissue bacterial infections clinically look like a ___ formation with ____, _____ and _____ |
|
Definition
| look like an abscess formation with pain, swelling and drainage |
|
|
Term
| most common superficial fungal infection |
|
Definition
|
|
Term
| examples of deep fungal infections |
|
Definition
1) histoplasmosis
2) zygomycosis
3) aspergillosis
4) cryptococcosis |
|
|
Term
| structure of candida and where it originates from |
|
Definition
| non-septate pseudo-hyphae from conidia |
|
|
Term
| most common type of candida |
|
Definition
|
|
Term
| candidiasis can either be ___ or _____ (timing) |
|
Definition
|
|
Term
| 2 types of acute candidiasis |
|
Definition
1) pseudomembranous (thrush): can be wiped off with some difficulty leaving a red, raw surface; sometimes they can't be wiped off
2) atrophic (angular cheilitis): corners of mouth are cracked |
|
|
Term
| _____ can look similar to pseudomembranous candidiasis on the tongue |
|
Definition
| hairy tongue can looks similar to candida, but it doesn't have plaques and papules on an erythematous base |
|
|
Term
| 2 types of chronic candidiasis |
|
Definition
1) atrophic (denture sore mouth): bright red, sore area outlining denture base
2) hyperplastic: chronic candidiasis associated with skin candida and endocrinopathy |
|
|
Term
| chronic hyperplastic candidiasis looks like what other oral lesion? |
|
Definition
|
|
Term
| what is median rhomboid glossitis? where is it located? |
|
Definition
| candidia infection in the middle of the tongue just anterior to the circumvallate papillae |
|
|
Term
| if median rhomboid glossitis is treated with _____ the lesions are ______ |
|
Definition
| treated with anti-fungals, the lesions are asymptomatic but still clinically present |
|
|
Term
| is culture a good way to determine if an infection is candida? |
|
Definition
| no, because 30% of the population has candida in their mouths |
|
|
Term
| treatment for candida (classes of drugs) |
|
Definition
1) polyenes: nystatin and amphotericin
2) imidazole
3) triazoles: fluconazole |
|
|
Term
| topical tx agents for angular cheilitis |
|
Definition
1) mycolog cream
2) vytone |
|
|
Term
| types of viral infections |
|
Definition
1) herpes family
2) human papilloma virus
3) coxsackie virus |
|
|
Term
| types of Herpes virus infections in humans |
|
Definition
1) herpes simplex type 1
2) herpes simplex type 2
3) varicella-zoster
4) epstein barr virus
5) cytomegalovirus
6) HHV6, 7
7) HHV8 (Kaposi's sarcoma) |
|
|
Term
| name for herpes simplex infection in mouth |
|
Definition
| primary herpetic gingivostomatitis |
|
|
Term
| ____% of primary herpetic gingivostomatitis lesions are subclinical |
|
Definition
|
|
Term
| clinical appearance of primary herpetic gingivostomatitis |
|
Definition
severe mouth sores involving all mucosa
-usually young patients with flu-like illness |
|
|
Term
| ____% of the adult population has antibodies to herpes simplex |
|
Definition
|
|
Term
| once infected with _____, there can be _____ |
|
Definition
| once infected with herpes simplex, there can be reactivation |
|
|
Term
| treatment for primary herpetic gingivostomatitis |
|
Definition
1) topical pain control
2) anti-viral: acyclovir, famciclovir |
|
|
Term
| HSV reactivation can be through _____ or ____ |
|
Definition
| asymptomatic shedding or HSV recrudescence |
|
|
Term
| ______ is the most important cause of spread of HSV |
|
Definition
|
|
Term
| what is HSV recrudescence? |
|
Definition
| clinically apparent HSV lesions |
|
|
Term
| what does HSV recrudescence look like in healthy patients? |
|
Definition
| -herpes labialis (cold sore) |
|
|
Term
| what does HSV recrudescence look like in immunocompromised patients? |
|
Definition
| lesions anywhere in mouth that look like aphthous ulcers (canker sores), ulcerated |
|
|
Term
| what is erythema multiforme? |
|
Definition
| hypersensitivity reaction usually to HSV reactivation that causes destruction of the epithelium and sloughing |
|
|
Term
| what is post-herpetic neuralgia? |
|
Definition
| shooting pain that can be caused by varicella zoster, may last for many years |
|
|
Term
| hairy leukoplakia is caused by _____ infection |
|
Definition
|
|
Term
| what population is hairy leukoplakia commonly seen in? |
|
Definition
| immunocompromised patients |
|
|
Term
| clinical appearance of hairy leukoplakia |
|
Definition
| white plaque on lateral tongue (usually in vertical striations) |
|
|
Term
| treatment for hairy leukoplakia |
|
Definition
| treat primary problem (immunocompromise) |
|
|
Term
| what population does CMV infection usually affect? |
|
Definition
| immunocompromised patients |
|
|
Term
| clinical presentation of CMV infection |
|
Definition
| single or multiple large painful ulcers present for weeks or months |
|
|
Term
| HHV8 is associated with ____ in patients with _____ |
|
Definition
| Kaposi sarcoma in patients with AIDS |
|
|
Term
| human papillomavirus causes many _____ growths |
|
Definition
|
|
Term
| _____ is associated with squamous cell carcinoma of oropharynx and tonsils |
|
Definition
|
|
Term
| if in HPV infection is white with distinct finger-like projections then it's called... |
|
Definition
|
|
Term
| if an HPV infection is soft with a more pink appearance then it's called... |
|
Definition
|
|
Term
| a large HPV infection is called a... |
|
Definition
|
|
Term
| histology of HPV infection shows ____ projections of _____ epithelium with prominent _____ |
|
Definition
| shows finger-like projections of squamous epithelium with prominent vessels |
|
|
Term
| coxsackie virus and enterovirus infection cause ______ in the _____ area |
|
Definition
| cause painful ulcers in the oropharynx area |
|
|
Term
|
Definition
none -- supportive only
(no anti-viral works) |
|
|
Term
| 3 types of mycobacterial infections |
|
Definition
1) tuberculosis
2) leprosy
3) mycobacterium avian intracellulare |
|
|
Term
| mycobacterium avian intracellulare infections what population? |
|
Definition
|
|
Term
| oral tuberculosis presents as a ___ or ____ |
|
Definition
|
|
Term
| in leprosy, ______ attacks _____ |
|
Definition
| mycobacterium leprae attacks nerve fibers |
|
|
Term
| on histo, tuberculosis shows.... |
|
Definition
| caseating granulomas that contain acid-fast bacilli |
|
|
Term
| true granulomas are collections of... |
|
Definition
|
|
Term
| in leprosy, histo shows... |
|
Definition
| non-caseating granulomas that contain acid-fast bacilli |
|
|
Term
| types of spirochetal infections |
|
Definition
1) borrelia vincentis
2) syphilis
3) lyme disease |
|
|
Term
|
Definition
| a granuloma of tertiary syphillis |
|
|
Term
| what is an indicator disease for HIV? |
|
Definition
| disease that allows you to diagnose person with full blown AIDS |
|
|
Term
| indicator diseases for HIV |
|
Definition
1) esophageal candidiasis
2) oral histoplasmosis
3) oral herpetic lesions
4) oral cytomegalovirus
5) kaposi sarcoma
6) lymphoma (immunoblastic or Burkitt) |
|
|
Term
| fungal diseases associated with HIV |
|
Definition
1) candidiasis
2) histoplasmosis
3) aspergillus
4) cryptococcus |
|
|
Term
| viral infections associated with HIV |
|
Definition
1) herpes simplex
2) varicella-zoster
3) EBV
4) CMV
5) human papillomavirus
6) poxvirus (molluscum contagiosum) |
|
|
Term
| types of periodontal disease associated with HIV |
|
Definition
1) linear gingival erythema
2) necrotizing ulcerative gingivitis
3) necrotizing ulcerative periodontitis |
|
|
Term
| neoplasms associated with HIV |
|
Definition
1) kaposi sarcoma
2) non-hodgkin lymphoma
3) squamous cell carcinoma |
|
|
Term
| miscellaneous lesions associated with HIV |
|
Definition
1) major aphthous ulcers
2) parotid lymphoepithelial cysts |
|
|
Term
| candidiasis affects ___% of AIDS patients |
|
Definition
|
|
Term
| candidiasis is seen in AIDS patients when the CD4 count is below what? |
|
Definition
|
|
Term
| what type of candidiasis is most common in AIDS patients? |
|
Definition
|
|
Term
| on histo, candida shows... |
|
Definition
| hyphae and/or conidia (fungal spores) |
|
|
Term
| atrophic candidiasis is an ____ form of candida |
|
Definition
|
|
Term
| where does atrophic candidiasis present most often? |
|
Definition
|
|
Term
| histoplasmosis presents with... |
|
Definition
| painful ulcers on palate, gingiva, tongue |
|
|
Term
| HSV infections are usually seen in HIV patients with CD4 count less than... |
|
Definition
|
|
Term
| HSV is an indicator of what for HIV patients? |
|
Definition
| progression to AIDS when it lasts more than 4 weeks |
|
|
Term
| in HSV, ____ rupture leaving ____ |
|
Definition
| vesicles rupture leaving ulcers |
|
|
Term
| on histo in HSV you see what features? |
|
Definition
1) acantholysis: loss of connections between keratinocytes
2) nuclear enlargement
3) nuclear clearing
4) chromatin clumping
5) molded nuclei into 1 keratinocyte |
|
|
Term
| clinical presentation of varicella-zoster |
|
Definition
| unilateral eruption of maculopapular linear vesicles and ulcers in the distribution of 1 branch of trigeminal nerve |
|
|
Term
| histo of varicella zoster is the same as... |
|
Definition
herpes simplex
1) acantholysis: loss of connections between keratinocytes
2) nuclear enlargement
3) nuclear clearing
4) chromatin clumping
5) molded nuclei into 1 keratinocyte |
|
|
Term
| EBV is associated with... |
|
Definition
| nasopharyngeal carcinoma & oral hairy leukoplakia in HIV patients |
|
|
Term
| oral hairy leukoplakia is seen in HIV patients when CD4 count is below what? |
|
Definition
|
|
Term
| is oral hairy leukoplakia premalignant? |
|
Definition
|
|
Term
| histo of oral hairy leukoplakia shows... |
|
Definition
1) thickened parakeratin
2) peripheral margination of chromatin (nuclear beading) |
|
|
Term
| what is the most common cause of blindness in HIV patients? |
|
Definition
|
|
Term
| what is the most common life-threatening viral infection in HIV patients? |
|
Definition
|
|
Term
| ____% of the population is infected with CMV, but only ___ get symptoms |
|
Definition
| 80% of ppl are infected with CMV, but only immunocompromised get symptoms |
|
|
Term
| clinically, how does CMV present? |
|
Definition
| painful, non-specific looking ulcer on palate and gingiva; can be big or small |
|
|
Term
| what does histo of CMV show? |
|
Definition
| vascular endothelial cells w/ intranuclear inclusion bodies ("owl eye" cells) |
|
|
Term
| types of human papillomavirus infections |
|
Definition
papilloma: cauliflower
verrucous: warty (cutaneous)
condyloma: pink, blunted projections |
|
|
Term
|
Definition
excision
*do not use laser b/c it can aerosolize and infect other ppl |
|
|
Term
| how does molluscum contagiosum present clinically? |
|
Definition
| single or multiple pruritic papules usually on bearded area of face (intra-oral is rare) |
|
|
Term
| how does linear gingival erythema present clinically? |
|
Definition
band of red margin along gingiva next to the teeth
-spontaneous bleeding |
|
|
Term
| treatment for linear gingival erythema |
|
Definition
1) hygiene
2) frequent dentist visits |
|
|
Term
| how does necrotizing ulcerative periodontitis present clinically? |
|
Definition
--> wraps around gingiva next to teeth
-painful
-spontaneous bleeding
-edema & erythema
-necrosis of interdental papillae
-rapid alveolar bone loss |
|
|
Term
| treatment for necrotizing ulcerative periodontitis |
|
Definition
| debridement and antibiotics |
|
|
Term
| what is the most common HIV associated neoplasm? |
|
Definition
|
|
Term
| how does Kaposi sarcoma look clinically? |
|
Definition
blue-red-purple macules on palate, gingiva or tongue
-ulceration or bleeding maybe |
|
|
Term
| histo of Kaposi sarcoma shows... |
|
Definition
1) proliferation of spindle (endothelial) cells
2) extravasated red blood cells
3) hemosiderin deposition |
|
|
Term
| second most common neoplasm in HIV patients? |
|
Definition
|
|
Term
| how does non-hodgkin lymphoma present clinically in HIV patients? |
|
Definition
| painful, rapidly enlarging ulcers |
|
|
Term
| on histo, non-hodgkin lymphoma usually shows |
|
Definition
| sheets of malignant B-cells |
|
|
Term
| clinically, major aphthous ulcers present with... |
|
Definition
| painful ulcers usually larger than 10 mm |
|
|
Term
| treatment for major aphthous ulcers |
|
Definition
topical steroids
***immune mediated ulcer! |
|
|
Term
| on histo, lyphoepithelial cyst shows... |
|
Definition
-cyst lined by stratified squamous epithelium
-dense infiltrate of lymphocytes in the wall of the cyst |
|
|
Term
| treatment for lymphoepithelial cyst |
|
Definition
|
|
